Conjunctivitis

Etiology

  • Bacterial: Staph, H flu, Strep, Moraxella, Neiserrial
  • Viral: Adenovirus, enterovirus (non-polio), other; Rarely: measels, zika
  • Allergic: Response to an allergen
  • Autoimmune: Associated w/psoriatic arthritis, reactive arthritis, Sjogrens, other

Risk Factors

  • Viral in particular is easily passed to others via close contact, sharing towels, poor hand hygiene

Symptoms

  • Bacterial: Acute onset, very red conjunctiva (more red than viral) with opaque d/c (copious and thicker compared w/viral); Eyelids may feel "glued shut" in morning; Irritated, but not usually itchy; Sometimes blurriness, but no significant visual changes; More often unilateral than bilateral; Neisseria causes hyper-acute findings, w/very large amounts of thick d/c
  • Viral: Acute redness of conjunctiva, with watery discharge (less red, less d/c compared w/bacterial); Sometimes URI sx; No visual change; Uni- or bilateral; Gritty sensation
  • Allergic: Itchy; Chronic watery d/c; No visual change; Typically bilateral; May have allergic nasal or pulmonary sx too

Physical Exam Findings

  • Bacterial: Diffuse redness of conjunctiva; Thick, opaque discharge
  • Viral: Often clear d/c; Diffuse redness of conjunctiva; Sometimes pre-auricular adenopathy
  • Allergic: Bilateral watery d/c; Bilateral conjunctival inflammation

Sub-Diseases

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