- Conjunctivitis is inflammation of the conjunctiva caused by bacteria, virus or allergy or associated with foreign body.
- Bacteria involved are commonly Staphylococcus, Streptococcus pneumoniae or Haemophilus influenza.
- More often Gram-negative bacteria in patients with contact lens.
- Eye feels gritty (allergic conjunctivitis is itchy).
- Watering of the eye - discharge may be yellow/white and mucopurulent.
- Check to exclude foreign body.
- May resolve without treatment.
- Avoid spread to contacts.
- Swab from discharge for culture and sensitivities.
- Topical chloramphenicol or gentamicin eye drops.
- Azithromycin twice daily for three days may be helpful.
- Gonococcal and chlamydia conjunctivitis requires topical and systemic antibiotics. This is likely to be sexually transmitted and so a full check of patient and contacts would be required.
Acute anterior uveitis (iritis)
- Painful red eye - usually unilateral.
- Photophobia and watering of the eye - not mucopurulent.
- Usually occurs after the age of 20. Usually idiopathic and may have recurrent episodes.
- May be associated with HLA-B27, herpes zoster, ankylosing spondylitis, inflammatory bowel disease, sarcoidosis, reactive arthritis or reaction to drugs.
- Irregular, poorly reactive constricted pupil as the condition develops.
- Patients should be referred urgently to the ophthalmic unit for slit lamp examination, fundoscopy, measurement of intraocular pressures and check of visual acuity.
- Specialist advice regarding mydriatics and cycloplegics such as cyclopentolate or homatropine eye drops.
- Prednisolone eye drops.