Conjunctivitis (ReelDx + Lecture) | ReelDx Virtual Rounds (Conjunctivitis)Patient will present as → a 6-year-old boy complaining of itchy eyes. The mother states that she has noted that he has been tearing up and that both of his eyes have been red for the past 4 days. The patient denies any pain but has had a runny nose for the past week. The mother states that he has not had any sick contacts, and he has been home from school for summer vacation. On exam, there is marked redness, tearing, and eyelid edema in both eyes. Viral conjunctivitis - copious watery discharge, scant mucoid discharge. Adenovirus (most common). Self-limiting associated with URI Bacterial conjunctivitis - will present with purulent (yellow) discharge, crusting, usually worse in the morning. It may be unilateral.
Allergic conjunctivitis - red eyes, itching and tearing, usually bilateral, cobblestone mucosa on the inner/upper eyelid TX: Bacterial: Treatment(s) in order of suggested use - the dose is 0.5 inches (1.25 cm) of ointment (preferable in children) deposited inside the lower lid or 1 to 2 drops instilled four times daily for five to seven days.
Contact lenses use = pseudomonas tx=fluoroquinolone (ciprofloxacin / Ciloxan drops)
Viral: There is no specific antiviral agent for the treatment of viral conjunctivitis. Some patients derive symptomatic relief from topical antihistamines/decongestants. Warm or cool compresses may provide additional symptomatic relief. Allergic conjunctivitis systemic antihistamines and topical antihistamines or mast cell stabilizers. (Naphcon-A, Ocuhist, generics)
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Subconjunctival hemorrhage | Patient will present as → a 45-year-old individual who noticed a bright red patch on the white of one eye upon waking up this morning. The patient reports no pain, vision changes, or recent injury to the eye but feels self-conscious about the appearance. The red patch does not extend to the iris, and there is no discharge or photophobia. Subconjunctival hemorrhage is a benign condition characterized by a sudden onset of a unilateral bright red patch on the sclera due to the rupture of small blood vessels under the conjunctiva
DX: Diagnosis is primarily clinical, based on the characteristic appearance of a bright red or dark red patch on the sclera, with clear demarcation, and absence of other symptoms such as pain, vision loss, or discharge
TX: Treatment is generally not required as the condition resolves on its own within two weeks. Artificial tears can help with any mild irritation |