Forms of Conjunctivitis-

Please note you do not need to refer to HES for conjunctivitis, Unless you believe it to be outside your remit of clinical ability,  Chlamydial, or despite management no resolution is possible or getting worse?

            CLPC 
      Allergic Acute 
          BACTERIAL 
        CHLAMYDIAL 
      MEDICAL 
  • Itchy- None specific irritationIncreases after CL removal  
  • Mucus Discharge- increases with lens movement 
  • CL intolerance and discomfort 
  • Blurred VA 
  • Bilateral  
  • Upper tarsal Conjunctival will show: 
-papillae 
-Hyperaemia 
-Stringy Mucus 
Conj.oedema 
  • Lens surface deposit 
  • Common in children 
  • Sudden Eyelid swelling 
  • Itchy eyes 
  • Oedema/erythema or chemosis  
  • Watery/ mucoid discharge  
  • No papillae 
  • No corneal involvement 
  • Children and elderly 
  • Acute Onset 
– red/discomfort 
-Gritty/burning 
-discharge 
-VA temp blurring 
-Crusty lids 
-Lids sticky/bathed to open 
  • Bilateral 
  • Purulent/Mucopurulent 
  • Cornea clear 
  • Lower cornea SPK? 
  • If significant: 
?Gonococcal bacteria 
              Contagious 
  • Young adults  (15-35) 
  • History >2/52 
  • Droopy lids/ptosis 
  • Gritty and sticky eyes 
  • Lid oedema/swelling 
  • Mucopurulent conjunctivitis  
  • Large follicles 
  • Epithelial KP(SPK) 
  • Subepithelial infiltrates 
  • Marginal infiltrates 
  • Superior pannus 
  • Delayed sensitivity to eye drops 
  • Pain.irritation,burning, 
  • photophobia lid swelling, VA blurred? 
  • Diffused Punctate staining 
  • Chronic Epithelial defect 
  • Corneal oedema 
  • Disciform Stromal Infiltrates 
Clinician’s Approach                                              © chaaban Zeidan 2019 
  • Remove CL 
  • Reduce exposure time 
  • Enhance fit 
  • Topical Mast cell Stabiliser: ex: 
  • Na Cromoglycate 
  • Nedocromil Na 
  • Lod oxamide 
  • Topical Steroid NOT RECOMMENDED 
  • Reassurance 
  • Topical Mast cell Stabiliser: ex:    Na Cromoglycate Nedocromil Na    Lod oxamide 
  • Cold compresses 
  • Identify allergen  
  • Seek help if persistent !
  • Often resolved <7/7 
  • Bath eyes /lid hygiene 
  • Antibiotics: 
-cream qid 7/7 
              Bd 5/7 
-drops 2hrly 2/7 
             qid    5/7 
  • Resolution 7/7 
  • No to CL 
  • Lubricants 
  • DO NOT OFFER ANY TREATMENT 
  • REFERAL:  
 

*URGENT

TO

STD

* via your agreed referral route

  • Withdraw offending drugs or offer the drug preservative free 
  • Cold compress 
  • Do not discontinue drug if can lead to more serious issues ex. Glaucoma 
  • Send back to prescriber 
NO REFERRAL NEEDED 
(generally) NO REFERRAL NEEDED 
Manage to resolution 
URGENT REF> TO STD 
    No referral Neede d