Conjunctivitis history and symptoms: Difference between revisions

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*Exposure history (contaminated fingers, oculogenital spread, and contaminated fomites)
*Exposure history (contaminated fingers, oculogenital spread, and contaminated fomites)
*[[Contact lens]] use
*[[Contact lens]] use
*Chronic use of [[topical]] medications
*Chronic use of topical medications
===Neonatal Conjunctivitis===
===Neonatal Conjunctivitis===
Specific areas of focus when obtaining a history from the patient include:<ref name="pmid3084664">{{cite journal| author=Fransen L, Nsanze H, Klauss V, Van der Stuyft P, D'Costa L, Brunham RC et al.| title=Ophthalmia neonatorum in Nairobi, Kenya: the roles of Neisseria gonorrhoeae and Chlamydia trachomatis. | journal=J Infect Dis | year= 1986 | volume= 153 | issue= 5 | pages= 862-9 | pmid=3084664 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3084664  }} </ref>
Specific areas of focus when obtaining a history from the patient include:<ref name="pmid3084664">{{cite journal| author=Fransen L, Nsanze H, Klauss V, Van der Stuyft P, D'Costa L, Brunham RC et al.| title=Ophthalmia neonatorum in Nairobi, Kenya: the roles of Neisseria gonorrhoeae and Chlamydia trachomatis. | journal=J Infect Dis | year= 1986 | volume= 153 | issue= 5 | pages= 862-9 | pmid=3084664 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3084664  }} </ref>
*History of [[sexually transmitted disease|sexually transmitted disease (STD)]] in mother
*History of [[sexually transmitted disease|sexually transmitted disease (STD)]] in mother
*[[Ocular]] [[prophylaxis]] with silver nitrate
*Ocular prophylaxis with silver nitrate
===Allergic Conjunctivitis===
===Allergic Conjunctivitis===
Specific areas of focus when obtaining a history from the patient include:<ref name="pmid23497516">{{cite journal| author=La Rosa M, Lionetti E, Reibaldi M, Russo A, Longo A, Leonardi S et al.| title=Allergic conjunctivitis: a comprehensive review of the literature. | journal=Ital J Pediatr | year= 2013 | volume= 39 | issue=  | pages= 18 | pmid=23497516 | doi=10.1186/1824-7288-39-18 | pmc=3640929 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23497516  }} </ref><ref name="pmid18282546">{{cite journal| author=Jun J, Bielory L, Raizman MB| title=Vernal conjunctivitis. | journal=Immunol Allergy Clin North Am | year= 2008 | volume= 28 | issue= 1 | pages= 59-82, vi | pmid=18282546 | doi=10.1016/j.iac.2007.12.007 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18282546  }} </ref><ref name="pmid15245362">{{cite journal| author=Bonini S| title=Atopic keratoconjunctivitis. | journal=Allergy | year= 2004 | volume= 59 Suppl 78 | issue=  | pages= 71-3 | pmid=15245362 | doi=10.1111/j.1398-9995.2004.00570.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15245362  }} </ref>
Specific areas of focus when obtaining a history from the patient include:<ref name="pmid23497516">{{cite journal| author=La Rosa M, Lionetti E, Reibaldi M, Russo A, Longo A, Leonardi S et al.| title=Allergic conjunctivitis: a comprehensive review of the literature. | journal=Ital J Pediatr | year= 2013 | volume= 39 | issue=  | pages= 18 | pmid=23497516 | doi=10.1186/1824-7288-39-18 | pmc=3640929 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23497516  }} </ref><ref name="pmid18282546">{{cite journal| author=Jun J, Bielory L, Raizman MB| title=Vernal conjunctivitis. | journal=Immunol Allergy Clin North Am | year= 2008 | volume= 28 | issue= 1 | pages= 59-82, vi | pmid=18282546 | doi=10.1016/j.iac.2007.12.007 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18282546  }} </ref><ref name="pmid15245362">{{cite journal| author=Bonini S| title=Atopic keratoconjunctivitis. | journal=Allergy | year= 2004 | volume= 59 Suppl 78 | issue=  | pages= 71-3 | pmid=15245362 | doi=10.1111/j.1398-9995.2004.00570.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15245362  }} </ref>
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**[[Sjögren's syndrome]]
**[[Sjögren's syndrome]]
**[[Rheumatoid arthritis]]
**[[Rheumatoid arthritis]]
*History of [[thyroid]] [[abnormalities]]
*History of [[thyroid]] abnormalities
*[[Contact lens]] use
*[[Contact lens]] use
*History of neurologic conditions ([[stroke]], [[Bell's palsy]], [[Parkinson's]], [[trigeminal nerve]] problem)
*History of neurologic conditions ([[stroke]], [[Bell's palsy]], [[Parkinson's]], [[trigeminal nerve]] problem)
*Prior eye [[surgery]]
*Prior eye surgery
===Superior limbic keratoconjunctivitis===
===Superior limbic keratoconjunctivitis===
Specific areas of focus when obtaining a history from the patient include:<ref name="pmid11914237">{{cite journal| author=Watson S, Tullo AB, Carley F| title=Treatment of superior limbic keratoconjunctivitis with a unilateral bandage contact lens. | journal=Br J Ophthalmol | year= 2002 | volume= 86 | issue= 4 | pages= 485-6 | pmid=11914237 | doi= | pmc=1771108 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11914237  }} </ref>
Specific areas of focus when obtaining a history from the patient include:<ref name="pmid11914237">{{cite journal| author=Watson S, Tullo AB, Carley F| title=Treatment of superior limbic keratoconjunctivitis with a unilateral bandage contact lens. | journal=Br J Ophthalmol | year= 2002 | volume= 86 | issue= 4 | pages= 485-6 | pmid=11914237 | doi= | pmc=1771108 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11914237  }} </ref>
*Prolonged condition with gradual clearing
*Prolonged condition with gradual clearing
*Have seen numerous eye specialists
*Have seen numerous eye specialists
*History of [[thyroid]] [[abnormalities]]
*History of thyroid abnormalities


