Conjunctivitis (“Red Eye”)

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ICD10 CODE: H10

Inflammation of the conjunctiva of the eye.

Cause

  • Infection: Bacterial or viral
  • Trauma: Chemicals, foreign bodies
  • Smoke, allergy

Clinical features

  • Watery discharge (viral or chemicals)
  • Pus discharge (bacteria)
  • Cornea is clear and does not stain with fluorescein
  • Visual acuity is normal
  • Redness (usually both eyes but may start/be worse in one; usually reddest at outer edge of the eye)
  • Swelling and itching (may be present)

Differential diagnosis

  • Corneal ulcer (tends to be in one eye only, redness is greatest near the cornea, pain is often great)

Investigations

  • Clinical features are diagnostic
  • Pus swab for culture and sensitivity

ManagementTreatment

Infective conjunctivitis

  • Apply chloramphenicol or gentamicin eye drops 2 or 3 hourly for 2 days then reduce to 1 drop every 6 hours for 5 days
  • Change treatment as indicated by results of culture and sensitivity where possible

Note: NB. Gonococcal conjunctivitis should be treated aggressively and in line with management of Sexually Transmitted Infections (See Sexually Transmitted Infections)

Allergic conjunctivitis

  • Cold compresses and facial hygiene
  • Betamethasone or hydrocortisone eye drops every 1-2 hours until inflammation is controlled then apply 2 times daily
  • Limit use of steroid eye drops to short durations

Caution: Do not use steroid preparations unless you are sure of the diagnosis as they may mask infections

Prevention

  • Personal hygiene; daily face washing
  • Avoid irritants and allergens