Presentation
1 Neonates: Gonococcal conjunctivitis: presents 2-4 days following birth. [emdocs.net]
When 3 of the 4 predictors were present, the probability of the child having a negative culture was high. When all 4 predictors were present, the probability was greater than 90%. [jamanetwork.com]
[…] in bacterial conjunctivitis, but mild in most cases; severe eyelid edema in the presence of copious purulent discharge raises the suspicion of N gonorrhoeae infection See Clinical Presentation for more detail. [emedicine.medscape.com]
Bacterial conjunctivitis was present in about one third (32.47% to 36.04%) of the patients with acute infective conjunctivitis, and it was more common in children. [nepjol.info]
Conclusion: The present consensus supports the use of topical antibiotics for bacterial conjunctivitis. [eurekaselect.com]
Entire Body System
- Weakness
Ectropion is caused by a loss of tissue elasticity and weakness in the muscles surrounding the eye, usually due to old age. Treatment includes minor surgery to tighten the eyelid. [clinicaladvisor.com]
Tears have some buffering capacity, and weak acids and bases, pH range 3.5–9 can be tolerated in the eye. Buffers may be included, such as borate and phosphate buffers. [pharmaceutical-journal.com]
The main weaknesses of the study were the limited number of culture‐proven cases at baseline and the fact that patient recruitment was performed during office hours only. [onlinelibrary.wiley.com]
- Fatigue
Extreme fatigue (to the point where it's hard for you to function). Shaking chills. Symptoms of serious illness in a baby may include the following: The baby is limp and floppy like a rag doll. [healthlinkbc.ca]
Symptoms Prodromal symptoms are typical: fatigue, malaise and low-grade fever for up to one week. Eye pain, redness, watering and photophobia may occur. Facial pain may precede other symptoms and is typically confined to one dermatome. [patient.info]
Gastrointestinal
- Nausea
Side effects of antihistamines include dry mouth, drowsiness, dizziness, nausea and vomiting, restlessness or moodiness (in some children), trouble urinating, blurred vision, or confusion. [rxlist.com]
[…] removing the contacts Persons with weakened immune systems All other people should seek care when any of the following symptoms are present: Eye pain Reduced or blurry vision Sensitivity to light Inability or refusal to open eyelid Severe headache or nausea [health.state.mn.us]
[…] redness is most pronounced in a ring at the limbus (the border of the cornea and the sclera) Photophobia (light sensitivity) Severe foreign body sensation that prevents the patient from keeping the eye open Corneal opacity Fixed pupil Severe headache with nausea [dermnetnz.org]
Signs of such conditions include decreased vision, significantly increased sensitivity to light, inability to keep the eye open, a pupil that does not respond to light, or a severe headache with nausea. [27] Fluctuating blurring is common, due to tearing [en.wikipedia.org]
- Vomiting
Side effects of antihistamines include dry mouth, drowsiness, dizziness, nausea and vomiting, restlessness or moodiness (in some children), trouble urinating, blurred vision, or confusion. [rxlist.com]
Skin
- Blister
Blistering mucocutaneous diseases (cicatricial pemphigoid, Stevens-Johnson syndrome). Conjunctival lesions (pigmented, squamous tumours and other tumours). Background [ 1 ] Bacterial conjunctivitis is usually a benign self-limiting illness. [patient.info]
Eyes
- Dry Eyes
These glands malfunction when inflamed, leading to chronic inflammation of the lid margins and the conjunctiva as well as dry eyes. [hopkinsmedicine.org]
However, they can proliferate and cause conjunctivitis in certain conditions, such as dry eye, after damage to the eye, or in a weakened immune system. [theconversation.com]
Disorders involving the eyelids or tear film such as chronic dry eye and lagophthalmos (in which the eye cannot close completely) may predispose the eye to frequent infections. [mdedge.com]
Pink Eye (Conjunctivitis). American Academy of Ophthalmology. EyeSmart ® Eye health. https://www.aao.org/eye-health/diseases/pink-eye-conjunctivitis-list. Accessed March 22, 2019. American Academy of Ophthalmology Cornea/External Disease Panel. [eyewiki.aao.org]
Dry eyes from lack of tears or exposure to wind and sun. Chemicals, fumes, or smoke ( chemical conjunctivitis ). Allergies. Viral and bacterial pink eye are contagious and spread very easily. [healthlinkbc.ca]
- Foreign Body Sensation
Clinically, bacterial conjunctivitis is characterized by a purulent eye discharge, or sticky eyes on awakening, a foreign body sensation and conjunctival injection (pink eye). The diagnosis is made clinically. Cultures are unnecessary. [eurekaselect.com]
These conditions may cause eye pain, a feeling that something is stuck in your eye (foreign body sensation), blurred vision and light sensitivity. If you experience these symptoms, seek urgent care. [mayoclinic.org]
