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For the WikiDoc page for this topic, click [[Conjunctivitis|here]]
==Overview==
'''Conjunctivitis''' (commonly called "'''pink eye'''" or "'''Madras eye'''"is an [[acute]] [[inflammation]] of the [[conjunctiva]] (the outermost layer of the [[eye]] and the inner surface of the [[eyelid]]s), most commonly due to an [[allergic reaction]] or an [[infection]] (usually [[viral]], but sometimes [[bacterial]].  Conjunctivitis is an irritating and fairly common condition, but rarely causes long term [[eye]] or [[vision]] damage.


==What is conjunctivitis?==
==What are the symptoms of Conjunctivitis?==
Redness ([[hyperaemia]]), irritation ([[chemosis]]) and watering ([[epiphora (medical)|epiphora]]) of the eyes are symptoms common to all forms of conjunctivitis.
Additionally, symptoms vary based on the specific type of conjunctivitis:
*'''Allergic conjunctivitis:'''{{main|Allergic conjunctivitis}} Allergic conjunctivitis is typically [[itch|itchy]], sometimes distressingly so, and often involves some [[Periorbital edema|eye swelling]].  [[Chronic]] [[allergy]] often causes just [[itch|itching]] or [[irritation]].  Allergic conjunctivitis often causes pale watery swelling of the [[conjunctiva]] and sometimes the whole [[eyelid]].  There is frequently a sticky [[mucus]] discharge, and there is variable redness.
*'''Viral conjunctivitis:''' ''Viral conjunctivitis'' is often associated with an [[infection]] of the upper [[respiratory tract]], a [[common cold]], and/or a [[sore throat]]. Its symptoms include watery discharge and variable [[itch]]. The [[infection]] usually begins with one [[eye]], but may spread easily to the other.  ''Viral conjunctivitis'' is commonly known as "pink eye."
*'''Bacterial conjunctivitis:''' ''Bacterial conjunctivitis'' due to the common [[pyogenic]] (pus-producing) bacteria causes marked grittiness/irritation and a stringy, opaque, grey or yellowish [[mucopurulent discharge]] (''[[mucus]]'', ''gowl'', ''goop'', ''gunk'', ''[[eye crust]]'',  or other regional names, officially known as '[[gound]]') that may cause the [[eyelid|lids]] to stick together (''matting''), especially after [[sleep|sleeping]]. Another symptom that could be caused by bacterial conjunctivitis is severe crusting of the infected [[eye]] and the surrounding [[skin]]. However, discharge is not essential to the diagnosis, contrary to popular belief.  Bacteria such as ''[[Chlamydia trachomatis]]'' or ''[[Moraxella]]'' can cause a non-exudative but persistent conjunctivitis without much redness. 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. Like viral conjunctivitis, it usually affects only one [[eye]] but may spread easily to the other [[eye]]. However, it is dormant in the [[eye]] for three days before the patient shows signs of symptoms.
*'''Chemical conjunctivitis:'''''Irritant''  or ''toxic conjunctivitis'' is [[irritable]] or painful when the infected [[eye]] is pointed far down or far up. Discharge and [[itch]] are usually absent. It show primarily marked redness.  This is the only group in which severe [[pain]] may occur.


'''Conjunctivitis''' (commonly called "'''pink eye'''" or "'''Madras eye'''"<ref>{{cite news
==What causes Conjunctivitis?==
|title=Beware, `Madras eye' is here!
Conjunctivitis is most commonly caused by [[viruses]], often [[adenovirus]], but many other factors can lead to its occurrence.  Other causes include:
|date=2001-10-12
* [[Allergies]] ([[allergic conjunctivitis]])
|work=The Hindu
* [[Bacteria]]
|url=http://www.hinduonnet.com/2001/10/12/stories/0412402c.htm
|accessdate=2008-10-30
}}</ref>) is an acute inflammation of the [[conjunctiva]] (the outermost layer of the [[eye]] and the inner surface of the [[eyelid]]s), most commonly due to an [[allergic reaction]] or an [[infection]] (usually [[viral]], but sometimes [[bacterial]]<ref>Langley JM. Adenoviruses. Pediatr Rev. 2005;26:238-242.</ref>).  Conjunctivitis is an irritating and fairly common condition, but rarely causes long term eye or vision damage.
 
