Acute conjunctivitis

SIGNS / SYMPTOMS

Typically a chronic condition of adults; occurs in women more than men; usually bilateral with minimal discharge or eyelash matting; minimal injection; no discharge or lymphadenopathy.

SIGNS / SYMPTOMS

Typically a chronic condition of adults; occurs in women more than men; usually bilateral with minimal discharge or eyelash matting; minimal injection; no discharge or lymphadenopathy; presence of meibomian gland dysfunction, eyelid margin telangiectatic vessels; collarets along the lashes.

SIGNS / SYMPTOMS

Unilateral more common than bilateral; typically segmental injection; no discharge or eyelid matting; minimal discomfort.

SIGNS / SYMPTOMS

History of sleeping in contacts; multiple recurrences; light sensitivity.

SIGNS / SYMPTOMS

Pain and light sensitivity more pronounced than irritation; unilateral more common than bilateral.

SIGNS / SYMPTOMS

Adult typically older than 40 years; nausea and vomiting may also be present as well as a deep, dull, periocular headache; unilateral; pain associated with decreased vision; mid-dilated, unreactive pupil; presence of an afferent pupillary defect.

SIGNS / SYMPTOMS

Patient may report intense pain, discharge, photophobia, increased lacrimation; the eyelid may also swell.

Examination may reveal a corneal ulcer that may be bacterial, viral, or fungal; reduced visual acuity; a swollen eyelid and discharge may be visible.

Rarely, bacterial conjunctivitis can develop into keratitis in patients with a history of contact lens use or who are immunocompromised.

SIGNS / SYMPTOMS

Patient may initially report a foreign body sensation, which progresses to photophobia, blurred vision, pain, and discharge; the eyelids may also swell.

Examination may reveal reduced visual acuity, often severe conjunctival injection; a swollen eyelid and discharge may be visible; corneal fluorescein stain seen; ulcer may be bacterial, viral, or fungal.

SIGNS / SYMPTOMS

Acute onset of ocular unease; this may have been preceded by a history of minor trauma.

Reduced visual acuity; normal pupillary reactions; single eye, conjunctival injection with corneal fluorescein stain seen; the eyelid may be swollen; no discharge.

SIGNS / SYMPTOMS

A foreign body sensation progressing to photophobia and pain may be reported; the sensation is frequently preceded by a gust of wind or following use of hammering or grinding equipment.

A foreign body may be seen either on the cornea, under the upper lid, or within the lower fornix; normal visual acuity and pupillary reactions.

SIGNS / SYMPTOMS

Often reduced vision; small particle foreign body into eye, often wind-blown with low velocity; persistent sharp scratching foreign body sensation, worse on blinking; watering, often profuse; no discharge.

On examination, possible reduced visual acuity; injected conjunctiva, often localized; foreign body visible on conjunctiva on eversion of eyelid (either upper or lower), often best visualized with fluorescein staining; corresponding fine linear corneal abrasions; normal pupil response.

SIGNS / SYMPTOMS

Usually appears spontaneously; occasionally history of Valsalva maneuver, coughing, sneezing, or heavy lifting; usually asymptomatic; occasional mild discomfort, or popping sensation at onset; possible association with systemic hypertension or anticoagulant medication.

Examination reveals well-circumscribed area of confluent hemorrhage underneath conjunctiva (if the posterior border cannot be seen then it may originate from intracranial hemorrhage, which warrants immediate emergency referral), often sectorial; cornea clear, no fluorescein stain; normal visual acuity and pupil response; possible systemic hypertension; blood pressure should be measured in all patients and managed as per guidelines.

SIGNS / SYMPTOMS

Patient may report severe ocular pain and redness (prominent feature); no discharge; reduced visual acuity may be present; past medical history should be reviewed for any known systemic associations such as connective tissue disorders including rheumatoid arthritis, granulomatosis with polyangiitis (formerly known as Wegener granulomatosis), systemic lupus erythematosus, and relapsing polychondritis.

Examination may reveal deep scleral vessel engorgement and pain on ocular palpation; no fluorescein stain; visual acuity and pupillary reactions may be abnormal depending on the position of the scleritis on the globe (anterior or posterior).