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==Overview==
==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. Complete history will help determine whether the condition is associated with any specific environmental or work-related exposure.<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="pmid10922425">{{cite journal| author=Leibowitz HM| title=The red eye. | journal=N Engl J Med | year= 2000 | volume= 343 | issue= 5 | pages= 345-51 | pmid=10922425 | doi=10.1056/NEJM200008033430507 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10922425  }} </ref>


[[Image:Pinkeye_twoangles.jpg|thumb|right|225px|Eyes with conjunctivitis.]]
==History==
Redness, irritation and watering of the eyes are symptoms common to all forms of conjunctivitis. Itch and the closing of the throat is variable.
A detailed and thorough history from the patient is necessary in order to determine the correct therapy.<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>


Acute ''allergic conjunctivitis'' is typically itchy. Sometimes distressingly so, and the patient often complains of some lid swelling.  Chronic allergy often causes just itch or irritation, and often much frustration because the absence of redness or discharge can lead to accusations of [[hypochondria]].
===Viral Conjunctivitis===
Specific areas of focus when obtaining a history from the patient include:<ref name="pmid10922425">{{cite journal| author=Leibowitz HM| title=The red eye. | journal=N Engl J Med | year= 2000 | volume= 343 | issue= 5 | pages= 345-51 | pmid=10922425 | doi=10.1056/NEJM200008033430507 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10922425  }} </ref><ref name="pmid21733975">{{cite journal| author=Drug and Therapeutics Bulletin| title=Management of acute infective conjunctivitis. | journal=Drug Ther Bull | year= 2011 | volume= 49 | issue= 7 | pages= 78-81 | pmid=21733975 | doi=10.1136/dtb.2011.02.0043 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21733975  }} </ref>
*History of contact with the infected person’s eye drainage
*Recent [[upper respiratory infection|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:<ref name="pmid17585426">{{cite journal| author=| title=Bacterial conjunctivitis in children: antibiotic eye drops only if eye washing is ineffective. | journal=Prescrire Int | year= 2007 | volume= 16 | issue= 89 | pages= 120-1 | pmid=17585426 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17585426  }} </ref><ref name="pmid15195156">{{cite journal| author=Høvding G| title=[Acute bacterial conjunctivitis]. | journal=Tidsskr Nor Laegeforen | year= 2004 | volume= 124 | issue= 11 | pages= 1518-20 | pmid=15195156 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15195156  }} </ref>
*History of [[sexually transmitted disease|sexually transmitted disease (STD)]]
*History of exposure (contaminated fingers, oculogenital spread, and contaminated fomites)
*[[Contact lens]] use
*Chronic use of topical medications
===Neonatal Conjunctivitis===
Specific areas of focus when obtaining a history from the patient include:<ref name="pmid3084664">{{cite journal| author=Fransen L, Nsanze H, Klauss V, Van der Stuyft P, D'Costa L, Brunham RC et al.| title=Ophthalmia neonatorum in Nairobi, Kenya: the roles of Neisseria gonorrhoeae and Chlamydia trachomatis. | journal=J Infect Dis | year= 1986 | volume= 153 | issue= 5 | pages= 862-9 | pmid=3084664 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3084664  }} </ref><ref name="pmid25606121">{{cite journal| author=Mallika P, Asok T, Faisal H, Aziz S, Tan A, Intan G| title=Neonatal conjunctivitis - a review. | journal=Malays Fam Physician | year= 2008 | volume= 3 | issue= 2 | pages= 77-81 | pmid=25606121 | doi= | pmc=4170304 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25606121  }} </ref><ref name=Neonatal-conjunctivitis >Centers for Disease Control and Prevention (2015)[http://www.cdc.gov/conjunctivitis/newborns.html] Accessed on June 30, 2016 </ref>
*History of [[sexually transmitted disease|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:<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="pmid18282546">{{cite journal| author=Jun J, Bielory L, Raizman MB| title=Vernal conjunctivitis. | journal=Immunol Allergy Clin North Am | year= 2008 | volume= 28 | issue= 1 | pages= 59-82, vi | pmid=18282546 | doi=10.1016/j.iac.2007.12.007 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18282546  }} </ref><ref name="pmid15245362">{{cite journal| author=Bonini S| title=Atopic keratoconjunctivitis. | journal=Allergy | year= 2004 | volume= 59 Suppl 78 | issue=  | pages= 71-3 | pmid=15245362 | doi=10.1111/j.1398-9995.2004.00570.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15245362  }} </ref>
*Family history of atopic disease such as:
**[[Allergic rhinitis]]
**[[Bronchial asthma]]
**[[Atopic dermatitis]]
===Keratoconjunctivitis Sicca===
Specific areas of focus when obtaining a history from the patient include:<ref name="pmid19506195">{{cite journal| author=Schaumberg DA, Dana R, Buring JE, Sullivan DA| title=Prevalence of dry eye disease among US men: estimates from the Physicians' Health Studies. | journal=Arch Ophthalmol | year= 2009 | volume= 127 | issue= 6 | pages= 763-8 | pmid=19506195 | doi=10.1001/archophthalmol.2009.103 | pmc=2836718 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19506195  }} </ref><ref name="pmid9820935">{{cite journal| author=Stern ME, Beuerman RW, Fox RI, Gao J, Mircheff AK, Pflugfelder SC| title=The pathology of dry eye: the interaction between the ocular surface and lacrimal glands. | journal=Cornea | year= 1998 | volume= 17 | issue= 6 | pages= 584-9 | pmid=9820935 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9820935  }} </ref>
*History of [[connective tissue disease]]
**[[Sjögren's syndrome]]
**[[Rheumatoid arthritis]]
*History of [[thyroid]] abnormalities
*[[Contact lens]] use
*History of neurologic conditions ([[stroke]], [[Bell's palsy]], [[Parkinson's]], [[trigeminal nerve]] problem)
*Prior eye surgery
===Superior limbic keratoconjunctivitis===
Specific areas of focus when obtaining a history from the patient include:<ref name="pmid11914237">{{cite journal| author=Watson S, Tullo AB, Carley F| title=Treatment of superior limbic keratoconjunctivitis with a unilateral bandage contact lens. | journal=Br J Ophthalmol | year= 2002 | volume= 86 | issue= 4 | pages= 485-6 | pmid=11914237 | doi= | pmc=1771108 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11914237  }} </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>
*History of prolonged condition with gradual clearing
*History of [[thyroid]] abnormalities


