Conjunctivitis secondary prevention: Difference between revisions

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==Overview==
==Overview==
There is no established method for secondary prevention of conjunctivitis except among newborns. Secondary prevention strategies following allergic conjunctivitis include  
[[Secondary prevention]] strategies following conjunctivitis include discontinued [[contact lens]] wear (infective conjunctivitis), ocular [[prophylaxis]] with 0.5% [[erythromycin]] ointment or 1% [[tetracycline hydrochloride]] ([[ophthalmia neonatorum]]), and avoiding the offending [[antigen]] ([[allergic conjunctivitis]]).  
Educating patients about disease process and [[precipitating factors]] is very important.There is no established method for secondary prevention of allergic conjunctivitis. however,  identify the [[allergen]] and avoid the offending [[antigen] is very important. In [[keratoconjunctivitis sicca|keratoconjunctivitis sicca (dry eye syndrome)]] and superior limbic keratoconjunctivitis, educating patients about disease process and [[precipitating factors]] may be help prevent the progression of disease and possible [[morbidity]].  
Secondary prevention strategies following [[keratoconjunctivitis sicca|keratoconjunctivitis sicca (dry eye syndrome)]] include avoiding very dry environments, dusty areas, and prolonged [[visual]] tasks. There is no established method for secondary prevention of [[superior limbic keratoconjunctivitis|superior limbic keratoconjunctivitis (SLK)]]. However, educating patients about disease process can improve [[compliance]] of patients with treatment, and help them to cope with the often prolonged [[symptoms]].<ref name="pmid17696792">{{cite journal| author=Rose P| title=Management strategies for acute infective conjunctivitis in primary care: a systematic review. | journal=Expert Opin Pharmacother | year= 2007 | volume= 8 | issue= 12 | pages= 1903-21 | pmid=17696792 | doi=10.1517/14656566.8.12.1903 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17696792  }} </ref><ref name="pmid24235191">{{cite journal| author=Matejcek A, Goldman RD| title=Treatment and prevention of ophthalmia neonatorum. | journal=Can Fam Physician | year= 2013 | volume= 59 | issue= 11 | pages= 1187-90 | pmid=24235191 | doi= | pmc=3828094 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24235191  }} </ref><ref name="pmid23497516">{{cite journal| author=La Rosa M, Lionetti E, Reibaldi M, Russo A, Longo A, Leonardi S et al.| title=Allergic conjunctivitis: a comprehensive review of the literature. | journal=Ital J Pediatr | year= 2013 | volume= 39 | issue=  | pages= 18 | pmid=23497516 | doi=10.1186/1824-7288-39-18 | pmc=3640929 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23497516  }} </ref><ref name="pmid25686388">{{cite journal| author=Messmer EM| title=The pathophysiology, diagnosis, and treatment of dry eye disease. | journal=Dtsch Arztebl Int | year= 2015 | volume= 112 | issue= 5 | pages= 71-81; quiz 82 | pmid=25686388 | doi=10.3238/arztebl.2015.0071 | pmc=4335585 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25686388  }} </ref><ref name="pmid2695351">{{cite journal| author=Nelson JD| title=Superior limbic keratoconjunctivitis (SLK). | journal=Eye (Lond) | year= 1989 | volume= 3 ( Pt 2) | issue=  | pages= 180-9 | pmid=2695351 | doi=10.1038/eye.1989.26 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2695351  }} </ref>
 
