Conjunctivitis differential diagnosis
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Conjunctivitis symptoms and signs are relatively non-specific. Even after biomicrosopy, laboratory tests are often necessary to determine the underlying pathophysiology with certainty. perform an eye examination can help to differentiating Conjunctivitis from other medical conditions.
Bacterial Conjunctivitis
A purulent discharge strongly suggests bacterial cause, unless there is known exposure to toxins. Infection with Neisseria gonorrhoeae and chlamydia trachomatis should be suspected if the discharge is particularly thick and copious. Bacterial Conjunctivitis must be differentiated from:
Viral Conjunctivitis
A diffuse, highly contagious, characterized by watery discharge, less "injected" conjunctivitis (looking pink rather than red) suggests a viral cause, especially if numerous follicles are present on the lower tarsal conjunctiva on biomicroscopy. Viral Conjunctivitis must be differentiated from:
- Keratoconjunctivitis
- Nasolacrimal duct obstruction
- Foreign body
- Keratitis
- Uveitis
- Pharyngoconjunctival fever
Allergic conjunctivitis
Allergic conjunctivitis must be differentiated from:
Allergic conjunctivitis has a protracted course, with the severity of symptoms waxing and waning throughout the allergy season. As recurrences within a short period of time are unlikely with bacterial or viral conjunctivitis.
Keratoconjunctivitis sicca
The differential diagnoses for dry eye syndrome (DES), or keratoconjunctivitis sicca