Diagnosis Of Acute Conjunctivitis Research Articles

Covid-19 and acute conjunctivitis: Controversial data from a tertiary refferral Italian center.

Although acute conjunctivitis has been listed from the beginning as a possible sign of COVID-19, the likelihood of this association remains unclear. The aim of this study was to investigate the relationship between COVID-19 and conjunctivitis. In this retrospective, observational study, we recruited all patients with signs and symptoms of acute conjunctivitis seen at the Eye Emergency Department (ED), Turin Eye Hospital, between 01/01/2020 and 12/05/2020 and cross-checked our data with the Piedmont Region online COVID-19 registry in the same period. Among 10,065 patients seen at our ED during the timespan considered, 88 underwent a nasopharyngeal swab (NS) for SARS-CoV-2 detection within 4 weeks before/after our examination. On average, NS was performed -0.72 ± 1.8 weeks before/after eye examination. Of the 77 patients with a negative NS, 26 (33.8%) had a diagnosis of acute conjunctivitis, whereas the remaining 51 (66.2%) had other eye disorders. Among the 11 patients with COVID-19, 7 (63,6%) had a diagnosis of acute conjunctivitis. We found a non-statistically significant increase in NS positivity rate (21.2%) among cases examined at our ED for acute conjunctivitis, compared to the NS positivity rate (7.3%) in patients examined for all other eye conditions (p = 0.092). The Odds Ratio of having a positive NS in patients with acute conjunctivitis was 3.43 (95% I.C. = 0.9-12.8, p = 0.06). Considering online-registry data of Turin population during the same time-span, among 2441 positive NS cases only 27 (1.1%) presented with acute conjunctivitis. Our results do not reveal a statistically significant correlation between COVID-19 and acute conjunctivitis. The present study analyzes retrospectively data from a tertiary eye referral center to investigate the relationship between COVID-19 infection and conjunctivitis.

Christmas Tree Cataract - A Cataract that Glitters.

A 54-year-old man presented to the Ophthalmology OPD with redness and discharge from his eyes. His vision was 20/20 in both the eyes. There was diffuse conjunctival congestion and mild discharge in both the eyes. On detailed examination, the left eye showed highly refractive, multi-coloured, iridescent crystals in the inferior cortex and nucleus of the crystalline lens. The colours changed with the change in the angle of the incident light. It was a spectacular display of different colours that glittered like an illuminated Christmas tree [Table/Fig-1,​,2].2]. The crystals cast thin and hairy shadows in retro-illumination ([Table/Fig-3] white arrows). There was an associated early cuneiform cataract inferiorly ([Table/Fig-3], blue arrows). A diagnosis of acute conjunctivitis in both eyes with a Christmas tree cataract (CTC) and early cuneiform cataract in the left eye was made. He was treated for the acute conjunctivitis with moxifloxacin 5% eyedrops (Vigamox, Alcon Laboratories Pvt. Ltd., Texus), 4 times a day for 1 week. The conjunctivitis got cured by 1 week. No treatment was required for the cataract since it was visually non-disturbing. Serum cholesterol, calcium, lipid profile and electromyogram were found to be within normal limits. Neurological consultation ruled out Myotonic dystrophy. [Table/Fig-1]: Anterior segment photograph of left eye (by slit lamp) showing highly refractive, multi-coloured, iridescent crystals in the inferior cortex and nucleus of the crystalline lens. [Table/Fig-2]: Anterior segment photograph (Magnified view, by slit lamp) of left eye showing the highly refractive, multi-coloured, iridescent crystals in the inferior cortex and nucleus of the crystalline lens. [Table/Fig-3]: Anterior segment photograph of left eye in retro-illumination showing the crystals casting thin and hairy shadows (white arrows) and associated early cuneiform cataract inferiorly (blue arrows). CTC is a rare type of cataract. It varies from other cataracts that show some amount of different colours of the crystalline lens, like the posterior subcapsular cataract or the complicated cataract, in that it shows a spectacular display of multiple colours that glitters with the change of incident light like an illuminated Christmas tree. The exact cause for the mechanism of formation of CTC is not very clear. Different researchers have postulated different mechanisms for its formation. Pau and Forster were the first ones to suggest that the opacities seen in CTC were cholesterol crystals [1]. Hayes and Fisher subsequently postulated the diffraction of light from parallel sided stacks of fused cell membranes to be the cause for the striking polychromatic lustre [2]. As per Anders and Wollensak, the crystals were cholesterol in nature and were the result of lens metabolism [3]. According to Shun-Shin et al., CTC needles were most likely made of cystine due to an age-related aberrant breakdown of crystallins induced by elevated Ca++ levels [4]. Similarly, Obi and Weir postulated that CTCs resulted from the accelerated breakdown of membrane associated proteins and that excess cystine concentration lead to growing crystals [5]. Reiter and Gramer found Myotonic Dystrophy in 16.7% of patients with CTC [6]. Few other authors have also reported CTC but they have not postulated any cause for its formation. They have simply described their cases [7–9]. [Table/Fig-4] shows all the case reports on CTC so far from different parts of the world. [Table/Fig-4]: Case reports on Christmas Tree Cataract (CTC) from different parts of the world. To conclude, CTC is a rare cataract that may be found incidentally since it is visually non-disturbing, as is in our case. Its spectacular display of brilliance is very striking and evokes a ‘wow’ feeling in the person observing it. It is a wonder, how an illuminated Christmas tree like glittering can be found in the human body. This type of cataract is aptly called as the “Christmas tree cataract”.

