Conjunctivitis

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1. DISEASES OF CONJUNCTIVA

2. CONJUNCTIVITIS DEFINITION Conjunctivitis is an inflammation of the conjunctiva characterized by cellular infiltration and exudation.

3. CLASSIFICATION 1. INFECTIVE CONJUNCTIVITIS B ACTERIAL ACUTE BACTERIAL CONJUNCTIVITIS H YPERACUTE CONJUNCTIVITIS C HRONIC CONJUNCTIVITIS A NGULAR CONJUNCTIVITIS CHLAMYDIAL CONJUNCTIVITIS TRACHOMA ADULT INCLUSION CONJUNCTIVITIS NEONATAL CHLAMYDIAL CONJUNCTIVITIS VIRAL CONJUNCTIVITIS ADENOVIRUS CONJUNCTIVITIS ENTEROVIRUS CONJUNCTIVITIS MOLLUSUM CONTAGIOSUM HSV CONJUNCTIVITIS OPHTHALIA NEONATORUM G RANULOMATOUS CONJUNCTIVITIS

4. CLASSIFICATION 2.ALLERGIC CONJUNCTIVITIS SIMPLE ALLERGIC PHLYCTENULAR VERNAL (SPRING CATARRH) GIANT PAPILLARY. 3 .CICATRICIAL CONJUNCTIVITIS O CULAR MUCOUS MEMBRANE PEMPHIGOID S TEVENS JOHNSONS SYNDROME T OXIC EPIDERMAL NECROLYSIS S ECONDARY CICATRICIAL CONJUNCTIVITIS 4 .TOXIC CONJUNCTIVITIS

5. BACTERIAL CONJUNCTIVITIS Bacterial contamination of the eye

6. Predisposing factors Mode of infection Causative organisms Flies, Poor hygienic conditions Hot dry climate Poor sanitation and Dirty habits EXOGENOUS INFECTION : Close contact , as air-borne infections or water-borne infections; Vector Transmission (e.g., flies); or Infected fingers of doctors, nurses, common towels, handkerchiefs, and infected tonometers . 2 . LOCAL SPREAD Infected lacrimal sac, lids, and nasopharynx . 3. Endogenous infections Gonococcal and meningococcal infections. Staphylococcus aureus Streptococcus pneumoniae Streptococcus pyogenes Haemophilus influenzae Moraxella lacunata Pseudomona pyocyanea Neisseria gonorrhoeae Neisseria meningitidis Corynebacterium diphtheria

7. Acute bacterial conjunctivitis Its characterized by marked conjunctival hyperemia and mucopurulent discharge from the eye

8. Causative organisms Symptoms Signs Staph aureus Koch-weeks bacillus Pneumococcus Streptocossus Discomfort Foreign body sensation Grittiness Blurring of vison Redness of sudden onset Mild photophobia Mucopurulent discharge sticking together lid margins Colored halos Fakes of mucopus ( fornices , canthi and lid margins) C onjunctival congestion-fiery red eye C hemosis P etechial haemorrhages (pneumococcus)

9. COMPLICATIONS SUPERFICIAL PUNCTATE EPITHELIOPATHY MARGINAL CORNEAL ULCERATION SUPERFICIAL KERATITIS BLEPHARITIS DACRYOCYSTITIS

10. Treatment Don’t Preventive measures Topical antibiotis Chloramphenicol Gentamicin Tobramicin Freyamicin Anti-inflammatory Analgesics Irrigation of conjuctival sac with sterile warm saline Dark goggles No bandage No steroids Frequent handwashing Avoidance of sharing towels, handkerchief and pillow with others

11. Hyperacute bacterial conjunctivitis AKA. ACUTE PURULENT CONJUNCTIVITIS OR ACUTE BLENORRHEA Characterized by violent purulent inflammatory response

12. Etiology Clinical features treatment Gonococcus Complications Corneal odema , ulceration, perforation, central necrosis Iridocyclitis Systemic complications Gonorrhea arthritis Endocartitis Septicaemia Symptoms Pain Purulent discharge Swelling of eyelids Signs Eyelids are tense and swollen Tenderness Discharge -thick purulent and copious Conjuctiva -Chemosis, red velvety appearance Pseudomembrane maybe seen on the conjunctival surface Systemic therapy 3 rd gen cephalosporins Quinolones Topical antibiotis Ofloxacin Ciprofloxacin Tobramycin Topical atropine Irrigation of eyes

13. CHRONIC BACTERIAL CONJUNCTIVITIS Mild catarrhal inflammation of conjuctiva

14. Etiology Clinical features Treatment Staph aureus Rare proteus mirabilis Klebsiella pneumonia E. coli Moraxella lacunata Symptoms Burning and grittiness of eye Mild chronic redness Difficulty keeping eyes open Mild mucoid discharge Watering Feeling of sleepiness Signs Congestion of posterior conjunctival vessels Mild papillary hypertrophy in palpebral conjunctiva Sticky look on the surface of the conjunctiva Lid margins maybe congested Topical antibiotics Chloramphenicol Tobramycin Gentamicin Astringent eye drops Zinc-boric acid drops

15. ANGULAR CONJUNCTIVITIS It’s a mild grade inflammation confined to the conjunctiva and lid margins near the angles associated with maceration of th e surrounding skin

16. Etiology Causative organism Moraxella axenfield Source Nasal cavity Mode of infection Contaminated fingers or handkerchief

17. Pathology MA bacillus Proteolytic enzyme c ollected at angles by action of tears Maceration of the conjunctival ep., lid margins and surrounding skin Vascular and cellular response Mild grade chronic inflammation

18. Symptoms Signs Treatment Irritation Burning sensation Discomfort in the eye Redness in the angle of the eyes Dirty-white foamy discharge at the angles Complications Blepharitis Shallow marginal catarrhal corneal ulcer Hyperemia of bulbar conjunctiva near canthi Hyperemia of lid margins near angles Excoriation of skin near angles Curative treatment Oxytetracycline eye ointment Zinc lotion

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