<!-- Image with unknown copyright status removed: [[Image:Grosseye.jpg|thumb|right|225px|]] -->
==Symptoms==
''Viral conjunctivitis'' is often associated with an infection of the upper [[respiratory tract]], a common cold, 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 fellow eye.
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.
===Viral Conjunctivitis===
[[Adenovirus]] is the most common cause of viral conjunctivitis. It has [[acute]] or [[subacute]] onset, and often occurs in community epidemics. Both eyes may be affected simultaneously, or the second eye may become involved a few days after the first eye.
Symptoms of viral conjunctivitis may include the following:<ref name="pmid10922425">{{cite journal| author=Leibowitz HM| title=The red eye. | journal=N Engl J Med | year= 2000 | volume= 343 | issue= 5 | pages= 345-51 | pmid=10922425 | doi=10.1056/NEJM200008033430507 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10922425  }} </ref><ref name="pmid21733975">{{cite journal| author=Drug and Therapeutics Bulletin| title=Management of acute infective conjunctivitis. | journal=Drug Ther Bull | year= 2011 | volume= 49 | issue= 7 | pages= 78-81 | pmid=21733975 | doi=10.1136/dtb.2011.02.0043 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21733975  }} </ref>
*[[Fever]]
*[[Sore throat]]
*Eye redness
*Watery discharge
*Eyelids swelling
*[[Swollen lymph node]] ([[ipsilateral]])
*Itchy eyes
*Tearing
*Minimal [[eye pain]]
*[[Light sensitivity]] (with corneal involvement)
====Acute Hemorrhagic Conjunctivitis====
Acute hemorrhagic conjunctivitis (AHC) is a rapidly progressive. The infection starts [[ipsilaterally]], but rapidly involves the fellow eye within 1 or 2 days. [[Symptoms]] of acute hemorrhagic conjunctivitis may include the following:<ref name="pmid1088513">{{cite journal| author=Yin-Murphy M| title=Simple tests for the diagnosis of picornavirus epidemic conjunctivitis (acute hemorrhagic conjunctivitis). | journal=Bull World Health Organ | year= 1976 | volume= 54 | issue= 6 | pages= 675-9 | pmid=1088513 | doi= | pmc=2366581 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1088513  }} </ref>
*Eyelids swelling
*Tearing
*Eye redness
*Severe [[eye pain]]
*[[Purulent]] discharge
*Subconjunctival [[hemorrhage]]
===Bacterial Conjunctivitis===
Bacterial conjunctivitis has hyperacute, [[acute]], and [[chronic]] onset. [[Symptoms]] of bacterial conjunctivitis may include the following:<ref name="pmid17585426">{{cite journal| author=| title=Bacterial conjunctivitis in children: antibiotic eye drops only if eye washing is ineffective. | journal=Prescrire Int | year= 2007 | volume= 16 | issue= 89 | pages= 120-1 | pmid=17585426 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17585426  }} </ref><ref name="pmid15195156">{{cite journal| author=Høvding G| title=[Acute bacterial conjunctivitis]. | journal=Tidsskr Nor Laegeforen | year= 2004 | volume= 124 | issue= 11 | pages= 1518-20 | pmid=15195156 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15195156  }} </ref>
*Itchy eyes
*[[Tearing]]
*[[Eye redness]]
*Minimal eye pain
*[[Purulent]] discharge (grey or yellowish)
*Eyelids swelling


