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Firstly, we know about Conjunctiva, it is a transparent mucous layer underlying the eyelids & cover the sclera up to limbus area.

• Conjunctivitis is inflammation of Conjunctiva with a discharge (may be like watery), either mucopurulent or purulent present, commonly known as pink eye. It can be caused by allergies or viral infections or Bacterial infections.
• Types of Conjunctivitis according to Signs & symptoms:

•  Infective Conjunctivitis: 

1. Bacterial Conjunctivitis: It is commonest types of conjunctivitis in developing countries. 

Clinical types of bacterial conjunctivitis.

• Acute bacterial conjunctivitis: it is basically called acute mucopurulent conjunctivitis cause of release conjunctival mucopurulent discharge from the eye.
• Symptoms: 

– discomfort & FB sensation on vessels.

– Mild photophobia.

– Mucopurulent discharge

• Signs: 

– Flakes of mucopus present in fornics.

– Conjunctival Congestion.

– Swelling of conjunctiva.

• Diagnosis: 

-acute red eye

• Treatment:

-*Tobramycin (0.3%) 3 times in a day.

-*Moxifloxacin (0.5%) 3 times in a day.

 

• Hyperacute bacterial conjunctivitis: these types of conjunctivitis also known as acute purulent conjunctivitis. This disease affects adults & predominantly male.
• Symptoms:  

-pain

– Purulent discharge

– Swelling of eyelids

• Signs:

-eyelids tense

-discharge thick purulent.

• Treatment:

– Norfloxacin orally for 5 days.

-erythromycin E/O every 2 hours for 2-3 days then 5 times daily for 7 days.

 

• Choronic bacterial conjunctivitis: it is also known as simple chronic conjunctivitis.
• Symptoms:

-Mild chronic redness in eyes.

-burning sensation

-difficulty in keeping eyes open.

• Signs:

-lid margins may be congested.

-surface of conjunctiva looks sticky.

• Treatment:

-*Tobramycin 3-4 times in a day for 2 weeks.

-*Gentamycin 3-4 times in a day for 2 weeks.

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• Angular bacterial conjunctivitis: it is a type of conjunctivitis characterized by mild grade inflammation.
• symptoms: 

– irritation.

-redness in angle of eye.

-dirty white foamy discharge.

• Signs:

-foamy mucopurulent.

-excoriation of the skin around the angles.

• Treatment:

-oxytetracycline (1%) ointment, 2-3 times day for 9-14 days.

 

Viral Conjunctivitis:

• Allergic Conjunctivitis: It is an inflammation of conjunctiva due to allergic or hypersensitivity reactions. 

• Simple allergic Conjunctivitis: It is mild allergic conjunctivitis characterized by itching and mild papillary response. 

• Symptoms:

– itching & burning sensation.

– watery discharge & mild photophobia.

• Signs:

– oedema of lids.

– swollen juicy appearance to the conjunctiva.

• Treatment:

-Naphazoline

-Ephedrine

• Vernal Keratoconjunctivitis (VKC):  It is recurrent, bilateral, self-limiting, allergic inflammation of the conjunctiva.

 

• Symptoms:

-burning sensation.

-itching sensation.

• Signs:

– cobblestone papillae.

– giant papillae.

– white ropy discharge.

 

 

• Atopic Keratoconjunctivitis:

– most of patients are young atopic dermatitis, with male predominance.

Symptoms:

-itching, soreness, dry sensation.

-mucoid discharge.

-photophobia or blurred vision.

Signs: 

-Tarsal Conjunctiva milky appearance

– very fine papillae

– scarring with shrinkage.

– corneal vascularization.

• Treatment:

-Treat with sodium cromoglycate drops.

– Steroids & tear supplement.

 

• Giant Papillary Conjunctivitis (GPC): it is inflammation of conjunctiva with large size papillae. Basically, physically rough & deposited surface.
• Symptoms:

– itching present.

– stringy discharge.

– reduce wearing time of contact lens.

• Signs:

– Papillary hypertrophy of the upper tarsal conjunctiva.

• Treatment: 

– After discontinuation of contact lens or artificial eye, the papillae resolve over a period of one month.

– Disodium Cromoglycate is gives relieve the symptoms.

– Steroids are not of much use in this condition.

• Phlyctenular Conjunctivitis: in these types of conjunctivitis nodular allergen affection present in Conjunctiva. These types of conjunctivitis is higher in developing countries.
• Symptoms: this types of conjunctivitis in simple phlyctenular have present mild discomfort, irritation & complain watering.

– Mucopurulent conjunctivitis due bacterial secondary infection.

• Signs:

– presence of pinkish white nodule near the limbus.

In basis of signs 3 types conjunctivitis under phlyctenular keratoconjunctivitis

1. Simple phlyctenular conjunctivitis
2. Necrotizing phlyctenular conjunctivitis
3. Miliary phlyctenular conjunctivitis

• Treatment: 

– gives topical Steroids, in the eye drop solution.

– antibiotic drops.

-atropine (1%)

•  Cicatricial Conjunctivitis:

– there are many types of cicatricial conjunctivitis.

-OMMP

-SJS

-TEN

-Secondary Cicatricial Conjunctivitis

 

• Toxic Conjunctivitis: these types of conjunctivitis – Toxic 

Conjunctivitis secondary to molluscum contagiosum.

Chemical toxic conjunctivitis.