Conjunctivitis, commonly known as pink eye, is an inflammation or infection of the transparent membrane (conjunctiva) that covers the white part of the eye and the inner surface of the eyelids. The main symptoms are redness, irritation, watering eyes, and discharge. It can be caused by allergies, bacteria, viruses, chemicals, or other irritants. Treatment depends on the cause but may include artificial tears, antihistamines, antibiotics, or other medications to relieve symptoms. Good hygiene practices can help prevent the spread of contagious forms of conjunctivitis.

1. conjunctivitis
Conjunctivitis (also called "madras eye" in south India
or "pink eye") is an acute inflammation of the
conjunctiva (the outermost layer of the eye and the
inner surface of the eyelids), most commonly due to an
allergic reaction or an infection (usually viral, but
sometimes bacterial.
Classification –
1.Allergic
2. Bacterial
3. Viral
4. Toxic

2. Classification
• Blepharoconjunctivitis is the dual
combination of conjunctivitis with blepharitis
(inflammation of the eyelids).
• Keratoconjunctivitis is the combination of
conjunctivitis and keratitis (corneal
inflammation).
• Episcleritis is an inflammatory condition that
produces a similar appearance to
conjunctivitis, but without discharge or
tearing.

3. Signs and symptoms
Eyes with conjunctivitis
• An eye, red due to acute conjunctivitis.
• An eye with bacterial conjunctivitis.
• Redness (hyperaemia), irritation (chemosis) and
watering (epiphora) of the eyes are symptoms
common to all forms of conjunctivitis.
Viral conjunctivitis is often associated with an
infection of the upper respiratory tract, a
common cold, and/or a sore throat. Its symptoms
include watery discharge and variable itch.

4. Cont..
• Foreign body sensation .
• Itching.
• Scratching.
• Burning sensation .
• Photophobia.
• Infection starts in one eye and then spread to
other eye .

5. Assessment and diagnostic
findings
• Four clinical features are important to
evaluate :
1) Type of discharge ( watery , mucoid, purulent
,or mucopurulent ) .
2) Type of conjunctival reaction ( follicular or
papillary ) :
• follicles are multiple slightly elevated lesions
encircled by tiny blood vessels .look like grain
of rice .

6. Cont..
• Papilla are hyperplastic conjunctival
epithelium in numerous projections usually
seen as a fine mosaic pattern under split
lamp examination .
3) Presence of pseudo membranes or true
membranes :
• Pseudo membranes consist of coagulated
exudates that adheres to the surface of the
inflamed conjunctiva .

7. Cont..
• True membranes form when exudates
adheres to superficial layer of conjunctiva
and removal results in bleeding.
4) Presence or absence of lymphadenopathy (
enlargement of preauricular and
submandibular lymph nodes where the
eyelid drains.

8. Cont..
• Diagnosis is based on distinctive
characteristics of ocular signs , acute and
chronic presentation .
• Positive result of swab smear preparation
and cultures confirm the diagnosis.

9. ALLERGIC CONJUCTIVITIS

10. ALERGIC CONJUNCTIVITIS
• Allergic conjunctivitis is inflammation of the
conjunctiva (the membrane covering the white part
of the eye) due to allergy. Although allergens differ
between patients, the most common cause is hay
fever.
• Symptoms consist of redness (mainly due to
vasodilation of the peripheral small blood vessels),
oedema of the conjunctiva, itching and increased
lacrimation (production of tears). If this is combined
with rhinitis, the condition is termed allergic
rhinoconjunctivitis.

11. CONT..
• symptoms that occur in the eye include: ocular itching,
eyelid swelling, tearing, photophobia, watery
discharge, and foreign body sensation.
• Among the most common allergens that cause
conjunctivitis are:
• Pollen from trees, grass and rag weed
• Animal skin and secretions such as saliva
• Perfumes
• Cosmetics
• Skin medicines
• Air pollution
• Smoke
• Dust mites

12. TREATMENT
• A detailed history allows physicians to
determine whether the presenting symptoms
are due to an allergen or another source.
Diagnostic tests such as conjunctival scrapings
to look for eosinophils are helpful in
determining the cause of the allergic
response.
• Antihistamines, medication that stabilizes
mast cells, and non-steroidal anti-
inflammatory drugs (NSAIDs) are safe and
usually effective.

