This document defines and describes various types of conjunctivitis, including infective bacterial conjunctivitis caused by organisms like Staphylococcus aureus and transmitted through flies or poor hygiene. Viral conjunctivitis is common and often caused by adenovirus. Ophthalmia neonatorum describes bilateral inflammation in infants less than 30 days old which can be caused by gonorrhea, chlamydia, or chemicals. Allergic conjunctivitis includes seasonal forms related to airborne allergens. Granulomatous conjunctivitis involves proliferative lesions possibly from tuberculosis, sarcoidosis, or leprosy. Cicatricial conjunctivitis can arise from conditions like

2.  Definition:
Conjunctival hyperaemia associated with
discharge which may be water, mucoid,
mucopurulent or purulent.

3. A. Infective Conjunctivitis
1. Bacterial Conjunctivitis
-Acute bacterial conjunctivitis
-Hyperacute bacterial conjunctivitis
-Chronic bacterial conjunctivitis
-Angular bacterial conjunctivitis

5. Predisposing factors:-
 Flies
 Poor hygienic conditions
 Hot dry climate
 Poor sanitation

6. Causative organisms:-
 Staph. aureus
 Koch-Weeks Bacillus (H. influenzae)
 Pneumococcus
 Streptococcus
 Moraxella
 N. gonorrhoea

7. Mode of infection:-
 Exogenous infections: directly,
vectortransmission,
material transfer.
 Local spread: infected lacrimal sac, lids
and nasopharynx.
 Endogenous infections: blood

8. Symptoms:
 Discomfort and foreign body sensation,
 Mild photophobia,
 Hyperaemia and Mucopurulent discharge,
 Sticking together of lid margins,
 Slight blurring of vision,
 Coloured halos

9. Signs:
 Flakes of mucopus seen at fornices, canthi
and lid margins,
 Conjunctival congestion,
 Chemosis,
 Papillae of fine type seen,
 Oedematous eyelids,
 Petechial hemorrhages,
 Matted cilia with yellow crusts

10.  Superficial punctate epitheliopathy,
 Marginal corneal ulceration,
 Superficial keratitis,
 Blepharitis,
 Dacryocystitis

12.  Etiology: Neisseria species,
most commonly N. gonorrhoeae
 Presentation: copious, purulent discharge
with rapidly progressive symptoms (12-24
hrs) pain which is moderate to severe,lid
swelling, and tender and enlarged
preauricular LNs.

14.  Symptoms-
• Burning and grittiness in eyes
• Mild chronic redness
• Feeling of heat and dryness in lid margins
• Mild mucoid discharge
 Signs- Congestion of post. Conunctival
vessels, mild papillary hypertrophy of
palpebral conjunctiva and congested lid
margins

16.  Mild inflammation near angles and
maceration of surrounding skin
 Causative organism- Moraxella axenfeld
 SOI- Usually nasal cavity
 Symptoms- Irritation in angles, h/o collection
of dirty white foamy discharge at angles,
redness at angles
 Signs- hyperaemia of bulbar conjunctiva near
canthi and of lid margins, excoriation of skin
around angles and foamy mucopurulent
discharge.

17. 2. Chlamydial Conjunctivitis
- Trachoma
- Adult inclusion conjunctivitis
- Neonatal chlamydial conjunctivitis

20.  WHO classification
F- T.inflammation Follicular
I- T.inflammation Intense
S- T.Scarring
T- T.Trichiasis
O- Corneal Opacity

21.  Conjunctival signs
• Congestion of upper tarsal and forniceal
conjunctiva
• Conjuntival follicles
• Papillary hyperplasia
• Conjunctival scarring
• Concretions

22.  Corneal signs
• Superficial keratitis
• Herbert follicles
• Pannus
• Corneal ulcers
• Herbert pits
• Corneal opacity

27.  Sub conjunctival fibrosis leads to lid
distorsion and causes eyelashes to rub on
cornea.
 If left untreated leads to corneal opacity.

30.  C/f: follicular and papillary hypertrophy,
superficial keratitis with ocassional pannus
 Preauricular lymphadenopathy usually found

32. 3. Viral Conjunctivitis
- Adenovirus conjunctivitis
>Epidemic keratoconjunctivitis
>Pharyngoconjunctival fever
- Enterovirus conjunctivitis
- Molluscum contagiosum conjunctivitis
- Herpes simplex conjunctivitis

33.  Common in all age groups.
 Most common cause : Adenovirus
 Others- Herpes simplex keratoconjunctivitis
 Pox virus conjunctivitis
 Myxovirus conjunctivitis
 Paramyxovirus conjunctivitis
 Arbovirus conjunctivitis
 Mostly , epithelium is affected (both of cornea
& conjunctiva) so, typical viral lesion is
Keratocunjunctivitis

34.  Acute Haemorrhagic Conjunctivitis
 Acute Follicular Conjunctivitis

35.  Acute catarrhal conjunctivitis.
 Associated with marked follicular hyperplasia
especially of lower fornix & lower palpebral
conjunctiva.

36.  Acute inflammation of conjunctiva
characterized by :
a) Multiple Conjunctival Haemorrhages
b) Conjunctival Hyperaemia
c) Mild Follicular Hyperplasia.

42. 4. Opthalmia Neonatorum

43.  Risk factors
oPrematurity
oMaternal infections harboured in birth
canal
oExposure to infectious organism (eg- N.
gonorrheae, S. aureus, S. pneumoniae, C.
trachomatis)
oOccular trauma during delivery.
oPoor prenatal care
oPoor hygienic delivery conditions
oSilver nitrate exposure

44.  Bilateral inflammation of conjunctiva in an
infant less than 30 days old
 Signs and Symptoms-
• Pain and tendernedd in eyeball
• Conjunctival discharge
• Swollen lids
• Hyperemia and chemosis

45. Causative agent Incubation period
Chemical 4-6 hours
Gonococcal 2-4 days
Other Bacterial 4-5 days
Neonatal Inclusion conjunctivitis 5-14 days
Herpes simplex 5-7 days

46. 5. Granulomatous Conjunctivitis

47.  Proliferative lesions
 Usually localised to one eye
 Regional lymphadenitis
 Common granulomatous conjunctival
inflammations- TB of conjunctiva, sarcoidosis
of conjunctiva, syphilitic conjunctivitis,
leprotic conjunctivitis, opthalmia nodosa

48. B. Allergic Conjunctivitis
1. Simplex Allergic Conjunctivitis
- Rhinoconjunctivitis
- Seasonal Allergic Conjunctivitis
- Perennial Allergic Conjunctivitis

49.  Most commonly seasonal allergic
rhinoconjunctivitis, also called hay fever
rhinoconjunctivitis
 IgE mediated hypersensitivity reaction
precipitated by small airborne allergens local
mast cell degranulation  release of chemical
mediators (histamine, eosinophil chemotactic
factors, PAF, etc)
 Presentation: bilateral, pruritis, redness, watery
discharge, rhinorrhea/congestion
 Patients often have h/o atopy, seasonal allergy
or specific allergy

50. 2. Vernal keratoconjunctivitis

51. 3. Atopic Keratoconjunctivitis

52. 4. Giant Papillary Conjunctivitis

53. 5. Phlyctenular Conjunctivitis

54. 6. Contact dermatoconjunctivitis

55. C. Cicatricial conjunctivitis
1. Ocular mucous membrane pemphigoid
2. Stevens Johnson Syndrome
3. Toxic Epidermal Necrolysis
4. Secondary Cicatricial Conjunctivitis

60. D. Toxic Conjunctivitis
1. Secondary to Molluscum Contagiosum
2. Chemical Toxic Conjunctivitis