30/12/2025
CONJUCTIVITIS
1. Define Conjunctivitis 5%
2. State the classifications of Conjunctivitis 10%
3. Mention the signs and symptoms of Conjunctivitis 15%
4. Discuss the management of conjunctivitis 50%
5. Explain five 5 patient teaching about conjuctivitis 25%
MARKING KEY
DEFINITION
It is the inflammation of the conjunctiva
CLASSIFICATION OF CONJUCTIVITIS
Classification is based on the cause of conjunctivitis.
Bacterial conjunctivitis
Viral conjunctivitis
Allergic conjunctivitis
Chemical conjuctivitis
BACTERIAL CONJUNCTIVITIS
This is inflammation of the conjunctiva due to bacterial invasion. Usually referred to as pink eye
It is highly infectious, especially in over crowed places such as schools and nursing homes .
CAUSATIVE ORGANISM
Staphylococcal areus.
Streptococcus
Haemophilus influenza
E.coli
Neisseria gonococcus
Chlamydia trachomatis
SIGNS AND SYMPTOM OF BACTERIAL CONJUNCTIVITIS
Hyperemia
Purulent eye discharge
Pain if corneal is affected
Edema (chemosis) of the conjunctiva
Lacrimation
Itching
Burning sensation
Gritty sensation
INVESTIGATIONS
History taking
Clinical examination.
Conjunctival swab for microscopy, culture and sensitivity to isolate the causative organism
TREATMENT
Local antibiotics:
Chloramphenicol eye drops 0.5% or 1% hourly for the first day and less frequent in the next day or when symptoms are relieved.
Gentamycin 0.3% eye drops
Tetracycline eye ointment QID or at night when drops are used during the day.
Vitamine A 200,000 i.u once daily for 3 days.
VIRAL CONJUNCTIVITIS
Definition
Inflammation of the conjunctiva as a result of viral infection.
CAUSATIVE ORGANISM
Adenovirus this is the most common cause of viral conjunctivitis especially type 8.
Picona viruses.
Measles virus.
Herpes simplex virus
SIGNS AND SYMPTOMS OF VIRAL CONJUNCTIVITIS
Sensation of a foreign body in the eye
Slight photophobia
Lacrimation
Hyperemia
Itchy eyes
DIAGNOSIS
History taking will reveal predisposing factors
Clinical examination will reveal signs and symptom
Visual acuity to assess vision
Corneal staining is done to rule out corneal involvement.
TREATMENT IS SYMPTOMATIC
Topical antibiotics to prevent secondary bacterial infections
Tetracycline 1% eye ointment
Chloramphenicol 1% eye ointment
Local steroids drops to reduce inflammation
Prednosolone 0.5% or 1% eye drops TDS.
Vitamin A 200,000 i.u OD for 3 days.
ALLERGIC CONJUNCTIVITIS
Definition
Inflammation of the conjunctiva as a result of allergy. The treatment simply relieves symptom and not cure.
CAUSES OF ALLERGIC CONJUNCTIVITIS
Geographical, genetic and environmental factors are influential in this disease.
Certain allergies are geographically determined such as allergy to dust are common in hot climates.
Environmental factors: the environment may be polluted e.g. with fumes from industries causing allergic conjunctivitis.
Seasons: allergic conjunctivitis is more common in rain season reason being that, that is when most flowers are sprouting and there’s pollen to which these people are allergic to.
Genetic: individuals may be allergic to certain substances e.g. cotton wool. Those patients who are asthmatic are at risk of having allergic conjunctivitis.
SIGNS AND SYMPTOM OF ALLERGIC CONJUNCTIVITIS
Itchy eyes
Sticky white discharge caused by increased secretion of viscous mucous in the tears
Limbal pigmentation
Smoky eyes
Lacrimation
DIAGNOSIS
Clinical examination
Conjunctival swab to rule out bacterial conjunctivitis
Hypersentivity tests
Visual acuity to assess acuteness of the eye
TREATMENT
Topical antibiotics to prevent secondary bacterial infections.
Tetracycline eye ointment
Chloramphenicol eye ointment
Local steroids drops to reduce inflammation.
Prednosolone 0.5% or 1% eye drops TDS.
Cromoglycate 4% eye drops
Prevents the release of histamine and toxins from the mast cells there by relieving the symptoms
Vitamin A 200,000 i.u OD for 3 days
CHEMICAL CONJUNCTIVITIS
Chemical eye injury is due to either an acidic or alkali substance getting in the eye alkalis are typically worse than acidic burns mild burns will produce conjunctivitis, while more severe burns may cause the cornea to turn white.
SIGNS AND SYMPTOM
Marked redness of the eye
Necrosis of the conjunctiva occurs with caustic alkalis such as sodium hydroxide
INVESTIGATIONS
Litmus paper examination to rule out the diagnosis by verifying whether the pH is within the normal range of 7.0—7.2
Slit lamp to determine extent of injury
TREATMENT
Irrigation is the treatment of choice and should continue until the pH is 6—8
Give local anaesthetic eye drops to decrease the pain
PATIENT TEACHING
Educate the patient about the disease and its treatment
Put emphasis on the infectiousness of the disease
Patient should avoid crowed places
Should keep the hands away from the face
Emphasize on frequent hand washing especially before and after instillation of eye drops and application of warm compresses
Teach on proper method of applying eye drops and ointment
Caution on the possibility of blurred vision after application of ointment
Should indentify the allergen in allergic conjunctivitis
Wear protective glasses when handling chemicals
