Last reviewed:October 2019
Last updated:July  2019

Summary

Definition

History and exam

Key diagnostic factors

  • watery discharge
  • ropy, mucoid discharge
  • purulent discharge
  • itching predominant symptom
  • eyelids stuck together in morning
  • tender, preauricular lymphadenopathy

Other diagnostic factors

  • conjunctival follicles
  • superficial punctate keratopathy
  • unilateral disease
  • corneal subepithelial infiltrates
  • corneal pannus
  • vesicular skin rash

Risk factors

  • exposure to infected person
  • infection in one eye
  • environmental irritants
  • allergen exposure
  • camps, swimming pools, military bases
  • Asian or Mediterranean young male
  • atopy
  • asthma
  • hay fever
  • contact lens use
  • ocular prosthesis
  • topical eye medication
  • oral antihistamine/anticholinergic drugs
  • sebaceous gland carcinoma
  • mechanical irritation
  • history of rheumatologic disease

Diagnostic investigations

1st investigations to order

  • rapid adenovirus immunoassay
Full details

Investigations to consider

  • cell culture
  • Gram stain
  • polymerase chain reaction
  • ocular pH
Full details

Treatment algorithm

Contributors

Fellowship-Trained Ophthalmologist

Manatee Sarasota Eye Clinic & Laser Center

Bradenton

FL

Disclosures

RS serves as a consultant for Quidel, the manufacturer of the QuickVue Adeonvirus test, an advisory board member for Allergan, the manufacturer of gatifloxacin, and NovaBay Pharmaceuticals, Inc, the manufacturer of aganocides.

Dr Robert Sambursky would like to gratefully acknowledge Dr Lee Raykovicz, a previous contributor to this topic.

Peer reviewersVIEW ALL

Director

Cornea, External Disease & Refractive Surgery

Long Island College Hospital Eye Center

Assistant Professor of Ophthalmology

SUNY Downstate Medical Center

Brooklyn

NY

Disclosures

ME declares that he has no competing interests.

Consultant Ophthalmologist

Sunderland Eye Infirmary

Sunderland

UK

Disclosures

SF declares that he has no competing interests.

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