Conjunctivitis natural history
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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
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. Acute hemorrhagic conjunctivitis will clear up in 5 to 7 days without treatment. Mild bacterial conjunctivitis may get better without antibiotic treatment and 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.
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
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
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.
References