Symptoms can include redness of the conjunctiva, burning, frequent styes, foreign body sensation and morning eyelash crusting or eyelash loss. Another type of chronic conjunctivitis is meibomitis. [hopkinsmedicine.org]
body sensation that prevents the patient from keeping the eye open Corneal opacity Fixed pupil Severe headache with nausea. [dermnetnz.org]
Other symptoms include tearing, foreign body sensation, itchiness, pain, swelling and redness of the eyes, matted eyelids after sleep, and sensitivity to light. Vision is not affected unless scarring of the cornea occurs after the infection. [chp.gov.hk]
- Conjunctival Injection
Clinically, bacterial conjunctivitis is characterized by a purulent eye discharge, or sticky eyes on awakening, a foreign body sensation and conjunctival injection (pink eye). The diagnosis is made clinically. Cultures are unnecessary. [eurekaselect.com]
One or both eyes may be affected, with the most common symptoms being bulbar conjunctival injection and mucopurulent discharge. [uspharmacist.com]
Inclusion: male or female; ≥ 1 day old with purulent bacterial conjunctivitis (bulbar conjunctival injection and purulent discharge). Primary efficacy variable: no signs in the worse eye at D9 and no discharge. [iovs.arvojournals.org]
injection Palpebral conjunctival papillary reaction Muco-purulent or watery discharge Chemosis Lid erythema Diagnostic procedures Gram stain & Cultures: Primarily used in cases of atypical conjunctivitis such as hyperacute or chronic/non-responding. [eyewiki.aao.org]
- Lacrimation
Also, an adjacent focus of infection, such as inflammation of the lacrimal gland (dacryocystitis), can cause recurrent or chronic conjunctivitis. 16 [mdedge.com]
Allergic conjunctivitis is not associated with any discharge, but will be associated with increased bilateral lacrimation. Itching will predominate with eyes appearing more pink than red. [pharmaceutical-journal.com]
Symptoms are hyperemia, lacrimation, irritation, and discharge. Diagnosis is clinical. Treatment is with topical antibiotics, augmented by systemic antibiotics in more serious cases. [merckmanuals.com]
[…] no effect on the histamine that has already been released. 9 They may be used for prophylaxis and maintenance of mild-to-moderate symptoms. 4,9 MC stabilizers also provide relief of nasal symptoms because of drainage from the nasal passages into the lacrimal [uspharmacist.com]
- Burning Eyes
More serious side effects include rash, itching or burning eyes, redness/ pain or swelling in or around the eyes, and vision problems. [rxlist.com]
Variables showing an association of P Subanalyses of children above and below the cutoff age were performed to determine whether subjective factors (ie, eye itch, foreign body sensation, eye burning, eye pain, photophobia, and sore throat) had a greater [jamanetwork.com]
Green or white discharge from the eye Itchy eyes Burning eyes Blurred vision More sensitive to light Swollen lymph nodes (often from a viral infection ) When to Call Your Doctor Make the call if: There’s a lot of yellow or green discharge from your eye [webmd.com]
Workup
Types Viral conjunctivitis Epidemic keratoconjunctivitis Herpes zoster ophthalmicus Herpes simplex keratitis Bacterial conjunctivitis Gonorrheal conjunctivitis Chlamydia conjunctivitis Allergic conjunctivitis Caustic keratoconjunctivitis Evaluation Workup [wikem.org]
The cellular response in conjunctivitis differs according to the cause, as follows: Bacterial infections: Neutrophils predominate Viral infections: Lymphocytes predominate Allergic reactions: Eosinophils predominate See Workup for more detail. [emedicine.medscape.com]
Microbiology
- Neisseria Gonorrhoeae
The two major organisms responsible for ophthalmia neonatorum are Neisseria gonorrhoeae and Chlamydia trachomatis. Gonococcal ophthalmia neonatorum is caused by Neisseria gonorrhoeae. [eyeworld.org]
Hyperacute conjunctivitis is primarily due to Neisseria gonorrhoeae, which is a sexually transmitted disease. [eyewiki.aao.org]
In adults, Neisseria gonorrhoeae causes hyperacute conjunctivitis and is associated with concurrent, often asymptomatic genital infection. [mdedge.com]
Complications can range from mild corneal irritation to severe visual loss, which develops in cases caused by extremely pathogenic bacteria, such as Chlamydia trachomatis or Neisseria gonorrhoeae. [emedicine.medscape.com]
Neisseria gonorrhoeae causes gonococcal conjunctivitis, which usually results from sexual contact with a person who has a genital infection. [merckmanuals.com]
Treatment
Antibiotics Treatment: Hygiene Seasonal Management Treatment for bacterial organisms is targeted toward S. aureus, S. pneumoniae, H. influenzae, Pseudomonas, N. gonorrhea, C. trachomatis Contact lens wearers should be given coverage for Pseudomonas [wikem.org]
A correct diagnosis is important so that appropriate treatment can be instituted. Objective: To provide an update on the evaluation, diagnosis, and treatment of bacterial conjunctivitis in children. [eurekaselect.com]
