Abstract
Conjunctivitis is a commonly encountered condition in ophthalmology clinics throughout the world. In the management of suspected cases of conjunctivitis, alarming signs for more serious intraocular conditions, such as severe pain, decreased vision, and painful pupillary reaction, must be considered. Additionally, a thorough medical and ophthalmic history should be obtained and a thorough physical examination should be done in patients with atypical findings and chronic course. Concurrent physical exam findings with relevant history may reveal the presence of a systemic condition with involvement of the conjunctiva. Viral conjunctivitis remains to be the most common overall cause of conjunctivitis. Bacterial conjunctivitis is encountered less frequently and it is the second most common cause of infectious conjunctivitis. Allergic conjunctivitis is encountered in nearly half of the population and the findings include itching, mucoid discharge, chemosis, and eyelid edema. Long-term usage of eye drops with preservatives in a patient with conjunctival irritation and discharge points to the toxic conjunctivitis as the underlying etiology. Effective management of conjunctivitis includes timely diagnosis, appropriate differentiation of the various etiologies, and appropriate treatment.
Highlights
Various studies have demonstrated that obtaining a thorough history is essential to narrow down the differential diagnosis and discover the underlying etiology for the conjunctivitis, while relying solely on the presenting signs and symptoms can be misleading and often leads to an inaccurate diagnosis
Viral conjunctivitis followed by bacterial conjunctivitis are the most common causes of infectious conjunctivitis.[15, 25, 81]
The majority of viral conjunctivitis cases are due to adenoviruses,[28] and the use of rapid antigen test to diagnose adenoviral conjunctivitis may present an appropriate strategy to avoid overuse of antibiotics
Summary
Conjunctivitis is characterized by inflammation and swelling of the conjunctival tissue, accompanied. It has been reported that nearly 60% of all patients with acute conjunctivitis receive antibiotic eye drops; and the vast majority receive their prescription from a non-ophthalmologist physician. 68% of patients who visited a physician at an emergency room received antibiotic eye drops while this figure dropped to 36% for those who saw an ophthalmologist.[1] Interestingly, patients from a higher socioeconomic status were more likely to receive and fill a prescription for their conjunctivitis.[1]. There are several ways to categorize conjunctivitis; it may be classified based on etiology, chronicity, severity, and extend of involvement of the surrounding tissue. Conjunctivitis may be associated with the involvement of the surrounding tissue such as the eyelid margins and cornea in blepharoconjunctivitis and viral keratoconjunctivitis, respectively. It is extremely important to differentiate conjunctivitis from other causes of “red eye” associated with severe sight- or life-threatening consequences such as acute angle closure glaucoma, uveitis, endophthalmitis, carotidcavernous fistula, cellulitis, and anterior segment tumors
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