Conjunctivitis

Question 1

What is Conjunctivitis?

Answer 1

Inflammation of the conjunctiva - a layer of tissue that covers the inside of the eyelids and the sclera of the eye; also known as ‘Pink Eye’.

Question 2

What is Keratoconjunctivitis?

Answer 2

Conjunctivitis associated with Corneal Inflammation.

Question 3

Give 3 causes of painless acute red eye.

Answer 3

1. Conjunctivitis.
2. Episcleritis.
3. Subconjunctival Haemorrhage.

Question 4

What is a Subconjunctival Haemorrhage?

Answer 4

A collection of blood between the conjunctiva and the sclera - it typically appears as a focal red region on the surface of the eye.

Question 5

Give 7 causes of painful red eye.

Answer 5

1. Glaucoma.
2. Anterior Uveitis.
3. Scleritis.
4. Corneal Abrasions / Ulceration.
5. Keratitis.
6. Foreign Body.
7. Traumatic / Chemical Injury.

Question 6

Epidemiology of Conjunctivitis (2).

Answer 6

1. Commonest eye presentation in primary care.

2. Commonest type - viral.

Question 7

Clinical Features of Conjunctivitis (3).

Answer 7

1. Sore Bloodshot / Red Eyes.
2. Itchy / Gritty Sensation.
3. Sticky Discharge from the Eye (especially in morning).

Question 8

What does Conjunctivitis not cause?

Answer 8

1. Pain.
2. Photophobia.
3. Reduced Visual Acuity (but discharge can blur vision).

Question 9

Is Conjunctivitis contagious?

Answer 9

Bacterial and viral conjunctivitis is contagious.

Question 10

VIRAL Conjunctivitis vs. Bacterial Conjunctivitis (4).

Answer 10

1. Other Symptoms of Viral Infection.
2. Tender Periauricular Lymph Nodes.
3. Usually Bilateral (unlike Bacterial - Unilateral).
4. Clear and Watery Discharge (Bacterial - yellow, white or green).

Question 11

Clinical Features of Allergic Conjunctivitis (3).

Answer 11

Bilateral Symptoms :

1. Conjunctival Erythema (dilation of blood vessels).
2. Chemosis (oedema in the conjunctiva).
3. Prominent Itch.

Question 12

Conservative Management of Conjunctivitis (4).

Answer 12

1. Resolves within 1-2 weeks.
2. Good Hygiene e.g. Avoid Sharing Towels, Rubbing Eyes and Washing Hands.
3. Avoid Contact Lens.
4. Clean Eyes with Cooled Boiled Water and Cotton Wool to help clear the discharge.

Question 13

Antibiotics in Conjunctivitis (2).

Answer 13

1. Chloramphenicol Drops 2-3 Hours Initially or Chloramphenicol Ointment QDS.
2. Topical Fusidic Acid - Pregnant Women : Twice Daily.

Question 14

Neonatal Conjunctivitis.

Answer 14

Neonates require urgent ophthalmological review - can be associated with gonococcal infection : loss of sight and more severe complications e.g. pneumonia.

Question 15

Management of Allergic Conjunctivitis (2).

Answer 15

1. 1st Line - Oral / Topical Antihistamines.
2. 2nd Line - Topical Mast Cell Stabilisers e.g. Sodium Cromoglicate and Nedocromil (preferred in chronic seasonal symptoms).