Conjunctivitis natural history
|
Conjunctivitis Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Conjunctivitis natural history On the Web |
|
American Roentgen Ray Society Images of Conjunctivitis natural history |
|
Risk calculators and risk factors for Conjunctivitis natural history |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [2]
Overview
The outcome is usually good with treatment. Conjunctivitis resolves, in 65% of cases, within 2 – 5 days.[1]
Natural History
If left untreated, most cases of viral conjunctivitis are mild and will clear up in 7–14 days without treatment and without any long-term consequences. if complications arise, viral conjunctivitis can take two or more weeks to resolve.If the conjunctivitis persists, the epithelial abnormalities may occur. In general, the stromal or subepithelial abnormalities may resolved. However, the stromal abnormalities may persist for months to years, long after the epithelial changes have resolved. In such cases, If subepithelial infiltrates are in the pupillary axis, they may lead to decreased vision.
If left untreated, Acute hemorrhagic conjunctivitis will clear up in 5 to 7 days, and almost always resolves without sequelae.
If left untreated, mild bacterial conjunctivitis may get better without causing any severe complications. Allergic conjunctivitis usually improves by eliminating or significantly reducing contact with the allergen (pollen or animal dander). Reinfection within a household or school may occur if you don't follow preventive measures.
is characterized by abrupt onset of bilateral conjunctivitis, watery discharge, hyperemia, chemosis and lymph node enlargement
Complications
Viral Conjunctivitis
- Bacterial superinfection
- Keratitis
- Subepithelial infiltrates
- Corneal ulceration with keratoconjunctivitis
- Chronic infection
Bacterial Conjunctivitis
Complications are expected to develop only in cases caused by extremely pathogenic bacteria, such as C trachomatis or N gonorrhoeae Mortality in the setting of bacterial conjunctivitis is related to the failure to recognize and treat the underlying disease. Sepsis and *meningitis caused by N gonorrhoeae can be life-threatening.[18] Chlamydial infection in the newborn can lead to pneumonia and/or otitis media
- Sepsis
- Meningitis caused by N gonorrhoeae can be life-threatening.[18] Chlamydial infection in the newborn can lead to pneumonia and/or otitis media
Neonatal Conjunctivitis
- Ocular complications
- Pseudomembrane formation
- Corneal edema
- Thickened palpebral conjunctiva,
- Peripheral pannus formation
- Corneal opacification
- Staphyloma
- Corneal perforation
- Endophthalmitis
- Loss of eye and blindness
- Systemic complications of chlamydia conjunctivitis
- Pneumonia
- Otitis
- Pharyngeal and rectal colonization
- Systemic complications of gonococcal conjunctivitis
- Arthritis
- Meningitis
- Anorectal infection
- Septicemia
- Death
Allergic Conjunctivitis
In general, the prognosis of SAC and PAC is good despite significant discomfort and undesirable cosmetic consequences. Occasionally, individuals with chronic recurrences develop significant conjunctivochalasis or, less commonly, a corneal Dellen secondary to persistent limbal conjunctival chemosis. Conversely, AKC and VKC may lead to significant corneal complications such as ulceration and opacification, leading to permanent visual loss. Lid involvement from any type of allergic conjunctivitis, particularly GPC, can significantly compromise contact lens tolerance. Medications used for allergic disease may lead to complications such as preservative toxicity and steroid-induced intraocular pressure elevations or cataract.
- Conjunctivochalasis (chronic recurrences)
- Ulceration
- Opacification
- Visual loss
- Steroid induced intraocular pressure elevations
- Cataract
Keratoconjunctivitis Sicca
Keratoconjunctivitis Sicca (Dry eye syndrome) may be complicated by sterile or infectious corneal ulceration, particularly in patients with SS. Ulcers are typically oval or circular, less than 3 mm in diameter, and located in the central or paracentral cornea. Occasionally, corneal perforation may occur. In rare cases, sterile or infectious corneal ulceration in dry eye syndrome can cause blindness. This risk is markedly increased with contact lens use, particularly with overnight wear. Punctate epithelial defects (PEDs) may be present. Significant punctate epitheliopathy can lead to corneal erosions, both sterile and infectious corneal ulceration, corneal neovascularization, corneal scarring, corneal thinning, and even corneal perforation. The prognosis of dry eye syndrome varies depending on the severity of the condition. Most patients have mild-to-moderate cases, and they can be treated symptomatically with lubricants, providing adequate relief of symptoms. In general, the prognosis for visual acuity in patients with dry eye syndrome is good. Patients with SS or prolonged untreated dry eye represent a subgroup with a worse prognosis, requiring a longer course of treatment.
- Corneal ulceration
- Corneal erosions
- Corneal neovascularization
- Corneal scarring
- Corneal thinning
- Corneal perforation
Prognosis
Acute hemorrhagic conjunctivitis almost always resolves without sequelae, and has a good visual prognosis. Mild bacterial conjunctivitis may get better without antibiotic treatment and without causing any severe complications. Prognosis of neonatal conjunctivitis is generally considered to be good as long as early diagnosis is made and prompt medical therapy is initiated. Most cases of infectious conjunctivitis respond to appropriate treatment. However, morbidity and mortality increases in cases of systemic involvement requiring hospitalization and intensive monitoring. The prognosis of allergic conjunctivitis is good. However, atopic keratovonjunctivitis and vernal keratoconjunctivitis may lead to leading to permanent visual loss.
In general, the prognosis for visual acuity in patients with dry eye syndrome is good. In general, the prognosis for superior limbic keratoconjunctivitis is excellent, with remission as the natural history and eventual total resolution, although symptoms may last for years.