13. CONT..
• effective.Corticosteroids are reserved for more
severe cases of ocular allergy disease and their use
should be monitored by an ophthalmologist. When
an allergen is identified, the patient should avoid the
allergen as much as possible.
• Decongestants may also be prescribed. Another
common mast cell stabilizer that is used for treating
allergic conjunctivitis is sodium cromoglicate, as in
Opticrom eye drops. much as possible.

14. Bacterial conjunctivitis

15. BACTERIAL CONJUNCTIVITIS

16. VIRAL CONJUNCTIVITIS
• Viral conjunctivitis is often associated with an
infection of the upper respiratory tract, a common
cold, and/or a sore throat. Its symptoms include
watery discharge and variable itch. The infection
usually begins with one eye, but may spread easily to
other eye.
• Viral conjunctivitis, commonly known as "pink eye,"
shows a fine diffuse pinkness of the conjunctiva d
easily to the other

17. Bacterial conjunctivitis due to the common pyogenic (pus-
producing) bacteria causes marked grittiness/irritation
and a stringy, opaque, greyish or yellowish mucopurulent
discharge that may cause the lids to stick together
(matting), especially after sleeping.
Bacteria such as Chlamydia trachomatis can cause a non-
exudative but persistent conjunctivitis without much
redness. The gritty and/or scratchy feeling is sometimes
localized enough for patients to insist they must have a
foreign body in the eye. The more acute pyogenic
infections can be painful.
Like viral conjunctivitis, it usually affects only one eye but
may spread easily to the other eye.

18. Management
• Allergic
• For the allergic type, cool water poured over the face with the
head inclined downward constricts capillaries, and artificial
tears sometimes relieve discomfort in mild cases. In more
severe cases, non-steroidal anti-inflammatory medications
and antihistamines may be prescribed. Persistent allergic
conjunctivitis may also require topical steroid drops.
Bacterial
• Bacterial conjunctivitis usually resolves without treatment.
Antibiotics, eye drops, or ointment are thus only needed if no
improvement is observed after 3 days. In patients receiving no
antibiotics recovery was in 4.8 days, immediate antibiotics 3.3
days, delayed antibiotics 3.9 days. No serious effects were
noted either with or without treatment.

19. management
Viral
• Although there is no specific treatment for viral
conjunctivitis, symptomatic relief may be achieved
with cold compresses and artificial tears. People are
often advised to avoid touching their eyes or sharing
towels and washcloths.
Chemical
• Conjunctivitis due to chemicals is treated via
irrigation with Ringer's lactate or saline solution.
Chemical injuries (particularly alkali burns) are
medical emergencies as they can lead to severe
scarring, and intraocular damage

20. TOXIC CONJUNCTIVITIS
• Chemical conjunctivitis can be result of
medications , chlorine from swimming pool .
• Exposure to toxic fumes among industrial
workers .
• Exposure to irritants such as smoke ,hair
sprays acids and alkalis .

21. prevention
• Individuals who are prone to developing
allergenic conjunctivitis may prevent getting
the condition by having proper eye hygiene,
especially if wearing contact lenses. People
who are allergic to pollen or mold, are also
advised to stay indoors when the weather
report states that the allergens levels are high.
Allergic persons are recommended to keep
the doors and windows closed and use air
conditioners during the summer months to
prevent developing allergic conjunctivitis.

22. PREVENTION
• Good hygiene can help prevent the spread of
conjunctivitis:
• Change pillowcases frequently.
• Do not share eye cosmetics.
• Do not share towels or handkerchiefs.
• Handle and clean contact lenses properly.
• Keep hands away from the eye.
• Replace eye cosmetics regularly.
• Wash your hands often

23. INSTRUCTIONS
• Wear dark glasses in bright light .
• Discard your makeup-articles .
• Don’t apply makeup until disease is over .
• Disinfection of equipment used for eye
examination must be followed .
• Use of vasoconstrictors such as topical
epinephrine solution ,cold compress ,ice pack
and cool ventilation provide comfort .