''Bacterial conjunctivitis'' due to the common [[pyogenic]] (pus-producing) bacteria causes marked grittiness/irritation and a stringy, opaque, grey or yellowish [[mucopurulent discharge]] (''gowl'', ''goop'', "gunk", ''sleep'', or other regional names) 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. Many other bacteria (e.g., ''[[Chlamydia]]'', ''[[Moraxella]]'') can cause a non-exudative but very persistent conjunctivitis without much redness. The gritty and/or scratchy feeling is sometimes localised 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.
====Hyperacute Bacterial Conjunctivitis====
Hyperacute [[bacterial]] conjunctivitis (HBC) is a severe, sight-threatening [[ocular]] infection that warrants immediate [[ophthalmic]] work-up and management. The infection has an abrupt [[onset]] and rapid progression. [[Symptoms]] of hyperacute bacterial conjunctivitis may include the following:<ref name="pmid21160459">{{cite journal| author=Workowski KA, Berman S, Centers for Disease Control and Prevention (CDC)| title=Sexually transmitted diseases treatment guidelines, 2010. | journal=MMWR Recomm Rep | year= 2010 | volume= 59 | issue= RR-12 | pages= 1-110 | pmid=21160459 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21160459  }} </ref>
*Eyelids swelling
*Tearing
*Diffuse eye redness
*[[Eye pain]]  
*Decreased vision
*Severe purulent discharge (yellow-green)
*[[Swollen lymph nodes]] (preauricular)


''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.
===Neonatal Conjunctivitis=== 
Symptoms of neonatal conjunctivitis ([[ophthalmia neonatorum]]), based on causality, may include the following:<ref name="pmid3084664">{{cite journal| author=Fransen L, Nsanze H, Klauss V, Van der Stuyft P, D'Costa L, Brunham RC et al.| title=Ophthalmia neonatorum in Nairobi, Kenya: the roles of Neisseria gonorrhoeae and Chlamydia trachomatis. | journal=J Infect Dis | year= 1986 | volume= 153 | issue= 5 | pages= 862-9 | pmid=3084664 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3084664  }} </ref><ref name="pmid25606121">{{cite journal| author=Mallika P, Asok T, Faisal H, Aziz S, Tan A, Intan G| title=Neonatal conjunctivitis - a review. | journal=Malays Fam Physician | year= 2008 | volume= 3 | issue= 2 | pages= 77-81 | pmid=25606121 | doi= | pmc=4170304 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25606121  }} </ref><ref name=Neonatal-conjunctivitis >Centers for Disease Control and Prevention (2015)[http://www.cdc.gov/conjunctivitis/newborns.html] Accessed on June 30, 2016 </ref>
====Gonococcal Conjunctivitis====
[[Gonococcal]] conjunctivitis is more severe than [[chlamydial]] conjunctivitis in [[newborns]]. The [[incubation period]] is 2-5 days. It is usually [[bilateral]]. Symptoms of gonococcal conjunctivitis may include the following:
*Severe purulent discharge ([[bilateral]])
*[[Tearing]]
*Eyelids swelling
====Chlamydial Conjunctivitis====
[[Chlamydial]] conjunctivitis has a later onset than gonococcal conjunctivitis in newborns. The [[incubation period]] is 5-14 days and the colonization of the eye after birth does not always result in infection. [[Symptoms]] of chlamydial conjunctivitis may include the following:
*[[Eye redness]]
*Watery or mild mucoid discharge
*Eyelids swelling
 
