Conjunctivitis

• Inflammation of the conjunctiva - thin protective layer on the surface of the eye
• Different causes - allergic/viral/bacterial
• Allergic conjunctivitis:

  • Common
  • Usually bilateral
  • Often accompanies with other allergy symptoms e.g. hay fever
  • Personal or family history of atopic conditions increases risk
  • Itching
  • Diffuse redness and watery discharge
  • Self limiting
  • Treatment - avoid allergens and antihistamine tablets PRN or topical antihistamine
  • Severe cases - topical steroids
• Bacterial conjunctivitis:

  • Causes - staphylococcus, streptococcus and haemophilus
  • Purulent discharge
  • Usually unilateral
  • Highly contagious - unprotected sexual intercourse in young people is a key risk factor
  • Treatment:
  • Lid hygiene measures
  • Avoidance of contact lenses
  • Strict hand hygiene
  • Topical antibiotics - chloramphenicol (overuse can cause allergic conjunctivitis)
• Viral:

  • Tends to have more severe symptoms
  • Often adenovirus, less commonly herpes
  • Watery discharge
  • Gritty sensation
  • Haemorrhagic conjunctivitis
  • Enlarged pre-auricular lymph nodes
  • Associated with a concurrent URTI
  • Extremely contagious
  • Self limiting - warm/cool compress, topical lubricants, topical antibiotics to prevent secondary bacterial infection
• Subconjunctival haemorrhage:

  • Often caused by vigorous coughing or vomiting
  • Spontaneous
  • Asymptomatic
  • Otherwise no specific treatment
  • Check blood pressure
  • If traumatic - refer to specialist only if you cant see the posterior limit of the bleed ? fracture of the orbit