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1. :
2. Allergic conjunctivitis
Answer IgE mediated disease in response to triggers. Common triggers can be seasonal
such as grass, pollens, and mold. Persistent allergic triggers include dust mites and animal
dander. Bilateral, itchy red eyes with rope like discharge and clear nasal discharge
Bilateral injected conjunctiva, clear discharge
Treatment based on identification and limiting exposure to allergen.
Medications include cromolyn ophthalmic drops, oral antihistamines, antihistamine eye drops
3. Viral conjunctivitis
Answer Most commonly caused by the adenovirus.
Unilateral or bilateral red eyes, reports of current or recent viral infection, such as a
UTI Unilateral or bilateral injected conjunctiva, watery discharge
No antibacterial therapy needed.
Virus resolves in 2-3 weeks
,4. Bacterial conjunctivitis
Answer Common bacteria include: Staphylococci, streptococci, chlamydial organisms
and gonococci.
Some bacterial causes can be quite serious.
Gonococcal conjunctivitis can result in blindness and can indicate underlying systemic
infection. Usually unilateral, red and irritated
Eyelids are "stuck together" upon awakening.
Injected palpebral and bulbar conjunctiva, purulent drainage
Treatment is provided to decrease spread of contagion and shorten course of
illness. Eye drop treatments include Polymixin B plus trimethoprim or
azithromycin.
5. Otitis Externa:
Answer inflammation of the externa ear canal, is also known commonly as swimmer's ear. Occurring
in both children and adults, otitis externa can present as a range of physical symptoms from a minor
inflammation to reports of intense pain.
Otitis Externa Risk Factors
Swimming
Impacted cerumen
, Use of hearing aids/ear plugs
Trauma from cotton tip applicators or other items used to clean ear canal
Foreign bodies
Anatomic causes: narrow ear canals, sharp angles in the ear canal or excessive hair in the canal
The normally acidic pH of the ear canal tends to inhibit microorganism growth. Swimming in a pool where the
pH is
usually alkaline can result in altered pH of the ear canal. It is thought that it is this alteration in pH creates a
favorable environment for bacteria or fungal growth. The most common causative agent is P. aeruginosa,
other causes include Candida or Aspergillus species.
Common complaints (subjective findings):
Children: irritability, crying, disrupted sleep. Unilateral ear tugging, unilateral
otalgia Adults: unilateral otalgia
Physical exam (objective findings): Ear pain is increased upon palpation of tragus. The external ear canal
epithelium edema may extend from the pinna all the way to the tympanic membrane. Purulent or serous
discharge is noted in the canal.
Medication management depends upon the causative factors:
Pain management: OTC analgesics include ibuprofen or acetaminophen as appropriate for age and weight
Bacterial Otitis externa can be treated with antimicrobial otic drops, which include polymyxin B plus neomycin