====Chemical conjunctivitis====
Chemical conjunctivitis usually occurs within 24 hours of instillation of silver nitrate solution and resolves spontaneously within a few days. Symptoms of chemical conjunctivitis may include the following:
*Eyelids swelling
*[[Eye redness]]
*[[Tearing]]
 
===Allergic Conjunctivitis===
Symptoms of [[allergic conjunctivitis]] may include the following:<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="pmid18786127">{{cite journal| author=Kumar S| title=Vernal keratoconjunctivitis: a major review. | journal=Acta Ophthalmol | year= 2009 | volume= 87 | issue= 2 | pages= 133-47 | pmid=18786127 | doi=10.1111/j.1755-3768.2008.01347.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18786127  }} </ref>
*Itchy eyes (most prominant)
*[[Tearing]]
*[[Eye redness]] ([[Bilateral]])
*Watery discharge
*[[Light sensitivity]] (with [[corneal]] involvement)
*Foreign body sensation
 
===Keratoconjunctivitis Sicca===
Symptoms of [[keratoconjunctivitis sicca|keratoconjunctivitis sicca (dry eye syndrome)]] may include the following:<ref name="pmid19506195">{{cite journal| author=Schaumberg DA, Dana R, Buring JE, Sullivan DA| title=Prevalence of dry eye disease among US men: estimates from the Physicians' Health Studies. | journal=Arch Ophthalmol | year= 2009 | volume= 127 | issue= 6 | pages= 763-8 | pmid=19506195 | doi=10.1001/archophthalmol.2009.103 | pmc=2836718 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19506195  }} </ref><ref name="pmid9820935">{{cite journal| author=Stern ME, Beuerman RW, Fox RI, Gao J, Mircheff AK, Pflugfelder SC| title=The pathology of dry eye: the interaction between the ocular surface and lacrimal glands. | journal=Cornea | year= 1998 | volume= 17 | issue= 6 | pages= 584-9 | pmid=9820935 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9820935  }} </ref><ref name="pmid16309672">{{cite journal| author=Zoukhri D| title=Effect of inflammation on lacrimal gland function. | journal=Exp Eye Res | year= 2006 | volume= 82 | issue= 5 | pages= 885-98 | pmid=16309672 | doi=10.1016/j.exer.2005.10.018 | pmc=1361268 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16309672  }} </ref>
*Foreign-body sensation
*[[Grittiness]]
*[[Hyperemia]]
*Mucoid discharge
*Excessive tearing (secondary to reflex secretion)
*[[Light sensitivity]]
*Itchy eye
*Fluctuating blurry vision
*[[Malaise]]
*[[Weight loss]]
 
===Superior Limbic Keratoconjunctivitis===
Symptoms of [[superior limbic keratoconjunctivitis|superior limbic keratoconjunctivitis (SLK)]] may include the following:ref name="pmid11914237">{{cite journal| author=Watson S, Tullo AB, Carley F| title=Treatment of superior limbic keratoconjunctivitis with a unilateral bandage contact lens. | journal=Br J Ophthalmol | year= 2002 | volume= 86 | issue= 4 | pages= 485-6 | pmid=11914237 | doi= | pmc=1771108 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11914237  }} </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>
*[[Light sensitivity]]
*Excessive [[blinking]]
*Burning sensation
*Itchy eye
*Dry eye sensation


