Conjunctivitis differential diagnosis: Difference between revisions

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Revision as of 13:14, 24 June 2016

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

Overview

Conjunctivitis symptoms and signs are relatively non-specific. Even after biomicrosopy, laboratory tests are often necessary to determine the underlying pathophysiology with certainty. perform an eye examination can help to differentiating Conjunctivitis from other medical conditions.

Bacterial Conjunctivitis

A purulent discharge strongly suggests bacterial cause, unless there is known exposure to toxins. Infection with Neisseria gonorrhoeae and chlamydia trachomatis should be suspected if the discharge is particularly thick and copious. Bacterial Conjunctivitis must be differentiated from:

Viral Conjunctivitis

A diffuse, highly contagious, characterized by watery discharge, less "injected" conjunctivitis (looking pink rather than red) suggests a viral cause, especially if numerous follicles are present on the lower tarsal conjunctiva on biomicroscopy. Viral Conjunctivitis must be differentiated from:

Allergic conjunctivitis

Allergic Conjunctivitis must be differentiated from:

Viral and Bacterial Conjunctivitis

Allergic conjunctivitis has a protracted course, with the severity of symptoms waxing and waning throughout the allergy season. As recurrences within a short period of time are unlikely with bacterial or viral conjunctivitis.

Keratoconjunctivitis sicca=

The differential diagnoses for dry eye syndrome (DES), or keratoconjunctivitis sicca

References

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 {{CMG}}
 {{Conjunctivitis}}
 ==Overview==
-Conjunctivitis must be differentiated from [[keratoconjunctivitis sicca]], [[trachoma]], dry eye, [[glaucoma]], [[uveitis]], and [[keratitis]].
+Conjunctivitis symptoms and signs are relatively non-specific. Even after [[biomicrosopy]], laboratory tests are often necessary to determine the underlying pathophysiology with certainty. perform an eye examination can help to differentiating Conjunctivitis from other medical conditions.
-==Differentiating Conjunctivitis from other Diseases==
-Conjunctivitis symptoms and signs are relatively non-specific. Even after [[biomicrosopy]], laboratory tests are often necessary to determine the underlying pathophysiology with certainty.
-===Bacterial Causes===
-A purulent discharge strongly suggests bacterial cause, unless there is known exposure to toxins. Infection with ''[[Neisseria gonorrhoeae]]'' should be suspected if the discharge is particularly thick and copious.
-===Viral Causes===
+===Bacterial Conjunctivitis===
-A diffuse, less "injected" conjunctivitis (looking pink rather than red) suggests a viral cause, especially if numerous follicles are present on the lower tarsal conjunctiva on biomicroscopy.
+A purulent discharge strongly suggests bacterial cause, unless there is known exposure to toxins. Infection with ''[[Neisseria gonorrhoeae]]'' and ''[[chlamydia trachomatis]]'' should be suspected if the discharge is particularly thick and copious. [[Bacterial Conjunctivitis]] must be differentiated from:
+*[[keratoconjunctivitis sicca]]
+*[[glaucoma]]
+*[[uveitis]]
+*[[iritis]]
+*[[keratitis]].
-===Trachoma===
+===Viral Conjunctivitis===
-Scarring of the tarsal conjunctiva suggests [[trachoma]], especially if seen in endemic areas, if the scarring is linear (von Arlt's line), or if there is also corneal vascularisation.
+A diffuse, highly contagious, characterized by watery discharge, less "injected" conjunctivitis (looking pink rather than red) suggests a viral cause, especially if numerous follicles are present on the lower tarsal conjunctiva on biomicroscopy. [[Viral Conjunctivitis]]  must be differentiated from:
+*[[keratoconjunctivitis]]
+*[[Nasolacrimal duct obstruction]]
+*[[Foreign body]]
+*[[keratitis]]
+*[[uveitis]]
+*[[Pharyngoconjunctival fever]]
-===Dry Eye Variants===
+===Allergic conjunctivitis===
-Clinical tests for lagophthalmos, dry eye (Schirmer test) and unstable tear film may help distinguish the various types of dry eye.
+Allergic Conjunctivitis  must be differentiated from:
+*[[Viral]] and [[Bacterial Conjunctivitis]]
+Allergic conjunctivitis has a protracted course, with the severity of symptoms waxing and waning throughout the allergy season. As recurrences within a short period of time are unlikely with bacterial or viral conjunctivitis.
-===Serious Illnesses such as [[Glaucoma]], [[Uveitis]], [[Keratitis]] and even [[Meningitis]] or [[Caroticocavernous Fistula]]===
+===Keratoconjunctivitis sicca====
+The differential diagnoses for dry eye syndrome (DES), or keratoconjunctivitis sicca
-Other symptoms including pain, blurring of vision and [[photophobia]] should not be prominent in conjunctivitis. Fluctuating blurring is common, due to tearing and mucoid discharge.  Mild photophobia is common.  However, if any of these symptoms are prominent, it is important to exclude other diseases such as [[glaucoma]], [[uveitis]], [[keratitis]] and even [[meningitis]] or [[caroticocavernous fistula]].
 ==References==