24. KERATOCONJUNTIVITIS
Keratoconjunctivitis sicca (KCS), also called keratitis
sicca,
sicca syndrome,xerophthalmia,dry eye syndrome
(DES), or simply dry eyes,is an eye disease caused by
decreased tear production or increased tear film
evaporation commonly found in humans and some
animals
The phrase "keratoconjunctivitis sicca" is Latin, and its
literal translation is "dryness of the cornea and
conjunctiva".

25. KERATOCONJUCTIVITIS

26. ETIOLOGY
• Lacrimal gland malfunction – genitically & injury
infection
• Systemic disorders
• Facial nerve palsy
• Infection
• Medication – antihistamine , oral contraceptives,
atropine decrease tear production
• Sjogrens syndrome

27. PATHOPHYSIOLOGY
• Having dry eyes for a while can lead to tiny
abrasions on the surface of the eyes.In
advanced cases, the epithelium undergoes
pathologic changes, namely squamous
metaplasia and loss of goblet cells

28. SYMPTOMS
• 1. dryness, burning and a sandy-gritty eye irritation
that gets worse as the day goes.
• 2. Itchy, scratchy, stingy or tired eyes.
• 3.Other symptoms are pain,redness, a pulling
sensation, and pressure behind the eye.
• 4. There may be a feeling that something, such as a
speck of dirt, is in the eye. The resultant damage to
the eye surface increases discomfort and sensitivity
to bright light.
• Both eyes usually are affected.

29. DIAGNOSIS
• Slit lamp examination show interrupted tear
meniscus at lower eye lid margin & conjunctiva
thickened.
• Management –
• Instillation of artificial tears during day & oint at
night is usual regimen to hydrate & lubricate the eye
through stimulating tears& preserving moist ocular
surface.
• Antiinflammatory medication & moisture
chambers.eg. Moisture chamber spectacles may
provide relief.

30. Cont..
• Concurrent treatment of infection such as
chronic blepharitis & treatment of systemic
disorders.

31. Blocking tear drainage
• In each eye, there are two puncta — little openings
that drain tears into the tear ducts. There are
methods to partially or completely close the tear
ducts. This blocks the flow of tears into the nose, and
thus more tears are available to the eyes.
• Punctal plugs are inserted into the puncta to block
tear drainage. For people who have not found dry
eye relief with drugs, punctal plugs may help.

32. Cont..
• Cauterization
• If punctal plugs are effective, thermal or
electric cauterization of puncti can be
performed.
• In thermal cauterization, a local anesthetic is
used, and then a hot wire is applied This
shrinks the drainage area tissues and causes
scarring, which closes the tear duct.

33. Artificial tears
• Artificial tears are lubricant eye drops used to treat
the dryness and irritation associated with deficient
tear production in keratoconjunctivitis sicca (dry
eyes).They are also used to moisten contact lenses
and in eye examinations.
Preparations contain carboxymethyl
cellulose,hydroxypropyl methylcellulose (a.k.a. HPMC
or hypromellose), and hydroxypropyl cellulose.

34. Artificial tears brand

35. UVEITIS

36. ORBITAL CELLULITIS

37. ORBITAL CELLULITIS

38. Blepharitis

39. HORDEOLUM

40. STY

41. ENTROPIAN
• Entropion is a medical condition in which the
eyelid (usually the lower lid) folds inward. It is
very uncomfortable, as the eyelashes
constantly rub against the cornea. Entropion is
usually caused by genetic factors and may be
congenital.[citation needed] Trachoma infection
may cause scarring of the inner eyelid, which
may cause entropion. In human cases this
condition is most common to people over 60
years of age.[1]

42. ENTROPIAN