One of the most common ophthalmologic complaints managed in the emergency department is conjunctivitis.

1. B.Sc Degree Course in Nursing (Basic)
MEDICAL SURGICAL NURSING
UNIT II: Nursing Care of patients with Eye
Disorders.
Topic: Conjunctivitis &
Subconjunctival Haemorrhage
PRESENTED BY
Mrs. SOUMYA SUBRAMANI, M.Sc.(N)
LECTURER, MSN DEPARTMENT
CON- SRIPMS, COIMBATORE.

2. INTRODUCTION
• One of the most common ophthalmologic
complaints managed in the emergency
department is conjunctivitis.
• Conjunctivitis is common in childhood rather
than adults and may be infectious or non-
infectious.
• Most commonly, conjunctivitis due to:
– Bacterial infection
– Viral infection
– Allergic hypersensitivity

3. Anatomy of the Eye

4. contd....
• The outer coat
which is
transparent
anteriorly is
called the
cornea.
• The white and
opaque coat is
the sclera.

5. DEFINITION
• Conjunctivitis is a
inflammation of the
membrane covering the
surface of the eye ball. It
can be result of infection or
irritation of the eye.The
inflammation of conjunctiva
cause the eye's blood
vessels to dilate resulting in
reddish appearance.

6. Etiology
Etiology
Bacteria
VirusAllergens

7. Classification
According to the causes the are:
1.Bacterial conjunctivitis - cause by bacteria
2.Viral conjunctivitis- offen associated with the
common cold, caused by the adenovirus
3.Chlamydia conjunctivitis -caused by sexually
transmitted infection
4.Allergic conjunctivitis -caused by pollens. dust.
5.Reactive conjunctivitis- caused by chemical such
as swimming pools.

8. Classification

9. Pathophysiology
• microbes enter the eye on contact with
infected objects
• Inflammation of the eye
• Dilation of blood vessels of eye
• Swelling,redness,exudate and discharge

10. Clinical manifestation
• Redness of the eye
• Increased tears
• Thick yellow discharge that when dries it crusts
over the eyelashes
• Itchy eyes or Burning sensation
• Blurred vision
• Increased sensativity to light/brightness of sun

11. CONTD....
•Redness in the white of
the eye or inner eyelid.
•Swollen conjunctiva.
•More tears than usual.
•Thick
yellow discharge that
crusts over the
eyelashes, especially
after sleep. ...

12. CONTD....
•Green or white discharge from the eye.
•Itchy eyes.
•Burning eyes.
•Blurred vision.

13. Diagnostic evaluation
• The four main clinical features important to
evaluate are:
- The type of discharge[ie,
watery,mucoid,purulent, or mucopurulent]
-Type of conjunctival reaction [ie, follicular or
papillary], presence of psedomembranes or true
membranes.
-And presence or absence of lymhadenopathy.
-Conjunctival epitelium in numerous projections
that are usually seen as a fine mosaic pattern
under slit - lamp examination.

14. CONTD....
-Diagnosis is based on the distinctive
characteristics of occular sign, acute or chronic
presentation,and identification of any prescipitating
events.
-positive results of swab smear preparations and
cultures confirm the diadnosis.
•Opthalmoscopy

15. Prevention
• Donot touch with hands.
• Wash hand often.
• Use clean towels and wash clothes.
• Do not share towels or washclothes.
• Avoid swimming in a swimming pool.
• Do not share eye cosmetics or personal eye
care items.
• Use any antibiotics for the complete periods
prescribed.

16. Management
Medical management:
Treatment depends on types of conjunctivitis
-Bacteria is treated with antibiotics [Quinolone in
form of eye drops, ointment or pills, Besivance eye
drops]
-Allergic conjunctivitis are treated with
corticosteroids.
-Wear spectacles to reduce light sensitivity.
-Discard old pair of contact lenses and use new
one when conjunctivitis is gone.
-Cold compression

17. Nursing diagnosis for conjunctivitis
1.Acute pain related to inflammation of the
conjunctiva.
2.Anxiety related to lack of knowledge about the
disease processes.
3.Risk of spread of infection associated with
inflammatory processes
4.Impaired self- concept [body image decreases]
related to the change of the eyelids
[swelling/edema].
5.Risk for injury related to limited vision

18. Subconjunctival Heamorrhage
Subconjunctival hemorrhage resulting in red coloration
of the white of the eye.

19. DEFINITION
• Subconjunctival bleeding, also known as
subconjunctival hemorrhage, is bleeding
from a small blood vessel in the
subconjunctiva of the eye.
• It results in a red spot in the sclera of the
eye.

20. ETIOLOGY
• Eye trauma
• Coagulation disorders
• Head injury
• Whooping cough or other extreme sneezing or coughing
• Severe hypertension
• Antiplatelets
• Infections- Conjunctivitis
• Leptospirosis
• Eye surgery such as LASIK

21. CLINICAL MANIFESTATIONS
• A subconjunctival bleeding usually does not
result in pain, although occasionally the affected
eye may feel dry, rough, or scratchy.
• A subconjunctival bleeding initially appears
bright-red underneath the transparent
conjunctiva.
• Later, the bleeding may spread and become
green or yellow as the hemoglobin is
metabolized. It usually disappears within 2
weeks.

22. DIAGNOSTIC EVALUATION
• History
• Physical examination
• Ophthalmoscopy
• Slit lamp examination

23. MANAGEMENT
• Typically a self-limiting condition that requires no
treatment unless there is evidence of an eye
infection or eye trauma.
• Artificial tears may be applied four to six times a
day if the eye feels dry or scratchy.
– Eg. Blinktears, refreshtears.
• The elective use of aspirin & NSAIDs is typically
discouraged.