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    Conjunctivitis

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    John Paul
    Conjunctivitis

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    Conjunctivitis

    Uploaded by

    John Paul
    5 views17 pages
    Conjunctivitis

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    Conjunctivitis

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    5 views17 pages

    Conjunctivitis

    Uploaded by

    John Paul
    Conjunctivitis

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 17

    DISEASES OF THE CONJUNCTIVA

    ODONGO SHADRACK(MBChB)
    Review: Anatomy of the Eyeball
    Eye Ball
    Conjunctivitis
    • Inflammation of the conjunctiva
    • Most common disease of conjunctiva & eye
    • Common in hot climates because of
    – Warm humid environment
    – Dust and solar radiations cause irritation
    – Insect vectors transmit dx
    – Poverty: overcrowding, poor ventilation, poor
    hygiene are risks factors
    Aetiology
    1. Infections
    a. Bacterial ; Viral; Trachoma;
    b. Granulomatous: TB, Syphilis, Myiasis, parasites
    • Bacterial most common
    – Primary: invade healthy conjunctiva- virulent org
    • Staph. Haemo. GC, strept
    – Secondary
    • When conj defences against infection are weakened
    • Eg. eyelid abn, lacrimal dx, KCS, conjunct abn: VAD
    Aetiology
    • Viral:
    a. Most common is adenovirus
    Others measles, molluscum contagiosum, Herpes simplex,
    herpers zooster, Ebola, corona viruses
    b. Viruses live in the epithelium hence invade
    cornea
    2. Allergy / vernal conjunctivitis
    • Vernal conjunctivitis
    • Drugs and cosmetics
    Aetiology
    3. Physical and chemical irritants
    • Acids, alkali, other chemicals
    • Foreign body, trauma
    4. Nutritional:
    – VAD
    5. Endogenous:
    – Dry eye / KCS;
    6. Secondary: dacryocystitis; TT; exposure, CVII palsy
    Aetiology
    7. Psychological
    • Tension
    • Anxiety
    • Depression
    Clinical Features
    • Discomfort
    – Few nerve supply hence pain not a prominent
    – Irritation
    – Itching
    – Significant pain indicates associated diseases like
    corneal involvement especially in viral infection
    • Visual symptoms
    – Usually no visual impairment
    – Reduced vision is due to secretions, corneal spread
    • Itching: allergy
    Clinical Features /Signs
    1. Red eye
    – Vasodilatation; spread out / diffused.
    2. Increased secretions cause by
    • irritation and reflex tear production
    • Protein exudation and vascular leakage
    – Purulent / mucopurulent: bacterial infections
    – Watery/ serous: viral
    – Thick sticky mucous: chronic allergic
    conjunctivitis
    – Slightly mucpurulent
    Clinical Features /Signs
    3. Oedema / chemosis
    4. Follicles
    – Due presence of lymphoid tissues under the epithelium
    – Lymphoid tissues enlarge esp in viral infections
    5. Papillae
    – Raised areas on the surface of the epithelium
    – Caused by vessels and inflammatory cells grpowing in the
    subconjunctival space
    – Found in the tarsal conjunctiva and (near limbus)
    Clinical Features /Other signs
    • Keratinization
    – Conjunctival epithelium produces keratin which and
    so becomes hard and unwettable
    • Membrane formation
    – Formed from inflammatory cell and fibrin
    – Forms a plague which covers and sticks to conjunc
    – Indicates severe adenoviral infection
    • Scaring fibrosis: end result of any inflammatn
    • Increased pigmentation: severe allergy & VAD
    Read
    • Clinical features of each

    – Bacterial conjunctivitis
    – Viral conjunctivitis
    – Allergic conjunctivitis
    • Vernal catarrh
    • Reactive conjuntivitis
    – Note : papillae and follicles
    Treatment
    • Bacterial • Allergic
    – Antibiotics drops &
    – Topical steroids
    ointments
    • Gentamycin,
    – Mast cells stabilizers
    chloramphenicol, Sodium Cromoglycate drops
    erythromycin, – Topical cyclosporine
    crprofloxacin, ofloxacin,
    Moxifloxacin, neomycin
    – Anti histamine
    etc • Oloptadine eye drops
    – Hygiene • Loratadine and its
    derivatives tablets
    – Avoid padding
    – Oral steroids (in severe
    cases)
    – Artificial tear drops, Zinc
    eye drops
    TREATMENT

    • Viral
    – Usually self limiting
    – Few antiviral ointment
    • Acyclovir
    • gancyclovir
    – Prophylactic antibiotics
    – Molluscum : excision
    – DO NOT GIVE A STEROID
    DROP IN VIRAL
    INFECTIONS
    Read /Clerk/clinic
    • Conjunctival Tumours
    – Squamous cell Ca
    – Pterygium
    – Pingecula
    – Nivea
    – Other conjunctival growths
    References
    • Eye diseases in hot climates 3rd, 4th and 5th
    Editions (Sanford Smith)

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