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Conjunctivitis: Symptoms
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Acute bacterial conjunctivitis typically presents with burning, irritation, tearing and, usually, a mucopurulent or purulent discharge (Figure 5). Patients with this condition often report that their eyelids are matted together on awakening. Conjunctival swelling and mild eyelid edema may be noted. The symptoms of acute bacterial conjunctivitis are far less severe, less rapid in onset, and progress at a much slower rate than those of hyperacute conjunctivitis.
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Other symptoms including pain, blurring of vision and photophobia should not be prominent in conjunctivitis. Fluctuating blurring is common, due to tearing and mucoid discharge. Mild photophobia is common. However, if any of these symptoms are prominent, it is important to exclude other diseases such as glaucoma, uveitis, keratitis and even meningitis or caroticocavernous fistula.
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Typically with viral conjunctivitis, the third through the fifth days are the worst. After that, eyes begin to improve on their own. Treatment of viral conjunctivitis usually involves supportive therapies such as eye drops that help reduce the symptoms — for example, vasoconstrictors to whiten the eye, decongestants to reduce the surface swelling and/or antihistamines to reduce occasional itching. Treatments are usually continued for one to two weeks, depending on the severity of the infection.
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Common noninfectious causes of conjunctivitis include dry eye and inflammation of the conjunctiva related to use of medications (Figure 11) or wearing contact lenses. These entities should be considered in patients with chronic signs and symptoms that do not appear to be of infectious or allergic origin.
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Allergic conjunctivitis can be treated by removing the allergic substance from a person's environment, if possible; by applying cool compresses to the eye; and by administering eye drops four to six times daily for four days. Also, oral antihistamines may help to relieve itchy eyes. However, many of these drugs ... dry the eyes. Therefore, many physicians suggest a combination of antihistamines and lubricating drops or the use of nasal corticosteroid sprays to help relieve allergic conjunctivitis, particularly when it is combined with nasal symptoms.
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Diagnosis of conjunctivitis is usually based on a medical history and physical examination. A doctor will ask when the symptoms began, how long the condition has been going on, the symptoms experienced, and if the patient has had any recent infections or diseases. Contact with anyone who has had conjunctivitis is ... important information.
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