Conjunctivitis

👁️‍🗨️ Conjunctivitis – "Pink Eye"

🔍 Definition

Conjunctivitis is inflammation or infection of the conjunctiva — the thin, transparent tissue covering the white part of the eye (sclera) and the inner surface of the eyelids.

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🔄 Types of Conjunctivitis

Type	Cause	Common Features
Viral	Adenovirus (most common), HSV	Watery discharge, red eye, very contagious
Bacterial	Staph, Strep, H. influenzae, Gonorrhea	Purulent discharge, sticky eyelids
Allergic	Pollen, dust, pet dander	Itching, tearing, both eyes affected
Chemical/Toxic	Smoke, chlorine, irritants	Redness, burning, history of exposure

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🧪 Symptoms of Conjunctivitis

• Redness (hyperemia)

• Discharge (watery, mucous, or purulent)

• Itching (especially in allergic)

• Tearing

• Gritty sensation

• Swollen eyelids

• Crusting on lashes (esp. in the morning)

• Blurry vision (if discharge covers cornea)

• Photophobia (in some viral or toxic cases)

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👁️ Signs on Slit Lamp / Examination

• Conjunctival injection (redness of vessels)

• Follicles (viral/allergic) vs. Papillae (bacterial/allergic)

• Discharge type helps differentiate cause

• Preauricular lymphadenopathy in viral conjunctivitis

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🦠 Detailed Types Breakdown

🔹 Viral Conjunctivitis

• Most common

• Usually starts in one eye, spreads to both

• Watery discharge, irritation

• Often associated with cold/URI symptoms

• Highly contagious

• Self-limiting in 7–10 days

⚠️ Rule out Herpes if there are vesicles on eyelids or corneal involvement

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🔹 Bacterial Conjunctivitis

• More common in children

• Thick, purulent discharge

• Eyelids stuck shut in the morning

• Can be unilateral or bilateral

• Can resolve in 7–10 days untreated, faster with antibiotics

👶 Hyperacute bacterial conjunctivitis (esp. Neisseria) is an emergency

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🔹 Allergic Conjunctivitis

• Bilateral itching, tearing, redness

• Often seasonal or due to environmental exposure

• Associated with hay fever, asthma, eczema

• Ropy mucous discharge

• Non-contagious

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🔹 Chemical Conjunctivitis

• Sudden redness and irritation after exposure

• Acidic or alkaline substances

• Requires immediate irrigation

• Can cause serious damage if not treated urgently

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💊 Treatment Options

Type	Treatment
Viral	Supportive care (cold compress, artificial tears)
Bacterial	Topical antibiotics (e.g. erythromycin, ciprofloxacin drops)
Allergic	Antihistamine drops, mast cell stabilizers, avoid allergens
Chemical	Immediate saline irrigation, refer if severe

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🛑 When to Refer or Urgently Treat

• Vision loss

• Intense photophobia

• Severe pain

• Vesicles on skin (suspect Herpes)

• Suspected gonococcal or chlamydial infection

• Lack of improvement with treatment

• Involvement of cornea

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🧼 Prevention Tips

• Hand hygiene

• Avoid touching/rubbing eyes

• Do not share towels, makeup, or eye drops

• Stay home if contagious (e.g. viral conjunctivitis)

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🧠 Key Points Recap

Feature	Viral	Bacterial	Allergic
Discharge	Watery	Purulent	Stringy/mucoid
Onset	One eye → both	One/both eyes	Both eyes
Contagious	Yes	Yes	No
Itching	Mild	No	Intense
Treatment	Supportive	Antibiotics	Antihistamines