==Symptoms==
==Symptoms==
The [[symptoms]] of conjunctivitis differ based on the cause of the [[inflammation]]. [[Redness]], [[excessive tearing]], and [[irritation]] are symptoms common to all forms of conjunctivitis. [[Photophobia]], [[itching]], [[mucopurulent]] or non-purulent discharge, [[chemosis]], burning eyes, [[blurred vision]] and [[eyelid]] [[swelling]] are variable.
The [[symptoms]] of conjunctivitis differ based on the cause of the [[inflammation]]. [[Redness]], [[excessive tearing]], and [[irritation]] are symptoms common to all forms of conjunctivitis. [[Photophobia]], [[itching]], [[mucopurulent]] or non-purulent discharge, [[chemosis]], burning eyes, [[blurred vision]] and [[eyelid]] [[swelling]] are variable.
===Viral Conjunctivitis===
===Viral Conjunctivitis===
''[[Adenovirus]]'' is the most common cause of [[viral]] conjunctivitis. It has [[Acute]] or [[subacute]] [[onset]], and often occurs in community epidemics. Both eyes may be affected simultaneously, or the second eye may become involved a few days after the first eye.
[[Adenovirus]] is the most common cause of [[viral]] conjunctivitis. It has [[Acute]] or [[subacute]] onset, and often occurs in community epidemics. Both eyes may be affected simultaneously, or the second eye may become involved a few days after the first eye.
[[Symptoms]] of [[viral]] conjunctivitis may include the following:<ref name="pmid21733975">{{cite journal| author=Drug and Therapeutics Bulletin| title=Management of acute infective conjunctivitis. | journal=Drug Ther Bull | year= 2011 | volume= 49 | issue= 7 | pages= 78-81 | pmid=21733975 | doi=10.1136/dtb.2011.02.0043 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21733975  }} </ref>
Symptoms of viral conjunctivitis may include the following:<ref name="pmid21733975">{{cite journal| author=Drug and Therapeutics Bulletin| title=Management of acute infective conjunctivitis. | journal=Drug Ther Bull | year= 2011 | volume= 49 | issue= 7 | pages= 78-81 | pmid=21733975 | doi=10.1136/dtb.2011.02.0043 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21733975  }} </ref>
*[[Fever]]  
*[[Fever]]  
*[[Sore throat]]  
*[[Sore throat]]  
*Eye [[redness]]
*Eye redness
*Watery discharge
*Watery discharge
*[[Eyelids]] swelling
*Eyelids swelling
*[[Swollen lymph node]] ([[Ipsilateral]])
*[[Swollen lymph node]] ([[Ipsilateral]])
*[[Itchy]] eyes
*[[Itchy eyes]]
*Tearing
*Tearing
*Minimal [[eye pain]]
*Minimal [[eye pain]]
*[[Light sensitivity]] (with [[corneal]] involvement)
*[[Light sensitivity]] (with corneal involvement)
====Acute Hemorrhagic Conjunctivitis====
====Acute Hemorrhagic Conjunctivitis====
[[Acute]] [[hemorrhagic]] conjunctivitis (AHC) is a rapidly progressive and contagious [[viral]] infection. The infection starts [[ipsilaterally]], but rapidly involves the fellow eye within 1 or 2 days and resolves within 5-7 days, during which the [[symptoms]] of pain and [[irritation]] are present. [[Symptoms]] of acute hemorrhagic conjunctivitis may include the following:<ref name="pmid1088513">{{cite journal| author=Yin-Murphy M| title=Simple tests for the diagnosis of picornavirus epidemic conjunctivitis (acute haemorrhagic conjunctivitis). | journal=Bull World Health Organ | year= 1976 | volume= 54 | issue= 6 | pages= 675-9 | pmid=1088513 | doi= | pmc=2366581 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1088513  }} </ref>
