Conjunctivitis

Bacterial

Bacterial conjunctivitis accounts for approximately 50% of all adult cases of conjunctivitis where swabs were taken [5] and between two-thirds and four-fifths of cases in children [6,7]. Common causative organisms include Streptococcus pneumoniae, Staphylococcus aureus and Haemophilus influenzae. Gonococcal and chlamydial conjunctivitis are rarer but potentially far more serious and should be suspected in:

• Neonates
• Adults with urogenital symptoms i.e. urethral or vaginal discharge
• Patients who fail to respond to initial treatment

If either gonococcal or chlamydial conjunctivitis is suspected, an eye swab should be taken and the patient referred for an ophthalmology assessment.

Viral Conjunctivitis

Viral conjunctivitis is commonly caused by infection with adenovirus, but other viruses (e.g. mumps, measles and herpes) may also be responsible. The infection is easily transmitted from eye to eye and between family members

Allergic Conjunctivitis

Allergic conjunctivitis is typically a seasonal problem and commonly associated with other atopic diseases. Symptoms include itching and watering of the eyes. Findings on examination include bilateral generalised conjunctival injection, eyelid swelling and occasionally conjunctival oedema. The problem is managed by removing exposure to the pathogen, application of cool compresses to the eyes and in severe cases, an oral or topical ocular antihistamine.