Acute conjunctivitis
Resumen
Definición
Conjunctivitis is the inflammation of the lining of the eyelids and eyeball caused by bacteria, viruses, allergic or immunologic reactions, mechanical irritation, or drugs.[Figure caption and citation for the preceding image starts]: Viral conjunctivitisFrom the collection of Robert Sambursky, MD; used with permission [Citation ends].
Anamnesis y examen
Principales factores de diagnóstico
- watery discharge
- ropy, mucoid discharge
- purulent discharge
- itching predominant symptom
- red eye
- eyelids stuck together in morning
- tender, preauricular lymphadenopathy
Otros factores de diagnóstico
- conjunctival follicles
- chemosis
- swollen eyelids
- superficial punctate keratopathy
- unilateral symptoms and signs
- use of drugs that may lead to eye irritation
- contact lens use
- corneal subepithelial infiltrates
- corneal pannus
- vesicular skin rash
- symptoms and signs of related systemic disease
Factores de riesgo
- 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 preparations
- use of oral antihistamines 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
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- rapid adenovirus immunoassay
Pruebas diagnósticas que deben considerarse
- conjunctival cultures
- special stains (Gram, Giemsa)
- polymerase chain reaction (PCR)
- ocular pH
- allergy skin testing
- tear immunoglobulin E level
Algoritmo de tratamiento
allergic conjunctivitis (seasonal/perennial)
bacterial conjunctivitis
chlamydial conjunctivitis (inclusion)
viral conjunctivitis
neonatal conjunctivitis
contact lens related
mechanical conjunctivitis
toxic/chemical conjunctivitis
drug-related conjunctivitis
Colaboradores
Autores
Christopher McStay, MD
Associate Professor of Emergency Medicine
Vice Chair of Clinical Operations
Columbia University Vagelos College of Physicians and Surgeons
New York
NY
Divulgaciones
CM declares that he has no competing interests.
Agradecimientos
Dr Christopher McStay would like to gratefully acknowledge Dr Lee Raykovicz and Dr Robert Sambursky, previous contributors to this topic.
Divulgaciones
LR declared he was Director of Clinical Relations, Rapid Pathogen Screening, Inc. RS is employed by Verséa Ophthalmics and serves on the board of Visus Therapeutics.
Revisores por pares
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
Divulgaciones
ME declares that he has no competing interests.
Scott Fraser, MD, FRCS (Ed), FRCOphth
Consultant Ophthalmologist
Sunderland Eye Infirmary
Sunderland
UK
Divulgaciones
SF declares that he has no competing interests.
Agradecimiento de los revisores por pares
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Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
Artículos principales
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 Resumen
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 Resumen
Artículos de referencia
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Diferenciales
- Dry eyes
- Blepharitis
- Episcleritis
Más DiferencialesGuías de práctica clínica
- Conjunctivitis preferred practice pattern
- Cornea/external disease summary benchmarks
Más Guías de práctica clínicaFolletos para el paciente
Conjunctivitis
Más Folletos para el paciente
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