==What are the symptoms of conjunctivitis?==
 
[[Image:Pinkeye twoangles.jpg|thumb|left|[[Eye]]s with conjunctivitis]]
[[Image:ConjunctivitisRedEye.jpg|thumb|left|An eye, red due to acute conjunctivitis.]]
[[Image:Swollen eye with conjunctivitis.jpg|thumb|left|An eye with bacterial conjunctivitis.]]
 
Redness ([[hyperaemia]]), irritation ([[chemosis]]) and watering ([[epiphora (medical)|epiphora]]) of the eyes are symptoms common to all forms of conjunctivitis.  Other general symptoms of conjunctivitis include:
 
* Blurred vision
* Crusts that form on the eyelid overnight
* Eye pain
* Gritty feeling in the eyes
* Increased tearing
* Itching of the eye
* Redness in the eyes
* Sensitivity to light
 
 
'''Allergic conjunctivitis'''
{{main|Allergic conjunctivitis}}Allergic conjunctivitis is typically itchy, sometimes distressingly so, and often involves some eye swelling.  Chronic allergy often causes just itching or irritation.
 
Allergic conjunctivitis shows pale watery swelling or [[edema]] of the conjunctiva and sometimes the whole eyelid, often with a ropy, ''non-purulent'' mucoid discharge. There is variable redness.
 
'''Viral conjunctivitis'''
''Viral conjunctivitis'' is often associated with an infection of the upper [[respiratory tract]], a [[common cold]], and/or a [[sore throat]]. Its symptoms include watery discharge and variable itch. 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 which is easily mistaken for the 'ciliary injection' of [[iritis]], but there are usually corroborative signs on [[Biology|bio]] [[microscopy]], particularly numerous [[Lymph follicle|lymphoid follicle]]s on the tarsal conjunctiva, and sometimes a punctate keratitis.
 
'''Bacterial conjunctivitis'''
''Bacterial conjunctivitis'' due to the common [[pyogenic]] (pus-producing) bacteria causes marked grittiness/irritation and a stringy, opaque, grey or yellowish [[mucopurulent discharge]] (''[[mucus]]'', ''gowl'', ''goop'', ''gunk'', ''[[eye crust]]'',  or other regional names, officially known as '[[gound]]') that may cause the lids to stick together (''matting''), especially after sleeping. Another symptom that could be caused by bacterial conjunctivitis is severe crusting of the infected eye and the surrounding skin. However discharge is not essential to the diagnosis, contrary to popular belief.  Bacteria such as ''[[Chlamydia trachomatis]]'' or ''[[Moraxella]]'' can cause a non-exudative but persistent conjunctivitis without much redness. 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. Like viral conjunctivitis, it usually affects only one eye but may spread easily to the other eye. However, it is dormant in the eye for three days before the patient shows signs of symptoms.
 
Pyogenic ''bacterial conjunctivitis'' shows an opaque purulent discharge, a very red eye, and on bio microscopy there are numerous white cells and desquamated [[epithelial cell]]s seen in the tear duct along the lid margin. The tarsal conjunctiva is a velvety red and not particularly follicular. Non-pyogenic infections can show just mild infection and be difficult to diagnose. Scarring of the tarsal conjunctiva is occasionally seen in chronic infections, especially in trachoma.
 
'''Chemical conjunctivitis'''
''Irritant'' or ''toxic conjunctivitis'' is irritable or painful when the infected eye is pointed far down or far up. Discharge and itch are usually absent. This is the only group in which severe pain may occur.
 
''Irritant''  or ''toxic conjunctivitis'' show primarily marked redness. If due to splash injury, it is often present only in the lower conjunctival sac.  With some chemicals—above all with caustic alkalis such as [[sodium hydroxide]]—there may be necrosis of the conjunctiva with a deceptively white eye due to vascular closure, followed by sloughing of the dead epithelium. This is likely to be associated with slit-lamp evidence of [[iritis|anterior uveitis]].
 
