Conjunctivitis history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Sara Mehrsefat, M.D. [2]
Overview
The symptoms of conjunctivitis differ based on the cause of the inflammation. Redness, excessive tearing, and irritation are symptoms common to all forms of conjunctivitis. Photophobia, itching, mucopurulent or non-purulent discharge, chemosis, burning eyes, blurred vision and eyelid swelling are variable.
History
Complete history will help determine the correct therapy. A detailed and thorough history from the patient is necessary. The history of a patient with conjunctivitis should include a thorough ocular, medical and medication history. The history establish whether the condition is acute, subacute, chronic or recurrent, and whether it is associated with any specific environmental or work-related exposure.
Viral Conjunctivitis
Specific areas of focus when obtaining a history from the patient include:
- Exposure history
- History of a recent upper respiratory infection (URI)
- Swimming in contaminated pools
- Contact lens use
Bacterial Conjunctivitis
Specific areas of focus when obtaining a history from the patient include:
- History of sexually transmitted disease (STD)
- Exposure history (contaminated fingers, oculogenital spread, and contaminated fomites)
- Contact lens use
Neonatal Conjunctivitis
Specific areas of focus when obtaining a history from the patient include:
- History of sexually transmitted disease (STD) in mother
- Ocular prophylaxis with silver nitrate
Allergic Conjunctivitis
Specific areas of focus when obtaining a history from the patient include:
- Family history of atopic disease such as:
Keratoconjunctivitis Sicca
Specific areas of focus when obtaining a history from the patient include:
- History of connective tissue disease
- History of sjögren syndrome
- History of rheumatoid arthritis
- History of thyroid abnormalities
- Contact lens use
- History of neurologic conditions (stroke, Bell's palsy, Parkinson's, trigeminal nerve problem)
Superior limbic keratoconjunctivitis
Specific areas of focus when obtaining a history from the patient include:
- Prolonged condition with gradual clearing
- Often have seen numerous eye specialists
Symptoms
Viral Conjunctivitis
Acute or subacute onset. Symptoms of viral conjunctivitis may include the following:
Pharyngoconjunctival Fever
- High fever
- Pharyngitis
- Bilateral conjunctivitis
- Periauricular lymphadenopathy
- Itchy eyes
- Tearing
- Minimal pain level
- Light sensitivity (with corneal involvement)
Epidemic Keratoconjunctivitis
- Watery discharge
- Hyperemia
- Chemosis
- Ipsilateral lymphadenopathy
- Itchy eyes
- Tearing
- Minimal pain level
Acute Hemorrhagic Conjunctivitis
- Chemosis
- Tearing
- Redness
- Severe pain level
- Purulent discharge
- Subconjunctival hemorrhaging
Bacterial Conjunctivitis
Hyperacute, acute, and chronic onset. Symptoms of bacterial conjunctivitis may include the following:
Hyperacute Bacterial Conjunctivitis
- Chemosis
- Tearing
- Redness
- Eye pain
- Decreased vision
- Severe purulent discharge
- Preauricular lymphadenopathy
Neonatal Conjunctivitis
Symptoms of neonatal bacterial conjunctivitis|neonatal bacterial conjunctivitis or ophthalmia neonatorum may include the following:[1]
Gonococcal Conjunctivitis
Chlamydial Conjunctivitis
Allergic Conjunctivitis
Symptoms of allergic conjunctivitis may include the following:
- Itchy eyes (most impotant)
- Tearing
- Bilateral redness
- Watery discharge
- Photophobia (with corneal involvement)
- Foreign body sensation
Keratoconjunctivitis Sicca
Symptoms of keratoconjunctivitis sicca (dry eye syndrome) may include the following:
- Foreign-body sensation
- Grittiness
- Hyperemia
- Mucoid discharge
- Excessive tearing (secondary to reflex secretion)
- Photophobia
- Itchy eye
- Fluctuating] blurry vision
- Malaise
- Weight loss
Superior Limbic Keratoconjunctivitis
Symptoms of superior limbic keratoconjunctivitis may include the following:
- Foreign body sensation
- Photophobia
- Excessive blinking
- Burning sensation
- Itchy eye
- Dry eye sensation