References:
- Global Infectious Diseases and Epidemiology Online Network: Infectious Diseases of the Philippines, 2013 eBook Edition, ISBN 978-1-61755-582-4, by Stephen Berger. Accessed here.
Inclusion Conjunctivitis
| Agent | BACTERIUM. Chlamydiae, Chlamydia trachomatis |
| Reservoir | Human |
| Vector | None |
| Vehicle | Infected secretions Sexual contact Water (swimming pools) |
| Incubation Period | 5 to 12 days |
| Diagnostic Tests | Demonstration of chlamydiae on direct fluorescence or culture of exudate |
| Typical Adult Therapy | Secretion precautions. Topical Erythromycin. Erythromycin 250 mg PO QID. X 14 days OR Doxycycline 100 mg PO BID X 14 days |
| Typical Pediatric Therapy | Secretion precautions. Topical Erythromycin. Azithromycin 1 g PO as single dose. Alternative If age >8 years, Doxycycline 100 mg PO BID X 7 days. |
| Clinical Hints | Ocular foreign body sensation, photophobia and discharge which may persist for months to as long as 2 years; keratitis and conjunctival follicles may be evident. |
| Synonyms | Inclusion conjunctivitis, Paratrachoma |
Ophthalmia neonatorum caused by Chlamydia is characterized by conjunctival injection without follicles.
Follicular conjunctivitis in adults is most prominent on the lower lid, and the presence of bulbar follicles is highly suggestive of a Chlamydia etiology.
- The infection is usually bilateral and accompanied by profuse discharge.
Parachlamydiaceae (including Parachlamydia acanthamoebae) have been associated with conjunctivitis, keratitis and uveitis.
Trachoma may be differentiated from inclusion conjunctivitis by the presence of corneal scarring and a preference of the latter for the upper tarsal conjunctivae.
Viral Conjunctivitis
| Agent | VIRUS. Picornavirus, Adenovirus |
| Reservoir | Human |
| Vector | None |
| Vehicle | Contact |
| Incubation Period | 1 to 3 days |
| Diagnostic Tests | Viral isolation is available but rarely practical. |
| Typical Adult Therapy | Supportive |
| Typical Pediatric Therapy | As for adult |
| Clinical Hints | Watery discharge, generalized conjunctival injection and mild pruritus; may be associated with an upper respiratory infection. |
| Synonyms | Apollo conjunctivitis, Apollo eye, Congiuntivite virale, Hemorrhagic conjunctivitis, Viral conjunctivitis. |
The symptoms of viral conjunctivitis include erythema, itching and lacrimation.
- The presence of large quantities of pus may suggest a bacterial etiology.
Hemorrhagic conjunctivitis is characterized by sudden onset of painful, swollen, red eyes with subconjunctival hemorrhaging, palpebral follicles, photophobia, foreign body sensation, eyelid edema, punctate keratitis, and excessive tearing.
- Symptoms usually persist for 3 to 5 days.