'''Other'''
''Inclusion conjunctivitis of the newborn'' (ICN) is a conjunctivitis that may be caused by the bacteria ''[[Chlamydia trachomatis]]'', and may lead to acute, purulent conjunctivitis.<ref name=Microbiology> {{cite book |author=Fisher, Bruce; Harvey, Richard P.; Champe, Pamela C. |title=Lippincott's Illustrated Reviews: Microbiology (Lippincott's Illustrated Reviews Series) |publisher=Lippincott Williams & Wilkins |location=Hagerstown, MD |year= 2007|pages= |isbn=0-7817-8215-5 |oclc= |doi=}}  </ref> However, it is usually self-healing.<ref name=Microbiology/>
 
Conjunctivitis is identified by irritation and redness of the conjunctiva. Except in obvious [[pyogenic]] or toxic/chemical conjunctivitis, a [[slit lamp]] (biomicroscope) is needed to have any confidence in the diagnosis. Examination of the tarsal conjunctiva is usually more diagnostic than the bulbar conjunctiva.
 
==What are the causes of conjunctivitis?==
 
Conjunctivitis is most commonly caused by viruses, often [[adenovirus]], but many other factors can lead to its occurrence.  Other causes include:
* Allergies (allergic conjunctivitis)
* Bacteria
* Certain diseases
* Certain diseases
* Chemical exposure
* Chemical exposure
* Chlamydia
* [[Chlamydia]]
* Fungi
* [[Fungi]]
* Parasites (rarely)
* [[Parasites]] (rarely)
* Use of contact lenses (especially extended-wear lenses)
* Use of [[contact lenses]] (especially extended-wear lenses)
Conjunctivitis is spread from person-to-person by:
* Direct contact with the infected person’s [[eye]] drainage or drainage from the person’s [[cough]], [[sneeze]], or [[runny nose]].
* Indirect contact with objects that may have the infected person’s drainage on them (e.g. eye makeup applicators, towels, shared eye medications).
* Contact with the infected person’s [[fingers]] or [[hands]] which may contain the [[virus]] or [[bacteria]].
[[Newborns]] can be infected by [[bacteria]] in the [[birth canal]]. This condition is called [[ophthalmia neonatorum]], and it must be treated immediately to preserve [[eyesight]].  Additionally, [[neonatal]] conjunctivitis is a red eye in a [[newborn]] caused by [[irritation]], a blocked [[tear duct]], or [[infection]].


Additionally, newborns can be infected by bacteria in the birth canal. This condition is called ophthalmia neonatorum, and it must be treated immediately to preserve eyesight.
==Who is at highest risk?==
People who are exposed to someone infected with the [[viral]] or [[bacterial]] form of conjunctivitis are at risk for developing conjunctivitis.  [[Children]] and [[adults]] can develop both [[bacterial]] and [[viral]] conjunctivitis, however bacterial conjunctivitis is more common in young [[children]]. 
Additionally, [[babies]] born to [[mothers]] infected with either [[Neisseria gonorrhoeae]] or [[Chlamydia trachomatis]] are at an increased risk for conjunctivitis.  During [[delivery]], these babies can contract [[ophthalmia neonatorum]], a form of bacterial conjunctivitis when their [[eyes]] are exposed to the [[bacteria]] in the [[birth canal]]. It must be treated immediately to prevent [[blindness]].


Commonly, conjunctival infections are passed from person-to-person due to lack of [[hygiene]] measures.
==When to seek urgent medical care?==
Urgent medical care is not usually necessary for conjunctivitis.  However, newborns with [[ophthalmia neonatorum]] must be treated immediately to prevent blindness.  