Acute hemorrhagic conjunctivitis (AHC) is a rapidly progressive and contagious [[viral]] infection. The infection starts [[ipsilaterally]], but rapidly involves the fellow eye within 1 or 2 days and resolves within 5-7 days, during which the [[symptoms]] of pain and [[irritation]] are present. [[Symptoms]] of acute hemorrhagic conjunctivitis may include the following:<ref name="pmid1088513">{{cite journal| author=Yin-Murphy M| title=Simple tests for the diagnosis of picornavirus epidemic conjunctivitis (acute hemorrhagic conjunctivitis). | journal=Bull World Health Organ | year= 1976 | volume= 54 | issue= 6 | pages= 675-9 | pmid=1088513 | doi= | pmc=2366581 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1088513  }} </ref>
*[[Eyelids]] [[swelling]]
*Eyelids swelling
*Tearing
*Tearing
*Eye [[redness]]
*Eye redness
*Severe [[eye pain]]
*Severe [[eye pain]]
*[[Purulent]] discharge
*[[Purulent]] discharge
*Subconjunctival [[hemorrhage]]
*Subconjunctival [[hemorrhage]]
===Bacterial Conjunctivitis===
===Bacterial Conjunctivitis===
[[Bacteria]]l conjunctivitis has Hyperacute, [[acute]], and [[chronic]] onset. [[Symptoms]] of bacterial conjunctivitis may include the following:
Bacterial conjunctivitis has Hyperacute, [[acute]], and [[chronic]] onset. [[Symptoms]] of bacterial conjunctivitis may include the following:
<ref name="pmid15195156">{{cite journal| author=Høvding G| title=[Acute bacterial conjunctivitis]. | journal=Tidsskr Nor Laegeforen | year= 2004 | volume= 124 | issue= 11 | pages= 1518-20 | pmid=15195156 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15195156  }} </ref>
<ref name="pmid15195156">{{cite journal| author=Høvding G| title=[Acute bacterial conjunctivitis]. | journal=Tidsskr Nor Laegeforen | year= 2004 | volume= 124 | issue= 11 | pages= 1518-20 | pmid=15195156 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15195156  }} </ref>
*[[Itchy]] eyes
*Itchy eyes
*Tearing
*Tearing
*Eye [[redness]]
*Eye redness
*Minimal [[eye pain]]
*Minimal eye pain  
*[[Purulent]] discharge (grey or yellowish)
*[[Purulent]] discharge (grey or yellowish)
*[[Eyelids]] swelling
*[[Eyelids swelling]]
====Hyperacute Bacterial Conjunctivitis====
====Hyperacute Bacterial Conjunctivitis====
Hyperacute [[bacterial]] conjunctivitis (HBC) is a severe, sight-threatening [[ocular]] infection that warrants immediate [[ophthalmic]] work-up and management. The infection has an abrupt [[onset]] and rapid progression. [[Symptoms]] of hyperacute bacterial conjunctivitis may include the following:<ref name="pmid21160459">{{cite journal| author=Workowski KA, Berman S, Centers for Disease Control and Prevention (CDC)| title=Sexually transmitted diseases treatment guidelines, 2010. | journal=MMWR Recomm Rep | year= 2010 | volume= 59 | issue= RR-12 | pages= 1-110 | pmid=21160459 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21160459  }} </ref>
Hyperacute [[bacterial]] conjunctivitis (HBC) is a severe, sight-threatening [[ocular]] infection that warrants immediate [[ophthalmic]] work-up and management. The infection has an abrupt [[onset]] and rapid progression. [[Symptoms]] of hyperacute bacterial conjunctivitis may include the following:<ref name="pmid21160459">{{cite journal| author=Workowski KA, Berman S, Centers for Disease Control and Prevention (CDC)| title=Sexually transmitted diseases treatment guidelines, 2010. | journal=MMWR Recomm Rep | year= 2010 | volume= 59 | issue= RR-12 | pages= 1-110 | pmid=21160459 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21160459  }} </ref>
*Eyelids swelling
*Eyelids swelling
*Tearing
*Tearing
*Diffuse eye [[redness]]
*Diffuse eye redness
*[[Eye pain]]  
*[[Eye pain]]  
*Decreased [[vision]]
*Decreased vision
*Severe [[purulent]] discharge (yellow-green)