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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. [2]; Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [3]

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. Complete history will help determine whether the condition is associated with any specific environmental or work-related exposure.[1][2]

History

A detailed and thorough history from the patient is necessary in order to determine the correct therapy.[1]

Viral Conjunctivitis

Specific areas of focus when obtaining a history from the patient include:[2][3]

Bacterial Conjunctivitis

Specific areas of focus when obtaining a history from the patient include:[4][5]

Neonatal Conjunctivitis

Specific areas of focus when obtaining a history from the patient include:[6][7][8]

Allergic Conjunctivitis

Specific areas of focus when obtaining a history from the patient include:[9][10][11]

Keratoconjunctivitis Sicca

Specific areas of focus when obtaining a history from the patient include:[12][13]

Superior limbic keratoconjunctivitis

Specific areas of focus when obtaining a history from the patient include:[14][15]

  • History of prolonged condition with gradual clearing
  • History of thyroid abnormalities

Symptoms

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.

Viral Conjunctivitis

Adenovirus is the most common cause of viral conjunctivitis. It has acute or subacute onset, and often occurs in community epidemics. Both eyes may be affected simultaneously, or the second eye may become involved a few days after the first eye. Symptoms of viral conjunctivitis may include the following:[2][3]

Acute Hemorrhagic Conjunctivitis

Acute hemorrhagic conjunctivitis (AHC) is a rapidly progressive. The infection starts ipsilaterally, but rapidly involves the fellow eye within 1 or 2 days. Symptoms of acute hemorrhagic conjunctivitis may include the following:[16]

Bacterial Conjunctivitis

Bacterial conjunctivitis has hyperacute, acute, and chronic onset. Symptoms of bacterial conjunctivitis may include the following:[4][5]

Hyperacute Bacterial Conjunctivitis

Hyperacute bacterial conjunctivitis (HBC) is a severe, sight-threatening ocular infection that warrants immediate ophthalmic work-up and management. The infection has an abrupt onset and rapid progression. Symptoms of hyperacute bacterial conjunctivitis may include the following:[17]

  • Eyelids swelling
  • Tearing
  • Diffuse eye redness
  • Eye pain
  • Decreased vision
  • Severe purulent discharge (yellow-green)
  • Swollen lymph nodes (preauricular)

Neonatal Conjunctivitis

Symptoms of neonatal conjunctivitis (ophthalmia neonatorum), based on causality, may include the following:[6][7][8]

Gonococcal Conjunctivitis

Gonococcal conjunctivitis is more severe than chlamydial conjunctivitis in newborns. The incubation period is 2-5 days. It is usually bilateral. Symptoms of gonococcal conjunctivitis may include the following:

Chlamydial Conjunctivitis

Chlamydial conjunctivitis has a later onset than gonococcal conjunctivitis in newborns. The incubation period is 5-14 days and the colonization of the eye after birth does not always result in infection. Symptoms of chlamydial conjunctivitis may include the following:

  • Eye redness
  • Watery or mild mucoid discharge
  • Eyelids swelling

Chemical conjunctivitis

Chemical conjunctivitis usually occurs within 24 hours of instillation of silver nitrate solution and resolves spontaneously within a few days. Symptoms of chemical conjunctivitis may include the following:

Allergic Conjunctivitis

Symptoms of allergic conjunctivitis may include the following:[9][18]

Keratoconjunctivitis Sicca

Symptoms of keratoconjunctivitis sicca (dry eye syndrome) may include the following:[12][13][19]

Superior Limbic Keratoconjunctivitis

Symptoms of superior limbic keratoconjunctivitis (SLK) may include the following:ref name="pmid11914237">Watson S, Tullo AB, Carley F (2002). "Treatment of superior limbic keratoconjunctivitis with a unilateral bandage contact lens". Br J Ophthalmol. 86 (4): 485–6. PMC 1771108. PMID 11914237. </ref>[15]