==Who is at risk for conjunctivitis?==
==Diagnosis==
Conjunctivitis may make you feel like you have something in your [[eye|eye(s)]] that you cannot get out.  Your eyes may feel crusted over or pasted shut when you wake up in the morning and there may be a discharge coming from the [[eyes]].  If the discharge has a yellow-greenish color, the cause of [[infection]] is more likely to be [[bacterial]].  The whites of the [[eyes]] usually have a pink or reddish cast to them.  Other symptoms include:
* Eye [[pain]]
* Increased [[tear|tearing]]
* Itching of the [[eye]]
* Sensitivity to light
Except in obvious [[pyogenic]] (pus-producing) or toxic/chemical conjunctivitis, a [[slit lamp]] (biomicroscope) is needed to have any confidence in the [[diagnosis]].  Even after [[Slit lamp|biomicroscopy]], laboratory tests are often necessary if proof of [[etiology]] is needed. Call for an appointment with your health care provider if your symptoms last longer than 3 or 4 days.


People who are exposed to someone infected with the viral or bacterial form of conjunctivitis are at risk for developing conjunctivitis. Children and adults can develop both bacterial and viral conjunctivitis, however bacterial conjunctivitis is more common in young children.
==Treatment options==
 
Treatment varies by the type of conjunctivitis under consideration:
Additionally, babies born to mothers infected with either [[Neisseria gonorrhoeae]] or [[Chlamydia trachomatis]] are at an increased risk for conjunctivitis.  During delivery, these babies can contract [[ophthalmia neonatorum]], a form of bacterial conjunctivitis when their eyes are exposed to the bacterial in the birth canal. It must be treated immediately to prevent blindness.
*'''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, [[NSAID|non-steroidal anti-inflammatory medications]] and [[antihistamine]]s may be prescribed. Persistent [[allergic conjunctivitis]] may also require topical [[steroid]] drops.
 
*'''Bacterial:''' Bacterial conjunctivitis usually resolves without [[treatment]].  [[Antibiotics]] eye drops or [[ointment]] are thus only needed if no improvement is observed after 3 days. Even though [[antibiotics]] speed recovery time ( from 4.6 days to 3.3 days) no serious effects were noted either with or without [[]treatment]].
==How to know you have conjunctivitis?==
*'''Viral:''' Although there is no specific [[treatment]] for [[viral]] conjunctivitis, symptomatic relief may be achieved with cold compresses and artificial tears. People are often advised to avoid touching their [[eyes]] or sharing towels and washcloths.
*'''Chemical:''' Conjunctivitis due to [[chemicals]] is treated via [[irrigation]] with [[Ringer's lactate]] or [[saline (medicine)|saline solution]]. Chemical injuries (particularly [[alkali]] burns) are medical emergencies as they can lead to severe [[scarring]], and intraocular damage.


==When to seek urgent medical care==
==Where to find medical care for (Conjunctivitis)?==
[http://maps.google.com/maps?q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|map+top+hospital+Conjunctivitis}}}}&oe=utf-8&rls=org.mozilla:en-US:official&client=firefox-a&um=1&ie=UTF-8&sa=N&hl=en&tab=wl Directions to Hospitals Treating Conjunctivitis]


==Treatment options==
==What to expect (Outlook/Prognosis)?==
The outcome is usually good with [[treatment]].  Conjunctivitis resolves, in 65% of cases, within 2 – 5 days.
==Possible complications==
Reinfection within a household or school may occur if you don't follow preventive measures.


==Diseases with similar symptoms==
==Diseases with similar symptoms==
 
Diseases with symptoms similar to conjunctivitis include:
==Where to find medical care for conjunctivitis==
* [[Keratoconjunctivitis sicca]]
[http://maps.google.com/maps?f=q&amp;hl=en&amp;geocode=&amp;q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|conjunctivitis}}}}&amp;sll=37.0625,-95.677068&amp;sspn=65.008093,112.148438&amp;ie=UTF8&amp;ll=37.0625,-95.677068&amp;spn=91.690419,149.414063&amp;z=2&amp;source=embed Directions to Hospitals Treating conjunctivitis]
* [[Trachoma]]