*Severe purulent discharge (yellow-green)
*[[Swollen lymph nodes]] (preauricular)
*[[Swollen lymph nodes]] (preauricular)
===Neonatal Conjunctivitis===   
===Neonatal Conjunctivitis===   
[[Symptoms]] of neonatal conjunctivitis ([[ophthalmia neonatorum]]), based on casualty, may include the following:<ref name="pmid25606121">{{cite journal| author=Mallika P, Asok T, Faisal H, Aziz S, Tan A, Intan G| title=Neonatal conjunctivitis - a review. | journal=Malays Fam Physician | year= 2008 | volume= 3 | issue= 2 | pages= 77-81 | pmid=25606121 | doi= | pmc=4170304 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25606121  }} </ref><ref name=Neonatal-conjunctivitis >Centers for Disease Control and Prevention (2015)[http://www.cdc.gov/conjunctivitis/newborns.html] Accessed on June 30, 2016 </ref>
Symptoms of neonatal conjunctivitis ([[ophthalmia neonatorum]]), based on casualty, may include the following:<ref name="pmid25606121">{{cite journal| author=Mallika P, Asok T, Faisal H, Aziz S, Tan A, Intan G| title=Neonatal conjunctivitis - a review. | journal=Malays Fam Physician | year= 2008 | volume= 3 | issue= 2 | pages= 77-81 | pmid=25606121 | doi= | pmc=4170304 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25606121  }} </ref><ref name=Neonatal-conjunctivitis >Centers for Disease Control and Prevention (2015)[http://www.cdc.gov/conjunctivitis/newborns.html] Accessed on June 30, 2016 </ref>
====''Gonococcal'' Conjunctivitis====
====Gonococcal Conjunctivitis====
''[[Gonococcal]]'' conjunctivitis is more severe than ''[[chlamydial]]'' conjunctivitis in [[newborns]]. The [[incubation period]] is 2-5 days. It is usually bilateral. [[Symptoms]] of ''gonococcal'' conjunctivitis may include the following:
[[Gonococcal]] conjunctivitis is more severe than [[chlamydial]] conjunctivitis in [[newborns]]. The [[incubation period]] is 2-5 days. It is usually bilateral. Symptoms of gonococcal conjunctivitis may include the following:
*Severe [[purulent]] discharge ([[bilateral]])
*Severe purulent discharge ([[bilateral]])
*Tearing
*Tearing
*Eyelids swelling
*Eyelids swelling
====''Chlamydial'' Conjunctivitis====
====Chlamydial Conjunctivitis====
''[[Chlamydial]]'' conjunctivitis has a later onset than ''[[gonococcal]]'' conjunctivitis in [[newborns]]. The [[incubation period]] is 5-14 days and the colonization of the eye after birth does not always result in infection. [[Symptoms]] of ''chlamydial'' conjunctivitis may include the following:
[[Chlamydial]] conjunctivitis has a later onset than gonococcal conjunctivitis in [[newborns]]. The [[incubation period]] is 5-14 days and the colonization of the eye after birth does not always result in infection. [[Symptoms]] of chlamydial conjunctivitis may include the following:
*Eye [[redness]]
*Eye redness
*Watery or mild mucoid discharge
*Watery or mild mucoid discharge
*Eyelids swelling
*Eyelids swelling
====Chemical conjunctivitis====
====Chemical conjunctivitis====
[[Chemical]] conjunctivitis usually occurs within 24 hours of instillation of silver nitrate solution and resolves spontaneously within a few days. [[Symptoms]] of chemical conjunctivitis may include the following:
Chemical conjunctivitis usually occurs within 24 hours of instillation of silver nitrate solution and resolves spontaneously within a few days. Symptoms of chemical conjunctivitis may include the following:
*[[Eyelids]] swelling  
*Eyelids swelling  
*Eye [[redness]]
*Eye redness
*Tearing
*Tearing
===Allergic Conjunctivitis===
===Allergic Conjunctivitis===