==Secondary Prevention==
==Secondary Prevention==
Routine use of 0.5% erythromycin, or 1% tetracycline ophthalmic ointments or drops instilled into each eye after delivery effectively prevents gonococcal ophthalmia. However, none of these agents prevents ''chlamydial'' [[ophthalmia neonatorum]]; povidone iodine 2.5% drops may be effective against chlamydia and gonococci but is not available in the US.<ref name="pmid24235191">{{cite journal| author=Matejcek A, Goldman RD| title=Treatment and prevention of ophthalmia neonatorum. | journal=Can Fam Physician | year= 2013 | volume= 59 | issue= 11 | pages= 1187-90 | pmid=24235191 | doi= | pmc=3828094 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24235191  }} </ref>
===Infective Conjunctivitis===
Effective measure for the [[secondary prevention]] of infective conjunctivitis include:<ref name="pmid17696792">{{cite journal| author=Rose P| title=Management strategies for acute infective conjunctivitis in primary care: a systematic review. | journal=Expert Opin Pharmacother | year= 2007 | volume= 8 | issue= 12 | pages= 1903-21 | pmid=17696792 | doi=10.1517/14656566.8.12.1903 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17696792  }} </ref>
* Discontinued [[contact lens]] wear
 
===Neonatal Conjunctivitis===
Effective measures for the secondary prevention of ophthalmia neonatorum include:<ref name="pmid24235191">{{cite journal| author=Matejcek A, Goldman RD| title=Treatment and prevention of ophthalmia neonatorum. | journal=Can Fam Physician | year= 2013 | volume= 59 | issue= 11 | pages= 1187-90 | pmid=24235191 | doi= | pmc=3828094 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24235191 }} </ref><ref name=CDC-Ophth>Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2010. MMWR Morb Mortal Wkly Rep 2010;59 (No. RR-12):55.</ref>
*Prompt diagnosis
*Initiate appropriate and aggressive treatment
 
===Allergic conjunctivitis===
Effective measures for the secondary prevention of [[allergic conjunctivitis]] include:<ref name="pmid23497516">{{cite journal| author=La Rosa M, Lionetti E, Reibaldi M, Russo A, Longo A, Leonardi S et al.| title=Allergic conjunctivitis: a comprehensive review of the literature. | journal=Ital J Pediatr | year= 2013 | volume= 39 | issue=  | pages= 18 | pmid=23497516 | doi=10.1186/1824-7288-39-18 | pmc=3640929 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23497516  }} </ref>
* Avoiding the offending [[antigen]]
* Discontinued contact lens wear
===Keratoconjunctivitis Sicca===
Effective measures for the secondary prevention of [[keratoconjunctivitis sicca|keratoconjunctivitis sicca (dry eye syndrome)]] include:<ref name="pmid25686388">{{cite journal| author=Messmer EM| title=The pathophysiology, diagnosis, and treatment of dry eye disease. | journal=Dtsch Arztebl Int | year= 2015 | volume= 112 | issue= 5 | pages= 71-81; quiz 82 | pmid=25686388 | doi=10.3238/arztebl.2015.0071 | pmc=4335585 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25686388  }} </ref>
*Avoiding very dry environments (furnaces and air conditioning can dry the air)
*Using a humidifier (puts moisture back into the air to prevent [[dry eyes]])
*Avoiding dusty and smoky areas
*Avoiding prolonged [[visual]] tasks (staring at a computer screen, driving, watching television, and reading)
 
===Superior Limbic Keratoconjunctivitis===
There is no established method for secondary prevention of [[superior limbic keratoconjunctivitis|superior limbic keratoconjunctivitis (SLK)]]. However, educating patients about disease process can improve [[compliance]] of patients with treatment, and help them to cope with the often prolonged [[symptoms]].<ref name="pmid2695351">{{cite journal| author=Nelson JD| title=Superior limbic keratoconjunctivitis (SLK). | journal=Eye (Lond) | year= 1989 | volume= 3 ( Pt 2) | issue=  | pages= 180-9 | pmid=2695351 | doi=10.1038/eye.1989.26 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2695351 }} </ref>