==Prevention of conjunctivitis==
==Prevention of conjunctivitis==
 
Good [[hygiene]] can help prevent the spread of conjunctivitis:
Good hygiene can help prevent the spread of conjunctivitis:
 
* Change pillowcases frequently.
* Change pillowcases frequently.
* Do not share eye cosmetics.
* Change towels and wash cloths daily.
* Do not share towels or handkerchiefs.
* Do not share personal articles that come in contact with the [[eyes]] (e.g. eye make-up applicators, towels, wash cloths, eye droppers)
* Handle and clean contact lenses properly.
* Handle and clean [[contact lenses]] properly.
* Keep hands away from the eye.
* Keep hands away from the [[eye]].
* Replace eye cosmetics regularly.
* Replace [[eye]] cosmetics regularly.
* Wash your hands often.
* Wash your [[hands]] often.
 
* Always wash [[hands]] with soap and water or an alcohol based hand sanitizer prior to and following contact with a person who has conjunctivitis.
==What to expect (Outlook/Prognosis)==
 
==Sources==
==Sources==
http://www.nlm.nih.gov/medlineplus/ency/article/001010.htm
http://www.nlm.nih.gov/medlineplus/ency/article/001010.htm


http://www.in.gov/isdh/21205.htm
http://www.in.gov/isdh/21205.htm
<references />


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{{WH}}
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[[Category:Patient Information]]
[[Category:Patient information]]
[[Category:Inflammations]]
[[Category:Ophthalmology]]
[[Category:Overview complete]]
[[Category:Disease]]
[[Category:Emergency medicine]]
[[Category:Up-To-Date]]
[[Category:Infectious disease]]

Latest revision as of 21:06, 29 July 2020

For the WikiDoc page for this topic, click here

Conjunctivitis (patient information)

Overview

What are the symptoms?

What causes Conjunctivitis?

Who is at highest risk?

When to seek urgent medical care?

Diagnosis

Treatment options

Where to find medical care for (Conjunctivitis)?

What to expect (Outlook/Prognosis)?

Diseases with similar symptoms

Prevention

Conjunctivitis (patient information) On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Conjunctivitis (patient information)

CDC on Conjunctivitis (patient information)

Conjunctivitis (patient information) in the news

Blogs on Conjunctivitis (patient information)

Directions to Hospitals Treating Conjunctivitis (patient information)

Risk calculators and risk factors for Conjunctivitis (patient information)

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Conjunctivitis (commonly called "pink eye" or "Madras eye"is an acute inflammation of the conjunctiva (the outermost layer of the eye and the inner surface of the eyelids), most commonly due to an allergic reaction or an infection (usually viral, but sometimes bacterial. Conjunctivitis is an irritating and fairly common condition, but rarely causes long term eye or vision damage.

What are the symptoms of Conjunctivitis?

Redness (hyperaemia), irritation (chemosis) and watering (epiphora) of the eyes are symptoms common to all forms of conjunctivitis. Additionally, symptoms vary based on the specific type of conjunctivitis:

  • Allergic conjunctivitis: Allergic conjunctivitis is typically itchy, sometimes distressingly so, and often involves some eye swelling. Chronic allergy often causes just itching or irritation. Allergic conjunctivitis often causes pale watery swelling of the conjunctiva and sometimes the whole eyelid. There is frequently a sticky mucus discharge, and there is variable redness.
  • Viral conjunctivitis: Viral conjunctivitis is often associated with an infection of the upper respiratory tract, a common cold, and/or a sore throat. Its symptoms include watery discharge and variable itch. The infection usually begins with one eye, but may spread easily to the other. Viral conjunctivitis is commonly known as "pink eye."
  • Bacterial conjunctivitis: Bacterial conjunctivitis due to the common pyogenic (pus-producing) bacteria causes marked grittiness/irritation and a stringy, opaque, grey or yellowish mucopurulent discharge (mucus, gowl, goop, gunk, eye crust, or other regional names, officially known as 'gound') that may cause the lids to stick together (matting), especially after sleeping. Another symptom that could be caused by bacterial conjunctivitis is severe crusting of the infected eye and the surrounding skin. However, discharge is not essential to the diagnosis, contrary to popular belief. Bacteria such as Chlamydia trachomatis or Moraxella can cause a non-exudative but persistent conjunctivitis without much redness. 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. Like viral conjunctivitis, it usually affects only one eye but may spread easily to the other eye. However, it is dormant in the eye for three days before the patient shows signs of symptoms.
  • Chemical conjunctivitis:Irritant or toxic conjunctivitis is irritable or painful when the infected eye is pointed far down or far up. Discharge and itch are usually absent. It show primarily marked redness. This is the only group in which severe pain may occur.