[[Symptoms]] of [[allergic]] conjunctivitis may include the following:<ref name="pmid18786127">{{cite journal| author=Kumar S| title=Vernal keratoconjunctivitis: a major review. | journal=Acta Ophthalmol | year= 2009 | volume= 87 | issue= 2 | pages= 133-47 | pmid=18786127 | doi=10.1111/j.1755-3768.2008.01347.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18786127  }} </ref>
Symptoms of [[allergic conjunctivitis]] may include the following:<ref name="pmid18786127">{{cite journal| author=Kumar S| title=Vernal keratoconjunctivitis: a major review. | journal=Acta Ophthalmol | year= 2009 | volume= 87 | issue= 2 | pages= 133-47 | pmid=18786127 | doi=10.1111/j.1755-3768.2008.01347.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18786127  }} </ref>
*[[Itchy]] eyes (most important)
*Itchy eyes (most important)
*Tearing
*Tearing
*Eye [[redness]] ([[Bilateral]])
*Eye redness ([[Bilateral]])
*Watery discharge
*Watery discharge
*[[Light sensitivity]] (with [[corneal]] involvement)
*[[Light sensitivity]] (with [[corneal]] involvement)
*[[Foreign body]] sensation
*Foreign body sensation
===Keratoconjunctivitis Sicca===
===Keratoconjunctivitis Sicca===
[[Symptoms]] of [[keratoconjunctivitis sicca|keratoconjunctivitis sicca (dry eye syndrome)]] may include the following:<ref name="pmid16309672">{{cite journal| author=Zoukhri D| title=Effect of inflammation on lacrimal gland function. | journal=Exp Eye Res | year= 2006 | volume= 82 | issue= 5 | pages= 885-98 | pmid=16309672 | doi=10.1016/j.exer.2005.10.018 | pmc=1361268 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16309672  }} </ref>
Symptoms of [[keratoconjunctivitis sicca|keratoconjunctivitis sicca (dry eye syndrome)]] may include the following:<ref name="pmid16309672">{{cite journal| author=Zoukhri D| title=Effect of inflammation on lacrimal gland function. | journal=Exp Eye Res | year= 2006 | volume= 82 | issue= 5 | pages= 885-98 | pmid=16309672 | doi=10.1016/j.exer.2005.10.018 | pmc=1361268 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16309672  }} </ref>
*Foreign-body sensation
*Foreign-body sensation
*[[Grittiness]]
*[[Grittiness]]
Line 121: Line 121:
*Excessive tearing (secondary to reflex secretion)
*Excessive tearing (secondary to reflex secretion)
*[[Light sensitivity]]  
*[[Light sensitivity]]  
*[[Itchy]] eye
*Itchy eye
*[[Fluctuating]] [[blurry]] vision
*Fluctuating blurry vision
*[[Malaise]]  
*[[Malaise]]  
*[[Weight loss]]
*[[Weight loss]]
===Superior Limbic Keratoconjunctivitis===
===Superior Limbic Keratoconjunctivitis===
[[Symptoms]] of [[superior limbic keratoconjunctivitis|superior limbic keratoconjunctivitis (SLK)]] may include the following:<ref name="pmid2695351">{{cite journal| author=Nelson JD| title=Superior limbic keratoconjunctivitis (SLK). | journal=Eye (Lond) | year= 1989 | volume= 3 ( Pt 2) | issue=  | pages= 180-9 | pmid=2695351 | doi=10.1038/eye.1989.26 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2695351  }} </ref>
Symptoms of [[superior limbic keratoconjunctivitis|superior limbic keratoconjunctivitis (SLK)]] may include the following:<ref name="pmid2695351">{{cite journal| author=Nelson JD| title=Superior limbic keratoconjunctivitis (SLK). | journal=Eye (Lond) | year= 1989 | volume= 3 ( Pt 2) | issue=  | pages= 180-9 | pmid=2695351 | doi=10.1038/eye.1989.26 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2695351  }} </ref>
*[[Foreign body sensation]]
*Foreign body sensation
*[[Light sensitivity]]  
*[[Light sensitivity]]  
*Excessive [[blinking]]  
*Excessive [[blinking]]  
*Burning sensation  
*Burning sensation  
*[[Itchy]] eye
*Itchy eye
*Dry eye sensation
*Dry eye sensation


