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Conjunctivitis
By Dr. Veena G.D., MBBS, DOMS
Conjunctivitis is one of the most common form of eye infection. The term conjunctivitis describes any inflammatory condition that involves the
conjunctiva. Conjunctiva is the tissue along with the blood vessels lining the underside of the lids and white part of the eye. It is the inflammation which
results in blood vessels to dilate (appear prominent in the eye). This appears as red or pink eye. Common red eye should be ruled out for conjunctivitis.
Conjunctivitis is a microbial infection involving the anterior-most surface of the eye. This condition, which is usually a benign self-limited
illness, sometimes can be serious or signify a severe underlying disorder.
Generally, conjunctivitis is divided based on age of occurrence or course of disease. Etiology (causative factor) often can be distinguished
on clinical grounds. It is further classified as viral, bacterial, fungal, parasitic, toxic, chlamydial, chemical and allergic. This is characterized by
diffused redness of the eye, itching of the eye or excessive tearing. In viral conjunctivitis, along with the conjunctiva, cornea is also involved. Then the
condition is known as Keratoconjunctivitis. This condition is protracted and the duration will be more than 3 months. Usually it is preceded by herpetic
viral infection.
Clinical Presentation and Diagnosis:
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Bacterial conjunctivitis is characterized by sudden onset,
with a bit of pain, mild itching and redness. It is contagious meaning spreads easily. Staphylococcal and streptococcal species are the most common bacteria.
It can occur in one eye or both. The eye discharge will be mucopurulent (yellowish thick discharge sticking to the lids).
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Viral conjunctivitis is characterized by sudden or sub
clinical onset, minimal pain and history of exposure is present. It is associated with itching, watering, photophobia and foreign body sensation. The eye
discharge is watery but the lids don’t stick.
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Chlamydial conjunctivitis is characterized by long duration
onset, minimal pain level, mild itching and irritation with a history of STD. Sometimes peripheral cornea is involved results in blurring of vision.
Negligible discharge is seen.
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Allergic conjunctivitis is characterized by sudden or sub
clinical onset, no pain, and no exposure history. Itching and irritation are the main features. Patient frequently blinks so as to overcome the dryness
resulting from allergic conjunctivitis. Watery discharge is typically stringy and colorless.
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An aggressive form of allergic conjunctivitis is vernal
conjunctivitis in children and atopic conjunctivitis in adults. Vernal keratoconjunctivitis (VKC), usually affecting young boys, tends to be
bilateral and occurs in warm weather.
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Under surface of upper eyelid with VKC lesion – cobblestone papillae
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Treatment:
The treatment is given for symptomatic relief of pain, redness, itching and discomfort in the eye along with appropriate antimicrobial,
antiviral, antifungal and antihistaminic for allergy. Suitable spectacles are given to cover the eyes from harsh and bright light. Follow up is advised.
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