Bacterial Conjunctivitis Vs Acute Anterior Uveitis

By Watkins, Jean

AT A GLANCE BACTERIAL CONJUNCTIVITIS

Presentation

* Conjunctivitis is inflammation of the conjunctiva caused by bacteria, virus or allergy or associated with foreign body.

* Bacteria involved are commonly Staphylococcus, Streptococcus pneumoniae or Haemophilus influenza.

* More often Gram-negative bacteria in patients with contact lens.

* Eye feels gritty (allergic conjunctivitis is itchy).

* Watering of the eye discharge may be yellow/white and mucopurulent.

Management

* Check to exclude foreign body.

* May resolve without treatment.

* Avoid spread to contacts.

* Swab from discharge for culture and sensitivities.

* Topical chloramphenicol or gentamicin eye drops.

* Azithromycin twice daily for three days may be helpful.

* Gonococcal and chlamydia conjunctivitis requires topical and systemic antibiotics. This is likely to be sexually transmitted and so a full check of patient and contacts would be required.

Conjunctivitis causes watering and discharge from the eye

ACUTE ANTERIOR UVEITIS (IRITIS)

Presentation

* Painful red eye – usually unilateral.

* Photophobia and watering of the eye – not mucopurulent.

* Usually occurs after the age of 20. Usually idiopathic and may have recurrent episodes.

* May be associated with HLA-B27, herpes zoster, ankylosing spondylitis, inflammatory bowel disease, sarcoidosis, reactive arthritis or reaction to drugs.

* Irregular, poorly reactive constricted pupil as the condition develops.

Management

* Patients should be referred urgently to the ophthalmic unit for slit lamp examination, fundoscopy, measurement of intraocular pressures and check of visual acuity.

* Specialist advice regarding mydriatics and cycloplegics such as cyclopentolate or homatropine eye drops. Prednisolone eye drops.

As acute anterior uveitis develops, the pupil becomes constricted

Contributed by Dr Jean Watkins, a sessional GP in Hampshire

Copyright Haymarket Business Publications Ltd. Jan 25, 2008

(c) 2008 GP. Provided by ProQuest Information and Learning. All rights Reserved.

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