Revision as of 18:18, 11 July 2016

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2] Sara Mehrsefat, M.D. [3]

Overview

Eyes with conjunctivitis

The history establish whether the condition is acute, subacute, chronic or recurrent, and whether it is associated with any specific environmental or work-related exposure.Complete history will help determine the correct therapy. The symptoms of conjunctivitis differ based on the cause of the inflammation. Redness, excessive tearing, and irritation are symptoms common to all forms of conjunctivitis. Photophobia, itching, mucopurulent or non-purulent discharge, chemosis, burning eyes, blurred vision and eyelid swelling are variable.[1][2]

History

The history of a patient with conjunctivitis should include a thorough ocular, medical and medication history. The history establish whether the condition is acute, subacute, chronic or recurrent, and whether it is associated with any specific environmental or work-related exposure. Complete history will help determine the correct therapy. A detailed and thorough history from the patient is necessary.[1]

Viral Conjunctivitis

Specific areas of focus when obtaining a history from the patient include:[2]

Bacterial Conjunctivitis

Specific areas of focus when obtaining a history from the patient include:[3]

Neonatal Conjunctivitis

Specific areas of focus when obtaining a history from the patient include:[4]

Allergic Conjunctivitis

Specific areas of focus when obtaining a history from the patient include:[5][6][7]

Keratoconjunctivitis Sicca

Specific areas of focus when obtaining a history from the patient include:[8][9]

Superior limbic keratoconjunctivitis

Specific areas of focus when obtaining a history from the patient include:[10]

  • Prolonged condition with gradual clearing
  • Have seen numerous eye specialists
  • History of thyroid abnormalities

Symptoms

The symptoms of conjunctivitis differ based on the cause of the inflammation. Redness, excessive tearing, and irritation are symptoms common to all forms of conjunctivitis. Photophobia, itching, mucopurulent or non-purulent discharge, chemosis, burning eyes, blurred vision and eyelid swelling are variable.