Conjuntivitis bacteriana: patógenos más prevalentes y sensibilidad antibiótica

Bacterial conjunctivitis is a self-limiting process, but topical antibiotic treatment is recommended to eradicate the pathogen and reduce symptom duration. Since this treatment is usually empirical and prior cultures are not normally taken, the etiological agents involved in the process are unknown. A total of 596 conjunctival exudates from pediatric outpatients with a diagnosis of acute conjunctivitis in Medical Area 6 of Madrid, Spain, were studied over 3 years (from 2000 to 2002 inclusive). The patients were divided into three age groups: group 1 (infants), group 2 (2- to 6-year-olds) and group 3 (7- to 14-year-olds). A total of 428 bacteria were isolated. The most prevalent bacteria were Haemophilus influenzae (44.8 %) and Streptococcus pneumoniae (30.6 %) followed by Staphylococcus aureus (7.5 %), S. viridans (7.2 %), Moraxella catarrhalis (6.8 %) and Enterobacteriaceae (4.2 %). In 56 exudates (15.1 %), two or more bacteria were isolated and S. pneumoniae 1 H. influenzae were found in 8.1 % of the cases. By age group, S. aureus was significantly more prevalent (p < 0.0001) in group 3 than in groups 1 and 2. Isolation of Enterobacteriaceae, S. viridans and non-fermentative Gram negative bacilli was significantly more frequent (p < 0.05) in group 1 and isolation of S. pneumoniae (p < 0.05) was significantly more frequent in group 2. S. pneumoniae showed the greatest level of resistance to antibiotics used in eye drops and ophthalmic ointments. Ciprofloxacin, chloramphenicol and rifampin were active in the most prevalent pathogens. The most prevalent bacteria were H. influenzae and S. pneumoniae. The most active antibiotics in these pathogens were ciprofloxacin, chloramphenicol and rifampin.

Epidemiology and Diagnosis of Acute Conjunctivitis at an Inner-city Hospital

Chlamydia has been found to be the cause of a high percentage of cases of neonatal and chronic conjunctivitis in an inner-city population. To assess the etiology and epidemiology of acute conjunctivitis in this population, conjunctival scrapings were sampled from 45 patients presenting to an ocular emergency room; and replicate chlamydial, viral, and bacterial cultures and cytology tests were done. No cases of chlamydial conjunctivitis were diagnosed, although a viral etiology was established in 36% of the cases and a bacterial etiology in 40%. Twenty-four percent of the cases were not diagnosed. The authors recommend limiting the initial laboratory workup of patients with acute conjunctivitis to obtaining conjunctival smears for Gram and Giemsa staining. Chlamydial direct immunofluorescent monoclonal antibody (DFA) should be done if the patient is sexually active. Hyperacute conjunctivitis or acute conjunctivitis refractory to treatment mandates a more complete set of laboratory tests.