Resumo
Definição
Conjunctivitis is the inflammation of the lining of the eyelids and eyeball caused by bacteria, viruses, allergic or immunologic reactions, mechanical irritation, or medications.[Figure caption and citation for the preceding image starts]: Viral conjunctivitisFrom the collection of Robert Sambursky, MD; used with permission [Citation ends].
História e exame físico
Principais fatores diagnósticos
- watery discharge
- ropy, mucoid discharge
- purulent discharge
- itching predominant symptom
- red eye
- eyelids stuck together in morning
- tender, preauricular lymphadenopathy
Outros fatores diagnósticos
- conjunctival follicles
- chemosis
- swollen eyelids
- superficial punctate keratopathy
- unilateral symptoms and signs
- use of medications that may lead to eye irritation
- contact lens use
- corneal subepithelial infiltrates
- corneal pannus
- vesicular skin rash
- symptoms and signs of related systemic disease
Fatores de risco
- exposure to infected person
- infection in one eye
- environmental irritants
- allergen exposure
- concurrent infection
- camps, swimming pools, military bases
- hot, dry climate
- atopic dermatitis
- contact lens use
- ocular prosthesis
- trauma: mechanical, chemical, or ultraviolet
- recent surgery or exposed sutures
- rosacea
- allogeneic stem cell transplantation
- Stevens-Johnson syndrome/toxic epidermal necrolysis (TEN)
- prior infection with herpes simplex virus
- in neonate: vaginal delivery
- oculogenital spread
- asthma
- hay fever
- use of topical eye medications
- use of oral antihistamine or anticholinergic drugs
- neoplasia
- history of rheumatologic disease
- dysthyroid states
- immunocompromised state
- vasculitis
- nasolacrimal duct obstruction
- abnormality of supporting structures of the eye (adnexa)
- severe tear deficiency
- trauma
- use of biologic agents
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- rapid adenovirus immunoassay
Investigações a serem consideradas
- cell culture
- special stains (Gram, Giemsa)
- polymerase chain reaction
- ocular pH
- allergy skin testing
- tear immunoglobulin E level
Algoritmo de tratamento
allergic conjunctivitis (seasonal/perennial)
bacterial conjunctivitis
chlamydial conjunctivitis (inclusion)
viral conjunctivitis
neonatal conjunctivitis
contact lens related
mechanical conjunctivitis
toxic/chemical conjunctivitis
medication-related conjunctivitis
Colaboradores
Autores
Robert Sambursky, MD
Fellowship-Trained Ophthalmologist
Manatee Sarasota Eye Clinic & Laser Center
Bradenton
FL
Declarações
RS is employed by Verséa Ophthalmics and serves on the board of Visus Therapeutics.
Agradecimentos
Dr Robert Sambursky would like to gratefully acknowledge Dr Lee Raykovicz, a previous contributor to this topic.
Declarações
LR declared he was Director of Clinical Relations, Rapid Pathogen Screening, Inc.
Revisores
Michael Ehrenhaus, MD
Director
Cornea, External Disease & Refractive Surgery
Long Island College Hospital Eye Center
Assistant Professor of Ophthalmology
SUNY Downstate Medical Center
Brooklyn
NY
Declarações
ME declares that he has no competing interests.
Scott Fraser, MD, FRCS (Ed), FRCOphth
Consultant Ophthalmologist
Sunderland Eye Infirmary
Sunderland
UK
Declarações
SF declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referências
Principais artigos
Cheung, Albert Y. et al. Conjunctivitis preferred practice pattern. Ophthalmology. 2024 Feb 12;131(4): 134-204.Texto completo
Castillo M, Scott NW, Mustafa MZ, et al. Topical antihistamines and mast cell stabilisers for treating seasonal and perennial allergic conjunctivitis. Cochrane Database Syst Rev. 2015 Jun 1;(6):CD009566.Texto completo Resumo
Chen YY, Liu SH, Nurmatov U, et al. Antibiotics versus placebo for acute bacterial conjunctivitis. Cochrane Database Syst Rev. 2023 Mar 13;3(3):CD001211.Texto completo Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Dry eyes
- Blepharitis
- Episcleritis
Mais Diagnósticos diferenciaisDiretrizes
- Conjunctivitis preferred practice pattern
- Cornea/external disease summary benchmarks
Mais DiretrizesFolhetos informativos para os pacientes
Conjunctivitis
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