Viral Conjunctivitis

Adenovirus is the most common cause of viral conjunctivitis. It has Acute or subacute onset, and often occurs in community epidemics. Both eyes may be affected simultaneously, or the second eye may become involved a few days after the first eye. Symptoms of viral conjunctivitis may include the following:[11]

Acute Hemorrhagic Conjunctivitis

Acute hemorrhagic conjunctivitis (AHC) is a rapidly progressive and contagious viral infection. The infection starts ipsilaterally, but rapidly involves the fellow eye within 1 or 2 days and resolves within 5-7 days, during which the symptoms of pain and irritation are present. Symptoms of acute hemorrhagic conjunctivitis may include the following:[12]

Bacterial Conjunctivitis

Bacterial conjunctivitis has Hyperacute, acute, and chronic onset. Symptoms of bacterial conjunctivitis may include the following: [13]

Hyperacute Bacterial Conjunctivitis

Hyperacute bacterial conjunctivitis (HBC) is a severe, sight-threatening ocular infection that warrants immediate ophthalmic work-up and management. The infection has an abrupt onset and rapid progression. Symptoms of hyperacute bacterial conjunctivitis may include the following:[14]

  • Eyelids swelling
  • Tearing
  • Diffuse eye redness
  • Eye pain
  • Decreased vision
  • Severe purulent discharge (yellow-green)
  • Swollen lymph nodes (preauricular)

Neonatal Conjunctivitis

Symptoms of neonatal conjunctivitis (ophthalmia neonatorum), based on casualty, may include the following:[15][16]

Gonococcal Conjunctivitis

Gonococcal conjunctivitis is more severe than chlamydial conjunctivitis in newborns. The incubation period is 2-5 days. It is usually bilateral. Symptoms of gonococcal conjunctivitis may include the following:

  • Severe purulent discharge (bilateral)
  • Tearing
  • Eyelids swelling

Chlamydial Conjunctivitis

Chlamydial conjunctivitis has a later onset than gonococcal conjunctivitis in newborns. The incubation period is 5-14 days and the colonization of the eye after birth does not always result in infection. Symptoms of chlamydial conjunctivitis may include the following:

  • Eye redness
  • Watery or mild mucoid discharge
  • Eyelids swelling

Chemical conjunctivitis

Chemical conjunctivitis usually occurs within 24 hours of instillation of silver nitrate solution and resolves spontaneously within a few days. Symptoms of chemical conjunctivitis may include the following:

  • Eyelids swelling
  • Eye redness
  • Tearing

Allergic Conjunctivitis

Symptoms of allergic conjunctivitis may include the following:[17]

Keratoconjunctivitis Sicca

Symptoms of keratoconjunctivitis sicca (dry eye syndrome) may include the following:[18]

Superior Limbic Keratoconjunctivitis

Symptoms of superior limbic keratoconjunctivitis (SLK) may include the following:[19]