There is no established method for secondary prevention in other subtypes of conjunctivitis. however, it may be helpful to consider following secondary prevention strategies such as:
* Discontinued [[contact lens]] wear (infective conjunctivitis and [[allergic conjunctivitis]])
* Identify the [[allergen]] and avoid the offending [[antigen]] ([[allergic conjunctivitis]])
*Avoid very dry environments (keratoconjunctivitis sicca)
*Use a humidifier (keratoconjunctivitis sicca)
*Avoid dusty and smoky areas (keratoconjunctivitis sicca)
*Avoid prolonged visual tasks such as staring at a computer screen, driving, watching television, and reading (keratoconjunctivitis sicca)
*Promptly use [[artificial tears]] (keratoconjunctivitis sicca)
*Educating patient about disease process  ([[keratoconjunctivitis sicca|keratoconjunctivitis sicca (dry eye syndrome)]] and superior limbic keratoconjunctivitis)
==References==
==References==
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[[Category:Ophthalmology]]
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Latest revision as of 21:07, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [2]

Overview

Secondary prevention strategies following conjunctivitis include discontinued contact lens wear (infective conjunctivitis), ocular prophylaxis with 0.5% erythromycin ointment or 1% tetracycline hydrochloride (ophthalmia neonatorum), and avoiding the offending antigen (allergic conjunctivitis). Secondary prevention strategies following keratoconjunctivitis sicca (dry eye syndrome) include avoiding very dry environments, dusty areas, and prolonged visual tasks. There is no established method for secondary prevention of superior limbic keratoconjunctivitis (SLK). However, educating patients about disease process can improve compliance of patients with treatment, and help them to cope with the often prolonged symptoms.[1][2][3][4][5]

Secondary Prevention

Infective Conjunctivitis

Effective measure for the secondary prevention of infective conjunctivitis include:[1]

Neonatal Conjunctivitis

Effective measures for the secondary prevention of ophthalmia neonatorum include:[2][6]

  • Prompt diagnosis
  • Initiate appropriate and aggressive treatment

Allergic conjunctivitis

Effective measures for the secondary prevention of allergic conjunctivitis include:[3]

  • Avoiding the offending antigen
  • Discontinued contact lens wear

Keratoconjunctivitis Sicca

Effective measures for the secondary prevention of keratoconjunctivitis sicca (dry eye syndrome) include:[4]

  • Avoiding very dry environments (furnaces and air conditioning can dry the air)
  • Using a humidifier (puts moisture back into the air to prevent dry eyes)
  • Avoiding dusty and smoky areas
  • Avoiding prolonged visual tasks (staring at a computer screen, driving, watching television, and reading)

Superior Limbic Keratoconjunctivitis

There is no established method for secondary prevention of superior limbic keratoconjunctivitis (SLK). However, educating patients about disease process can improve compliance of patients with treatment, and help them to cope with the often prolonged symptoms.[5]

References

  1. 1.0 1.1 Rose P (2007). "Management strategies for acute infective conjunctivitis in primary care: a systematic review". Expert Opin Pharmacother. 8 (12): 1903–21. doi:10.1517/14656566.8.12.1903. PMID 17696792.
  2. 2.0 2.1 Matejcek A, Goldman RD (2013). "Treatment and prevention of ophthalmia neonatorum". Can Fam Physician. 59 (11): 1187–90. PMC 3828094. PMID 24235191.
  3. 3.0 3.1 La Rosa M, Lionetti E, Reibaldi M, Russo A, Longo A, Leonardi S; et al. (2013). "Allergic conjunctivitis: a comprehensive review of the literature". Ital J Pediatr. 39: 18. doi:10.1186/1824-7288-39-18. PMC 3640929. PMID 23497516.
  4. 4.0 4.1 Messmer EM (2015). "The pathophysiology, diagnosis, and treatment of dry eye disease". Dtsch Arztebl Int. 112 (5): 71–81, quiz 82. doi:10.3238/arztebl.2015.0071. PMC 4335585. PMID 25686388.
  5. 5.0 5.1 Nelson JD (1989). "Superior limbic keratoconjunctivitis (SLK)". Eye (Lond). 3 ( Pt 2): 180–9. doi:10.1038/eye.1989.26. PMID 2695351.
  6. Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2010. MMWR Morb Mortal Wkly Rep 2010;59 (No. RR-12):55.

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