II. Symptoms
-
Eye Discharge
- Bacterial Conjunctivitis: Mucoid, purulent discharge
- Viral Conjunctivitis: Watery discharge
- Allergic Conjunctivitis: Mucoid discharge
-
Eye Pain minimal
- Scratchy foreign body Sensation
- Worse pain in Corneal Injury, Iritis, Keratitis and Acute Angle-Closure Glaucoma
- Photophobia minimal
III. Signs
-
Conjunctiva erythema
- Palpebral Conjunctiva injection
- Diffuse erythema over bulbar Conjunctiva
-
Cornea normal
- Epithelial defect in Corneal Injury or diffuse uptake in Keratitis
- Fluorescein stain
- Diffusely cloudy in acute Glaucoma
- Epithelial defect in Corneal Injury or diffuse uptake in Keratitis
-
Visual Acuity normal
- Vision blurred in acute Iritis and Corneal Injury
- Vision markedly reduced (<20/200) in acute Glaucoma
-
Pupil size and reactivity normal
- Small pupil in Corneal Injury or Iritis
- Dilated non-reactive pupil in Glaucoma
-
Intraocular Pressure normal
- Elevated in acute Glaucoma
- No Ciliary Flush
-
Preauricular Lymphadenopathy
- Seen in Viral Conjunctivitis (not in Bacterial)
IV. Differential Diagnosis: Red Eye
- Keratitis
- Episcleritis
- Uveitis
- Acute Iritis
- Scleritis
- Narrow Angle Glaucoma
- Subconjunctival Hemorrhage
- Mucous membrane Pemphigoid
- Sjogren Syndrome
- Kawasaki Disease
- Stevens-Johnson Syndrome
- Carotid Cavernous Fistula
V. Causes: Common
- Infectious
- Non-Infectious
- Allergic
- Dry Eye
- Toxic or Chemical Reaction
- Contact Lens use
- Occult Conjunctival neoplasm
- Foreign body
- Factitious
- Idiopathic
VI. Causes: Serious Conditions to Exclude
-
Herpes Simplex Conjunctivitis
- Unilateral Conjunctival/Corneal Inflammation with severe pain
- Concurrent Cold Sores may be present
- Dendritic Ulcers on Fluorescein staining of Cornea
-
Herpes Zoster
- See Herpes Ophthalmicus
- Observe for Herpes Zoster lesions in the V1 or V2 distribution
- Hutchinson sign (Vesicles on the tip of the nose)
-
Chlamydial Conjunctivitis
- Unilateral Conjunctivitis with hyperemia and mucopurulent discharge
- May present as subacute case (>4 weeks)
-
Lymphoid follicle formation (also seen in some Viral Conjunctivitis)
- Tiny, rice grain size, gelatinous pale bumps on the Conjunctiva
-
Gonococcal Conjunctivitis (Hyperacute Bacterial Conjunctivitis)
- Severe purulent Eye Discharge, Eye Pain and decreased Vision
- Risk of Corneal involvement including Corneal Ulceration
- Obtain cultures and treat systemically for both Gonorrhea and Chlamydia
VII. Labs
- Eye Gram Stain and culture indications
- Corneal Ulceration
- Orbital Cellulitis
- Severe recurrent or refractory eye infection
- Other testing to consider
- Chlamydia PCR
- Giemsa Stain and viral culture for herpes
VIII. Management
- See Specific management protocols
- See Viral Conjunctivitis
- See Epidemic Keratoconjunctivitis
- See Bacterial Conjunctivitis
- See Allergic Conjunctivitis
- See Gonococcal Conjunctivitis
- See Herpes Simplex Keratitis
- See Vernal Conjunctivitis
IX. Management: Ophthalmology Referral Indications (typically at one week)
- Contact Lens users
- Topical Corticosteroids required
- Photophobia
- No improvement after 7 days
X. Resources (Include Patient Education)
Images: Related links to external sites (from Bing)
Related Studies
| Definition (NCI) | Inflammation of the conjunctiva of the eye. |
| Definition (NCI_CTCAE) | A disorder characterized by inflammation, swelling and redness to the conjunctiva of the eye. |
| Definition (NCI_NCI-GLOSS) | A condition in which the conjunctiva (membranes lining the eyelids and covering the white part of the eye) become inflamed or infected. |
| Definition (CSP) | inflammation of the mucous membrane that lines the inner surface of the eyelids and the anterior part of the sclera; also called pinkeye and redeye. |
| Concepts | Disease or Syndrome (T047) |
| MSH | D003231 |
| ICD9 | 372.30 |
| ICD10 | H10 , H10.9 |
| SnomedCT | 193857008, 193875009, 193858003, 9826008 |
| LNC | MTHU020828 |
| English | Conjunctivitides, Conjunctivitis, Conjunctivitis, unspecified, conjunctivitis, conjunctivitis (diagnosis), Unspecified conjunctivitis, Conjunctivitis [Disease/Finding], inflammation of conjunctiva, conjunctiva inflammation, Conjunctivitis NOS, Unspecified conjunctivitis (disorder), Conjunctiva inflamed, CONJUNCTIVITIS, Pink Eye, Inflammation of conjunctiva, Conjunctivitis (disorder), Conjunctivitis, NOS |
| French | CONJONCTIVITE, Conjonctivite, non précisée, Conjonctivite SAI, Conjonctivite |
| Portuguese | CONJUNTIVITE, Conjuntivite NE, Conjuntivite |
| Spanish | CONJUNTIVITIS, Conjuntivitis NEOM, Conjuntivitis no especificada, conjuntivitis no especificada (trastorno), conjuntivitis no especificada, conjuntivitis (trastorno), conjuntivitis, inflamación de la conjuntiva, Conjuntivitis |
| German | KONJUNKTIVITIS, Konjunktivitis NNB, Konjunktivitis, unspezifisch, Konjunktivitis, nicht naeher bezeichnet, Konjunktivits, Konjunktivitis, Augenbindehaut-Entzündung, Bindehautentzündung |
| Dutch | conjunctivitis, niet-gespecificeerd, conjunctivitis NAO, Conjunctivitis, niet gespecificeerd, conjunctivitis, Conjunctivitis |
| Italian | Congiuntivite NAS, Congiuntivite, non specificata, Congiuntivite |
| Japanese | 結膜炎ＮＯＳ, 結膜炎, 結膜炎、詳細不明, ｹﾂﾏｸｴﾝｼｮｳｻｲﾌﾒｲ, ｹﾂﾏｸｴﾝ, ｹﾂﾏｸｴﾝNOS |
| Swedish | Bindhinneinflammation |
| Czech | konjunktivitida, spojivka - zánět, zánět spojivek, Konjunktivitida, Konjunktivitida NOS, Blíže neurčená konjunktivitida |
| Finnish | Sidekalvotulehdus |
| Russian | KON"IUNKTIVIT, КОНЪЮНКТИВИТ |
| Korean | 결막염, 상세불명의 결막염 |
| Croatian | KONJUNKTIVITIS |
| Polish | Zapalenie spojówek |
| Hungarian | Kötőhártyagyulladás, Conjunctivitis k.m.n., Kötőhártyagyulladás, nem meghatározott |
| Norwegian | Øyebetennelse, Konjunktivitt, Øyekatarr, Bindehinnebetennelse |