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 2.2 Leibowitz HM (2000). "The red eye". N Engl J Med. 343 (5): 345–51. doi:10.1056/NEJM200008033430507. PMID 10922425.
  3. ↑ 3.0 3.1 Drug and Therapeutics Bulletin (2011). "Management of acute infective conjunctivitis". Drug Ther Bull. 49 (7): 78–81. doi:10.1136/dtb.2011.02.0043. PMID 21733975.
  4. ↑ 4.0 4.1 "Bacterial conjunctivitis in children: antibiotic eye drops only if eye washing is ineffective". Prescrire Int. 16 (89): 120–1. 2007. PMID 17585426.
  5. ↑ 5.0 5.1 Høvding G (2004). "[Acute bacterial conjunctivitis]". Tidsskr Nor Laegeforen. 124 (11): 1518–20. PMID 15195156.
  6. ↑ 6.0 6.1 Fransen L, Nsanze H, Klauss V, Van der Stuyft P, D'Costa L, Brunham RC; et al. (1986). "Ophthalmia neonatorum in Nairobi, Kenya: the roles of Neisseria gonorrhoeae and Chlamydia trachomatis". J Infect Dis. 153 (5): 862–9. PMID 3084664.
  7. ↑ 7.0 7.1 Mallika P, Asok T, Faisal H, Aziz S, Tan A, Intan G (2008). "Neonatal conjunctivitis - a review". Malays Fam Physician. 3 (2): 77–81. PMC 4170304. PMID 25606121.
  8. ↑ 8.0 8.1 Centers for Disease Control and Prevention (2015)[1] Accessed on June 30, 2016
  9. ↑ 9.0 9.1 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.
  10. ↑ Jun J, Bielory L, Raizman MB (2008). "Vernal conjunctivitis". Immunol Allergy Clin North Am. 28 (1): 59–82, vi. doi:10.1016/j.iac.2007.12.007. PMID 18282546.
  11. ↑ Bonini S (2004). "Atopic keratoconjunctivitis". Allergy. 59 Suppl 78: 71–3. doi:10.1111/j.1398-9995.2004.00570.x. PMID 15245362.
  12. ↑ 12.0 12.1 Schaumberg DA, Dana R, Buring JE, Sullivan DA (2009). "Prevalence of dry eye disease among US men: estimates from the Physicians' Health Studies". Arch Ophthalmol. 127 (6): 763–8. doi:10.1001/archophthalmol.2009.103. PMC 2836718. PMID 19506195.
  13. ↑ 13.0 13.1 Stern ME, Beuerman RW, Fox RI, Gao J, Mircheff AK, Pflugfelder SC (1998). "The pathology of dry eye: the interaction between the ocular surface and lacrimal glands". Cornea. 17 (6): 584–9. PMID 9820935.
  14. ↑ Watson S, Tullo AB, Carley F (2002). "Treatment of superior limbic keratoconjunctivitis with a unilateral bandage contact lens". Br J Ophthalmol. 86 (4): 485–6. PMC 1771108. PMID 11914237.
  15. ↑ 15.0 15.1 Nelson JD (1989). "Superior limbic keratoconjunctivitis (SLK)". Eye (Lond). 3 ( Pt 2): 180–9. doi:10.1038/eye.1989.26. PMID 2695351.
  16. ↑ Yin-Murphy M (1976). "Simple tests for the diagnosis of picornavirus epidemic conjunctivitis (acute hemorrhagic conjunctivitis)". Bull World Health Organ. 54 (6): 675–9. PMC 2366581. PMID 1088513.
  17. ↑ Workowski KA, Berman S, Centers for Disease Control and Prevention (CDC) (2010). "Sexually transmitted diseases treatment guidelines, 2010". MMWR Recomm Rep. 59 (RR-12): 1–110. PMID 21160459.
  18. ↑ Kumar S (2009). "Vernal keratoconjunctivitis: a major review". Acta Ophthalmol. 87 (2): 133–47. doi:10.1111/j.1755-3768.2008.01347.x. PMID 18786127.
  19. ↑ Zoukhri D (2006). "Effect of inflammation on lacrimal gland function". Exp Eye Res. 82 (5): 885–98. doi:10.1016/j.exer.2005.10.018. PMC 1361268. PMID 16309672.


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