What causes Conjunctivitis?

Conjunctivitis is most commonly caused by viruses, often adenovirus, but many other factors can lead to its occurrence. Other causes include:

Conjunctivitis is spread from person-to-person by:

  • Direct contact with the infected person’s eye drainage or drainage from the person’s cough, sneeze, or runny nose.
  • Indirect contact with objects that may have the infected person’s drainage on them (e.g. eye makeup applicators, towels, shared eye medications).
  • Contact with the infected person’s fingers or hands which may contain the virus or bacteria.

Newborns can be infected by bacteria in the birth canal. This condition is called ophthalmia neonatorum, and it must be treated immediately to preserve eyesight. Additionally, neonatal conjunctivitis is a red eye in a newborn caused by irritation, a blocked tear duct, or infection.

Who is at highest risk?

People who are exposed to someone infected with the viral or bacterial form of conjunctivitis are at risk for developing conjunctivitis. Children and adults can develop both bacterial and viral conjunctivitis, however bacterial conjunctivitis is more common in young children. Additionally, babies born to mothers infected with either Neisseria gonorrhoeae or Chlamydia trachomatis are at an increased risk for conjunctivitis. During delivery, these babies can contract ophthalmia neonatorum, a form of bacterial conjunctivitis when their eyes are exposed to the bacteria in the birth canal. It must be treated immediately to prevent blindness.

When to seek urgent medical care?

Urgent medical care is not usually necessary for conjunctivitis. However, newborns with ophthalmia neonatorum must be treated immediately to prevent blindness.

Diagnosis

Conjunctivitis may make you feel like you have something in your eye(s) that you cannot get out. Your eyes may feel crusted over or pasted shut when you wake up in the morning and there may be a discharge coming from the eyes. If the discharge has a yellow-greenish color, the cause of infection is more likely to be bacterial. The whites of the eyes usually have a pink or reddish cast to them. Other symptoms include:

Except in obvious pyogenic (pus-producing) or toxic/chemical conjunctivitis, a slit lamp (biomicroscope) is needed to have any confidence in the diagnosis. Even after biomicroscopy, laboratory tests are often necessary if proof of etiology is needed. Call for an appointment with your health care provider if your symptoms last longer than 3 or 4 days.

Treatment options

Treatment varies by the type of conjunctivitis under consideration:

Where to find medical care for (Conjunctivitis)?

Directions to Hospitals Treating Conjunctivitis

What to expect (Outlook/Prognosis)?

The outcome is usually good with treatment. Conjunctivitis resolves, in 65% of cases, within 2 – 5 days.

Possible complications

Reinfection within a household or school may occur if you don't follow preventive measures.

Diseases with similar symptoms

Diseases with symptoms similar to conjunctivitis include:

Prevention of conjunctivitis

Good hygiene can help prevent the spread of conjunctivitis:

  • Change pillowcases frequently.
  • Change towels and wash cloths daily.
  • Do not share personal articles that come in contact with the eyes (e.g. eye make-up applicators, towels, wash cloths, eye droppers)
  • Handle and clean contact lenses properly.
  • Keep hands away from the eye.
  • Replace eye cosmetics regularly.
  • Wash your hands often.
  • Always wash hands with soap and water or an alcohol based hand sanitizer prior to and following contact with a person who has conjunctivitis.

Sources

http://www.nlm.nih.gov/medlineplus/ency/article/001010.htm

http://www.in.gov/isdh/21205.htm

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