Conjunctivitis: Systematic Approach to Diagnosis and Therapy

Abstract

Conjunctivitis is a common problem in primary health care. Inflammation of the conjunctiva may result from infection or noninfectious causes. Microbial conjunctivitis may be caused by bacteria, viruses, or parasites. Although usually a benign, self-limited disease in healthy individuals, serious complications (eg, keratitis) may be sight-threatening. Accurate diagnosis and specific treatment of conjunctivitis remain challenging. History taking and physical examination are occasionally insufficient for correct diagnosis, thus laboratory testing may play a vital role in identification of specific pathogen(s). However, diagnostic testing has several limitations, including time-consuming methods, increased cost, and requirement for expertise in performance and interpretation. Treatment with empirical topical antibiotics for suspected infectious conjunctivitis is controversial. Although antibiotic treatment can diminish risk of adverse events and shorten the course of disease, drug resistance, toxicity, and expense are important considerations in management of acute infectious conjunctivitis.

Etiology of Acute Conjunctivitis Due to Coxsackievirus A24 Variant, Human Adenovirus, Herpes Simplex Virus, and Chlamydia in Beijing, China

“…Because of the considerable overlap in presentation, infectious conjunctivitis is difficult to distinguish clinically. The results of the present study were in agreement with those of previous reports (38).…”

Management of dupilumab‐associated conjunctivitis in atopic dermatitis

“…Affected patients should be seen by an ophthalmologist in order to correctly establish the diagnosis of dupilumab‐associated conjunctivitis and to rule out other types of conjunctivitis (e.g., bacterial or viral). The diagnosis is facilitated by obtaining a detailed history, clinical features (discharge, pruritus, other concurrent symptoms) as well as slit‐lamp examination . Unilateral involvement is suggestive of an infectious origin, whereas bilateral clinical manifestations are more indicative of allergic keratoconjunctivitis.…”

Gatifloxacin 0.5% Administered Twice Daily for the Treatment of Acute Bacterial Conjunctivitis in Patients One Year of Age or Older

“…5 Incidence and prevalence rates are difficult to ascertain owing to the inability to collect specimens, inadequacy of specimens, and spontaneous remission before diagnosis. 6 Collectively, acute conjunctivitis (bacterial, viral, and allergic) is estimated to account for 1% to 4% of all visits to the primary care physician in the developed world. [7][8][9][10] Although it is often a self-limiting disease, approximately 70% of patients with acute conjunctivitis seek treatment at primary and urgent care centers in the United States.…”