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Conjunctivitis

  
 
Inflammation of the conjunctiva is usually caused by either infection or allergy. The eye is red 
and uncomfortable but pain is not common. 

Presentation:

  • Infective conjunctivitis usually present with discharging or sticky eyes. There may be 

  • a history of contact with people with red eyes.
  • Allergic conjunctivitis is commonly seen in patients with atopy or hay fever. Itchy red 

  • eye is a prominent feature
Examination:
  • The visual acuity is normal although in some cases of viral conjunctivitis caused by 

  • adenovirus, the vision may be blurred due to associated keratitis
  • One or both eyes may be affected and the eyelids may be swollen
  • The conjunctiva is oedematous and there are visible changes on the tarsal conjunctiva
Treatment:
  • In the general practice, it is difficult to differentiate between bacterial from viral conjunctivitis.

  • However, it is acceptable to treat all infective conjunctivitis with topical antibiotics such as 
    chloramphenicol as it can prevent secondary infection in viral conjunctivitis. The conjunctivitis 
    usually takes about one or two weeks to settle.
  • Patient with allergic conjunctivitis will benefit from topical sodium cromoglycate such as opticrom. 

  • Oral antihistamine (such as triludene) is useful in reducing itchiness. It is important to determine
    the cause as the allergen (for example eye drops or cosmetic) may be eliminated.
  • Refer the patient to the casualty only if the conjunctivitis fails to respond to treatment
Figure 1.
A patient with conjunctivitis. Note the lumpy appearance of the tarasal conjunctiva 
(best seen with the lid everted). These may be infectious or allergic. A history of 
itchiness favours allergic conjunctivitis whereas sticky eye infective conjunctivitis.

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