References

  1. ↑ 1.0 1.1 Rose P (2007). "Management strategies for acute infective conjunctivitis in primary care: a systematic review". Expert Opin Pharmacother. 8 (12): 1903–21. doi:10.1517/14656566.8.12.1903. PMID 17696792.
  2. ↑ 2.0 2.1 Leibowitz HM (2000). "The red eye". N Engl J Med. 343 (5): 345–51. doi:10.1056/NEJM200008033430507. PMID 10922425.
  3. ↑ "Bacterial conjunctivitis in children: antibiotic eye drops only if eye washing is ineffective". Prescrire Int. 16 (89): 120–1. 2007. PMID 17585426.
  4. ↑ Fransen L, Nsanze H, Klauss V, Van der Stuyft P, D'Costa L, Brunham RC; et al. (1986). "Ophthalmia neonatorum in Nairobi, Kenya: the roles of Neisseria gonorrhoeae and Chlamydia trachomatis". J Infect Dis. 153 (5): 862–9. PMID 3084664.
  5. ↑ La Rosa M, Lionetti E, Reibaldi M, Russo A, Longo A, Leonardi S; et al. (2013). "Allergic conjunctivitis: a comprehensive review of the literature". Ital J Pediatr. 39: 18. doi:10.1186/1824-7288-39-18. PMC 3640929. PMID 23497516.
  6. ↑ Jun J, Bielory L, Raizman MB (2008). "Vernal conjunctivitis". Immunol Allergy Clin North Am. 28 (1): 59–82, vi. doi:10.1016/j.iac.2007.12.007. PMID 18282546.
  7. ↑ Bonini S (2004). "Atopic keratoconjunctivitis". Allergy. 59 Suppl 78: 71–3. doi:10.1111/j.1398-9995.2004.00570.x. PMID 15245362.
  8. ↑ Schaumberg DA, Dana R, Buring JE, Sullivan DA (2009). "Prevalence of dry eye disease among US men: estimates from the Physicians' Health Studies". Arch Ophthalmol. 127 (6): 763–8. doi:10.1001/archophthalmol.2009.103. PMC 2836718. PMID 19506195.
  9. ↑ Stern ME, Beuerman RW, Fox RI, Gao J, Mircheff AK, Pflugfelder SC (1998). "The pathology of dry eye: the interaction between the ocular surface and lacrimal glands". Cornea. 17 (6): 584–9. PMID 9820935.
  10. ↑ Watson S, Tullo AB, Carley F (2002). "Treatment of superior limbic keratoconjunctivitis with a unilateral bandage contact lens". Br J Ophthalmol. 86 (4): 485–6. PMC 1771108. PMID 11914237.
  11. ↑ Drug and Therapeutics Bulletin (2011). "Management of acute infective conjunctivitis". Drug Ther Bull. 49 (7): 78–81. doi:10.1136/dtb.2011.02.0043. PMID 21733975.
  12. ↑ Yin-Murphy M (1976). "Simple tests for the diagnosis of picornavirus epidemic conjunctivitis (acute hemorrhagic conjunctivitis)". Bull World Health Organ. 54 (6): 675–9. PMC 2366581. PMID 1088513.
  13. ↑ Høvding G (2004). "[Acute bacterial conjunctivitis]". Tidsskr Nor Laegeforen. 124 (11): 1518–20. PMID 15195156.
  14. ↑ Workowski KA, Berman S, Centers for Disease Control and Prevention (CDC) (2010). "Sexually transmitted diseases treatment guidelines, 2010". MMWR Recomm Rep. 59 (RR-12): 1–110. PMID 21160459.
  15. ↑ Mallika P, Asok T, Faisal H, Aziz S, Tan A, Intan G (2008). "Neonatal conjunctivitis - a review". Malays Fam Physician. 3 (2): 77–81. PMC 4170304. PMID 25606121.
  16. ↑ Centers for Disease Control and Prevention (2015)[1] Accessed on June 30, 2016
  17. ↑ Kumar S (2009). "Vernal keratoconjunctivitis: a major review". Acta Ophthalmol. 87 (2): 133–47. doi:10.1111/j.1755-3768.2008.01347.x. PMID 18786127.
  18. ↑ Zoukhri D (2006). "Effect of inflammation on lacrimal gland function". Exp Eye Res. 82 (5): 885–98. doi:10.1016/j.exer.2005.10.018. PMC 1361268. PMID 16309672.
  19. ↑ Nelson JD (1989). "Superior limbic keratoconjunctivitis (SLK)". Eye (Lond). 3 ( Pt 2): 180–9. doi:10.1038/eye.1989.26. PMID 2695351.


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