Conjunctivitis

Definition:  An inflammation of the conjunctiva characterized by dilation of the blood vessels of the conjunctiva, purulent or watery discharge, and conjunctival edema. 

Signs/Symptoms: 

• Chemosis (conjunctival swelling)

• Red eye

• Discharge

• Foreign body sensation

• Eyelid swelling

• Preauricular lymphadenopathy

FEATURES OF CONJUNCTIVITIS

Differential Diagnosis:  

• Bacterial

• Viral

• Allergic conjunctivitis

• Chronic conjunctivitis

• Iritis

Causes:

• Bacterial conjunctivitis:                       

  • staphylococcal

  • streptococcal

  • H. flu

  • neisseria     

• Viral conjunctivitis:

  • adenovirus (EKC, PCF)

  • chlamydia

  • herpes

Evaluation: 

• History

• Visual acuity

• Detailed examination of the anterior segment

Treatments: 

Bacterial. In general use antibiotic therapy 

• Trimethroprim/polymyxin 4 times a day

• Ciprofloxacin drops 4 times a day

• Erythromycin ointment 4 times a day for 5 to 7 days.

Viral (most common is adenovirus)

• Artificial tears  4-8 times a day

• Cool compresses

• Frequent hand washing

• Very contagious  isolate for 10-12 days

Herpes simplex

• Antiviral therapy trifluorothymidine 1 % drops 5 times a day

• Cool compresses            

Prognosis: 

• Bacterial:  generally good prognosis as long as patient remains on antibiotic as recommended

• Viral: generally good and self limiting.  Adenovirus is very contagious and can be a problem in a crew if allowed to go unchecked. 

This section provided by CAPT Robert B. North, Jr., MC, USN

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