Diferencia entre revisiones de «Viral conjunctivitis»

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===Background===
===Background===
*Form of viral conjunctivitis that causes keratitis in addition to conjunctivitis
*Form of viral conjunctivitis that causes keratitis in addition to conjunctivitis
*Caused by certain types of adenovirus
*Vision-threatening
*Caused by adenovirus infection that is highly contagious and tends to occur in epidemics


===Clinical Features===
===Clinical Features===
*Often preceded by cough, high fever, malaise, myalgias, N/V
*Usual symptoms of viral conjunctivitis plus:
*Usual symptoms of viral conjunctivitis plus:
**Foreign body sensation
**Foreign body sensation
**Multiple corneal infiltrates
**Photohobia
**Decreased visual acuity
**Chemosis
**Papillae of inf palpebral conjunctiva
**Ipsilateral preauricular LAD
 
===Diagnosis===
*Slit Lamp
**Diffuse, superficial keratitis but no corneal ulceration


===Treatment===
===Treatment===
*Artifical tears
*Cool compresses
*Cycloplegics if photophobia is severe
===Disposition===
*Referral to ophthalmologist to confirm dx and decide if pt requires course of steroids
*Referral to ophthalmologist to confirm dx and decide if pt requires course of steroids


==Source==
==Source==
*Tintinalli
*Tintinalli
*Mahmood AR, Narang AT. Diagnosis and management of the acute red eye. Emerg Med Clin N Am. 2008;26:35-55.
*Mahmood, Narang. Diagnosis and management of acute red eye. Emerg Med Clin N Am 2008;26


[[Category:Ophtho]]
[[Category:Ophtho]]
[[Category:ID]]
[[Category:ID]]

Revisión del 19:04 25 oct 2011

Typical Viral Conjunctivitis

Background

  • Most common cause of infectious conjunctivitis
  • Often preceded by URI (usually adenovirus)

Clinical Features

  • Complaint of "red eye" with mild-moderate, watery discharge
  • Usually painless unless there is some degree of keratitis
  • Often one eye will be involved initially with other eye involved within days
  • Unilateral or bilateral conjunctival injection with perilimbal sparing
  • Chemosis and subconj hemorrhages may be present

Diagnosis

  • Slit Lamp
    • Follicles on inferior palpebral conjunctival
    • Mild, punctate fluorescein staining of cornea (occasional)
      • Must differentiate from herpetic dendrite

DDx

Eye Algorithm (Main)

Treatment

  1. Artificial tears 5-6x per day
  2. Cold compresses
  3. Consider topical abx if unable to differentiate from bacterial conjunctivitis
  4. Frequent hand-washing (highly contagious)

Disposition

  • Follow-up with ophtho if worsening or no improvement in 7 days

See Also

Epidemic Keratoconjunctivitis

Background

  • Form of viral conjunctivitis that causes keratitis in addition to conjunctivitis
  • Vision-threatening
  • Caused by adenovirus infection that is highly contagious and tends to occur in epidemics

Clinical Features

  • Often preceded by cough, high fever, malaise, myalgias, N/V
  • Usual symptoms of viral conjunctivitis plus:
    • Foreign body sensation
    • Photohobia
    • Chemosis
    • Papillae of inf palpebral conjunctiva
    • Ipsilateral preauricular LAD

Diagnosis

  • Slit Lamp
    • Diffuse, superficial keratitis but no corneal ulceration

Treatment

  • Artifical tears
  • Cool compresses
  • Cycloplegics if photophobia is severe

Disposition

  • Referral to ophthalmologist to confirm dx and decide if pt requires course of steroids

Source

  • Tintinalli
  • Mahmood, Narang. Diagnosis and management of acute red eye. Emerg Med Clin N Am 2008;26