The evaluation for ocular surface disorders includes a carefully detailed patient history, assessment of associated risk factors, and examination of the anterior ocular structures and their functions.
There are several causes of conjunctivitis and it is important to make the correct diagnosis to avoid complications.
Evaluation of a patient exhibiting blepharitis, dry eye symptoms or signs consistent with blepharitis includes many of the elements of a comprehensive eye and vision examination and a more in-depth evaluation of the ocular surface and adnexa1,2.
Not every 'red eye' is 'bacterial conjunctivitis'. Be wary, particularly in cases that are sub-acute in onset, not responding to treatment or that are associated with other symptoms such as reduced vision, photophobia, double vision or significant eye pain2.
In patients who are contact lens wearers, be alert to the possibility of contact lens-related corneal infection.
Learn about broad differential features of bacterial, viral, chlamydial and allergic conjunctivitis.2
Learn more about the signs and symptoms of blepharitis.4,5
This condition varies in severity from mild hyperaemia and tearing to a severe conjunctivitis with copious purulent discharge. Rarely conjunctivitis is sight threatening causing irreversible scarring.
Conjunctivitis has been described as clinically differentiated by symptoms and signs, i.e. discharge, conjunctival reaction, membranes and lymphadenopathy2.
Type | Conjunctivital2 | Itching | Discharge | Lymphadenopathy | Associated Fever and Sore Throat |
---|---|---|---|---|---|
Bacterial | Papilliary | Minimal | Purulent | Uncommon | Yes |
Viral | Follicular | Minimal | Watery | Common | Yes |
Allergic | Papilliary with chemosis | Severe | Watery | None | No |
Chlamydial | Follicular | Minimal | Mucopurulent | Common in inclusion conjunctivitis | No |
Acute onset of:
Blepharitis is suspected when both the eyelids burn, itch and stick together, with the symptoms becoming worse in the morning. Symptoms are often intermittent, with exacerbation and remissions occurring over long periods3.
Evaluation of a patient exhibiting dry eye symptoms or signs consistent with blepharitis includes many of the elements of a comprehensive eye and vision examination and a more in-depth evaluation of the ocular surface and adnexa1.
Note: Cases of rapid onset of visual loss or an acutely painful red eye if present should be referred to the ophthalmologist for same day evaluation.
Conditions | Symptoms12 | Signs12 |
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Staphylococcal Blepharitis |
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Seborrheic Blepharitis |
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Meibomian gland dysfunction |
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Combination of seborrheic Blepharitis and meibomian gland dysfunction |
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Fusidic acid 1% w/v eye drops
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