Allergic conjunctivitis

Clinical Features

1. Itching
2. Watery discharge
3. Injected and edematous conjunctiva
4. Papillae on inferior conjunctival fornix
5. Red, swollen eyelids

Diagnosis

Clinical diagnosis of conjunctivitis^

Conjunctivitis

	Bacterial	Viral	Allergic
Bilateral	50%	25%	Mostly
Discharge	Mucopurulent	Clear, Watery	Cobblestoning, none
Redness	Yes	Yes	Yes
Pruritis	Rarely	Rarely	Yes
Increased Likelihood	Presence of mucopurulent discharge; otitis media	Concomitant pharyngitis; an enlarged preauricular node; contact with another person with red eye	NA
Additional	Treatment: Antibiotics	Treatment: Hygiene	Seasonal

Differential Diagnosis

Conjunctivitis Types

• Viral conjunctivitis
  • Epidemic keratoconjunctivitis
  • Herpes zoster ophthalmicus
  • Herpes simplex keratitis
• Bacterial conjunctivitis
  • Gonorrheal conjunctivitis
  • Chlamydia conjunctivitis
• Allergic conjunctivitis
• Caustic keratoconjunctivitis

Treatment

1. Mild: avoid triggers, cool compresses x 15 minutes QID
2. Moderate: Histamine-blocking drops (e.g. olopatadine, pemirolast, or ketotifen)
3. Severe: referral to opthalmology for possible steroid therapy

Disposition

• Outpatient ophthalmology follow-up

See Also

• Conjunctivitis
• Eye Algorithm (Main)

Source

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