Cochereau I, Meddeb-Ouertani A, Khairallah M, et al. 3-Day treatment with azithromycin 1.5% eye drops versus 7-day treatment with tobramycin 0.3% for purulent bacterial conjunctivitis: multicentre, randomised and controlled trial in adults and children [ncbi.nlm.nih.gov]
Conclusions: 3 days treatment azith 1.5% solution shows bacteriological efficacy for the treatment of purulent bacterial conjunctivitis and compared with the reference product has the advantage of a low dosing regimen of 1 drop in each eye twice daily [iovs.arvojournals.org]
Treatment should be given if the condition has not resolved spontaneously after 5 days Clean away infected secretions from eyes with cotton wool soaked in cooled boiled water Remove contact lenses until all symptoms have resolved and any treatment completed [ljf.scot.nhs.uk]
Prognosis
Prognosis of viral conjunctivitis Viral conjunctivitis is extremely contagious and remains so for 14 days, which also is often how long the symptoms remain. The prognosis is very good for viral conjunctivitis. [intechopen.com]
Prognosis [ 11 ] Eyelid and conjunctival lesions tend to resolve over 1-2 weeks. Epithelial keratitis resolves over two weeks and has a good prognosis. Stromal keratitis is more likely to result in corneal scarring. [patient.info]
Complications Acute bacterial conjunctivitis is almost invariably a disease with a highly favourable prognosis. [onlinelibrary.wiley.com]
Etiology
Chlamydial conjunctivitis: most common etiology of infectious conjunctivitis in the newborn; occurs 1 week to 2 months following birth. 1 Chlamydial infection may cause concomitant pneumonia (staccato cough), otitis media, proctitis, and vulvovaginitis [emdocs.net]
Conjunctivitis, which is defined as inflammation of the bulbar and/or palpebral conjunctiva (the transparent lubricating mucous membrane that covers both the surface of the eye and lining of the undersurface of the eyelids), has many etiologies, including [emedicine.medscape.com]
Title: Bacterial Conjunctivitis in Childhood: Etiology, Clinical Manifestations, Diagnosis, and Management VOLUME: 12 ISSUE: 2 Author(s): Alexander K.C. Leung*, Kam L. Hon, Alex H.C. Wong and Andrew S. [eurekaselect.com]
Differentiating Features in Acute Conjunctivitis Etiology Discharge/Cell Type Eyelid Edema Node Involvement Itching Bacterial Purulent/polymorphonuclear leukocytes Moderate Usually none None Viral Clear/mononuclear cells Minimal Often present None Allergic [merckmanuals.com]
Epidemiology
Clinical Trial: www.clinicaltrials.gov NCT00357773 Keywords: conjunctivitis • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • antibiotics/antifungals/antiparasitics © 2008, The Association for Research [iovs.arvojournals.org]
The epidemiology of acute bacterial conjunctivitis in Australia due to causes other than trachoma and gonococcal infection is not well documented. Infections are most common in children under five years of age, and incidence decreases with age. [www2.health.vic.gov.au]
Epidemiology Although the literature on the epidemiology of bacterial conjunctivitis contains several references to its highly contagious nature [ 7 – 10 ] no overall population-based data exists on the incidence of bacterial conjunctivitis. [bmcophthalmol.biomedcentral.com]
Epidemiology [ edit ] Conjunctivitis is the most common eye disease. [35] Rates of disease is related to the underlying cause which varies by the age as well as the time of year. [en.wikipedia.org]
Epidemiology and diagnosis of acute conjunctivitis at an inner-city hospital. Ophthalmology 1989;96:1215–1220. [ PubMed ] [ Google Scholar ] 9. Woodland RM, Darougar S, Thaker U, et al. [ncbi.nlm.nih.gov]
Pathophysiology
Learning outcomes At the end of this case study, you will be able to: Outline the pathophysiology, signs and symptoms, and diagnosis of bacterial conjunctivitis; Describe the treatment options available for bacterial conjunctivitis; Outline the chemistry [pharmaceutical-journal.com]
Allergic conjunctivitis: update on pathophysiology and prospects for future treatment. J Allergy Clin Immunol. 2005;115:118-122. 8. Horton JC. Disorders of the eye. In: Fauci AS, Braunwald E, Kasper DL, et al, eds. [uspharmacist.com]
Prevention
Control measures for acute bacterial conjunctivitis Preventive measures Preventative measures include careful treatment of affected eyes and personal hygiene, particularly handwashing. [www2.health.vic.gov.au]
The ointment helps prevent eye infection. Jan. 03, 2019 [mayoclinic.org]
Prevention Prevention is important for avoiding the disease and stopping its spread. Careful washing of the hands, the use of clean handkerchiefs, and the avoidance of contagious individuals are all helpful. [ophthalmologyltd.com]
Topical antibiotics shorten the course of the disease, reduce discomfort, prevent person-to-person transmission and reduce the rate of reinfection. [eurekaselect.com]
Therefore any significant benefit arising from the use of antibiotics in these studies appears to be related to the rate of resolution of the condition, rather than due to prevention of complications. [thennt.com]