Conjunctivitis is inflammation of the conjunctiva

It is commonly due to an infection (usually viral, but sometimes bacterial or an allergic reaction.

Classification

Classification can be either by cause or by extent of the inflamed area.

By cause:

-Viral conjunctivitis
-Allergic conjunctivitis
-Bacterial conjunctivitis
-Chemical conjunctivitis
-Neonatal conjunctivitis is often defined separately due to different organisms.

By extent of involvement:

-Blepharoconjunctivitis is the dual combination of conjunctivitis with blepharitis (inflammation of the eyelids).

-Keratoconjunctivitis is the combination of conjunctivitis and keratitis (corneal inflammation).


Symptoms:

-Red eye (hyperaemia),
-swelling of conjunctiva (chemosis)
-and watering (epiphora) of the eyes
are symptoms common to all forms of conjunctivitis. However, the pupils should be normally reactive and the visual acuity normal.

Viral

-Viral conjunctivitis is often associated with an infection of the upper respiratory tract, a common cold, and/or a sore throat.

-Its symptoms include excessive watering and itching.

- The infection usually begins with one eye, but may spread easily to the other.

-Viral conjunctivitis, commonly known as pink eye, shows a fine, diffuse pinkness of the conjunctiva


Bacterial

-Bacterial conjunctivitis causes the rapid onset of conjunctival redness, swelling of the eyelid, and mucopurulent discharge.

-Typically, symptoms develop first in one eye, but may spread to the other eye within 2–5 days.

-Bacterial conjunctivitis due to common pyogenic (pus-producing) bacteria causes marked grittiness/irritation and a stringy, opaque, greyish or yellowish mucopurulent discharge that may cause the lids to stick together, especially after sleep.

- The gritty and/or scratchy feeling is sometimes localized enough for patients to insist they must have a foreign body in the eye.

The more acute pyogenic infections can be painful. Common bacteria responsible for non-acute bacterial conjunctivitis are Staphylococci and Streptococci.

Chemical

-Chemical eye injury is due to either an acidic or alkali substance getting in the eye. Alkalis are typically worse than acidic burns.

- Mild burns will produce conjunctivitis while more severe burns may cause the cornea to turn white.


Allergic

-Itching (rubbing eyes) is the hallmark symptom of allergic conjunctivitis.

- Other symptoms include history of eczema, or asthma.

Management

Conjunctivitis resolves in 65% of cases without treatment, within two to five days. The prescription of antibiotics is not necessary in most cases.

Allergic

-For the allergic type, cool water poured over the face with the head inclined downward constricts capillaries, and artificial tears sometimes relieve discomfort in mild cases.

- In more severe cases, nonsteroidal anti-inflammatory medications and antihistamines may be prescribed.

- Persistent allergic conjunctivitis may also require topical steroid drops.

Bacterial

-Bacterial conjunctivitis usually resolves without treatment. Antibiotics, eye drops, or ointment may only be needed if no improvement is observed after three days.

-In people receiving no antibiotics, recovery was in 4.8 days, with immediate antibiotics it was 3.3 days, and with delayed antibiotics 3.9 days. No serious effects were noted either with or without treatment.

Viral

-brief povidone iodine eye wash

Chemical

-Conjunctivitis due to chemicals is treated via irrigation with Ringer's lactate or saline solution