### Conjunctivitis Overview
1■■ INTRODUCTION
Conjunctivitis, commonly referred to as "pink eye," is an inflammation or infection of the conjunctiva, the
Relevance: Conjunctivitis is a frequent cause of eye discomfort and is highly contagious in the case of i
2■■ CLASSIFICATION / TYPES
- Viral Conjunctivitis: Caused by viruses (e.g., adenovirus), highly contagious.
- Bacterial Conjunctivitis: Caused by bacteria (e.g., Staphylococcus aureus, Streptococcus pneumoniae
- Allergic Conjunctivitis: Triggered by allergens such as pollen, dust, or pet dander.
- Irritant Conjunctivitis: Induced by exposure to chemicals, smoke, etc.
- Chronic Conjunctivitis: Persistent or recurrent conjunctival inflammation.
3■■ ETIOLOGY / RISK FACTORS
Non-modifiable:
- Age (more common in children)
- Genetic predisposition (especially for allergies)
Modifiable:
- Poor hygiene practices
- Contact lens use
- Exposure to allergens or irritants
- Close contact with infected individuals
4■■ PATHOPHYSIOLOGY
Trigger (infection, allergen, irritant)
→ Conjunctival epithelium activation
→ Inflammatory mediator release (histamine, cytokines)
→ Vasodilation & increased permeability
→ Redness, swelling, discharge
- Viral: Often accompanies URI; causes watery discharge.
- Bacterial: Causes thick, purulent discharge.
- Allergic: IgE-mediated; histamine causes itching & swelling.
5■■ CLINICAL FEATURES / SIGNS & SYMPTOMS
- Red or bloodshot eyes
- Itching or burning
- Watery or purulent discharge
- Swollen eyelids
- Crusting (especially upon waking)
- Photophobia
- Foreign body sensation
6■■ DIAGNOSIS
- Clinical assessment based on symptoms and history
- Slit-lamp examination
- Culture/PCR (for bacterial/viral identification if needed)
- Allergy testing for allergic causes
- Differential diagnosis: Dry eye syndrome, keratitis, blepharitis, uveitis
7■■ COMPLICATIONS
- Chronic conjunctivitis
- Keratitis or corneal involvement (rare but serious)
- Scarring of conjunctiva
- Pseudomembrane formation (adenoviral conjunctivitis)
- Spread to cornea → vision loss (rare)
8■■ MANAGEMENT / TREATMENT
A. NON-PHARMACOLOGICAL
- Maintain hand hygiene
- Warm compress for bacterial, cold compress for viral
- Avoid contact lenses during infection
- Discontinue or replace eye makeup
B. PHARMACOLOGICAL
| Type | Treatment | Medications | Duration |
|------------|------------------------------|--------------------------------------------|--------------|
| Viral | Supportive care | Artificial tears (PRN), cold compresses | Self-limiting (1–2 weeks
| Bacterial | Antibiotic eye drops | Erythromycin 0.5% ointment BID-QID, Ciprofloxacin 0.3% drops
| Allergic | Antihistamines, Mast Cell Stabilizers | Olopatadine 0.1% BID, Ketotifen 0.025% BID | Until s
| Irritant | Avoid irritants | Artificial tears PRN | Variable |
9■■ PREVENTION / COUNSELLING POINTS
- Wash hands regularly
- Avoid touching eyes
- Don’t share towels, eye makeup
- Proper contact lens hygiene
- Avoid allergens in allergic conjunctivitis
- School exclusion if infectious
■ MNEMONICS
Viral Conjunctivitis: "VIRAL"
V – Viral
I – Infectious
R – Red eyes
A – Acute
L – Light sensitivity
Bacterial Conjunctivitis: "BACTERIA"
B – Bright yellow discharge
A – Antibiotics needed
C – Contagious
T – Thick discharge
E – Eyeballs swollen
R – Rapid onset
I – Inflammation
A – Antibiotic treatment
Allergic Conjunctivitis: "ALLERGY"
A – Acute itching
L – Lacrimation
L – Lid swelling
E – Eosinophils (in scraping)
R – Reaction to allergen
G – Give antihistamines
Y – Yearly recurrences
■ DIAGNOSTIC OR TREATMENT STRATEGY
Diagnosis:
- History + clinical signs
- Slit-lamp exam
- Lab tests if needed
Quick Evaluation Algorithm:
Red Eye → Examine discharge:
→ Watery + mild: Viral → Supportive treatment
→ Purulent discharge: Bacterial → Antibiotics
→ Itchy + stringy discharge: Allergic → Antihistamines
Treatment:
- Viral: Hygiene + cold compresses, artificial tears
- Bacterial: Topical antibiotics
- Allergic: Antihistamines/mast cell stabilizers