Study Guide / Newest 2025/2026 Actual Exam /
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Allergic Conjunctivitis - Inflammation of theconjunctiva due
to allergies is common, occurring in up
to 40% of the population. Itching is the
most consistent sign of allergic
conjunctivitis; it is also characterized by
red eyes and other allergic disease
symptoms such as sneezing.
- Symptoms: severe itching (MOST
PROMINENT) , generalized hyperemia
of the conjunctiva, & mild-moderate
tearing. Rubbing of eyelids can lead to
eyelid edema and temporary
hyperpigmentation
(allergic shiners/raccoon eyes).
Allergic conjunctivitis often
accompanied by s/s of allergic
rhinitis, including the presence of a
crease on the nose from frequent
manipulation (toddler salute).
- Treatment: Mild-moderate
,symptoms ma be managed with
artificial tears and cool/cold
compresses. Severe s/s may require an
ophthalmology consultation, and
immune modulation with topical
antihistamine, mast cell stabilizer, or
mild steroid.
,Bacterial Conjunctivitis Bacterial conjunctivitis is the
second most common cause of
infectious conjunctivitis, Red, itchy eyes
are associated with this condition, as is
purulent or mucopurulent discharge in one or both eyes.
- Symptoms: copious mucopurulent
discharge (MOST
PROMINENT), often unilateral
(helps distinguish from
allergic/viral etiology) but may
spread to both eyes via hands
when rubbing eyes, and
pain/irritation with severe
hyperemia. **There should be NO
frank vision loss.**
- Treatment: Usually with topical
antibiotic ointments or drops.
**Otherwise immunocompetent
patients with unilateral disease may
be treated empirically with topical
fluoroquinolones such as
moxifloxacin or gatifloxixin. If no
improvement within 48 hours,
cultures should be repeated and
ophthalmology should be consulted.
- Inflammation of the conjunctiva due
to medications, chemicals, or toxins can
cause red, itchy eyes.
Toxic Conjunctivitis
, - Viral conjunctivitis is the
mostcommon cause of infectious
conjunctivitis. Red, itchy eyes are
associated with this condition, as is a
watery discharge.
**65-90 % of viral conjunctivitis are
caused by adenoviruses, which are
highly contagious and spread
through direct contact.
Communicability is estimated to be
10-14 days. Topical ophthalmic
antihistamines (preferably OTC)
may be recommended to reduce
itching and soothe the eyes.
- Symptoms: Usually presents
bilaterally, but symptoms often start
in 1 eye 1-2 days prior. Pain and
burning are the MOST PROMINENT
symptoms, and
eyes are very red with copious
tearing. Preauricular lymph node
may be palpated, which is
relatively specific to viral etiology.
**Symptoms tend to worsen for
the first few days, and generally
resolve within 1-2 weeks.**
**Hand washing and contact
precautions are imperative to
prevent the spread of infection.** If
hospital staff become infected, they
will have to be off for 7 days after
Viral Conjunctivitis