ConjunctivitisConjunctivitis

Adenoviral

Follicular - chlamydiaVernal

Bacterial

Follicles consist of hyperplastic lymphoid tissue & appear as elevated lesions encircled by blood vessels. Typically seen in reaction to topical agents, adenoviral & chlamydial disease

Papillae consist of hyperplastic conjunctival tissue full of inflammatory cells, normally seen in the palpebral conjunctiva. Associated with bacterial, and allergic conjunctivitis

VernalVernalAtopicAtopic

SAC / PACSAC / PAC Acute / ToxicAcute / Toxic

Allergic Allergic ConjunctivitisConjunctivitis

Herpes simplex conjunctivitisHerpes simplex conjunctivitis

TreatmentTreatment

Unilateral eyelid vesicles Unilateral eyelid vesicles Acute follicular conjunctivitisAcute follicular conjunctivitis

- topical antivirals to prevent keratitis- topical antivirals to prevent keratitis

Signs

•Sight threatening diseaseSight threatening disease•Ocular emergencyOcular emergency•Deep irregular vascular pattern of Deep irregular vascular pattern of hyperemiahyperemia

EpislceritisEpislceritis

ScleritisScleritis

• Normally idiopathicNormally idiopathic• 33% of cases – systemic link33% of cases – systemic link• Acute onsetAcute onset• Mild acheMild ache• Normally unilateralNormally unilateral• Can recurCan recur• Radial vascular hyperemiaRadial vascular hyperemia• Will ‘bleach’ with 2.5% Phenylephrine HydWill ‘bleach’ with 2.5% Phenylephrine Hyd

Flashes & FloatersFlashes & Floaters

Take a history to determine other causes of floaters e.g. vitreous bleed or inflammation of the eye (cyclitis or posterior uveitis) and rarely asteroid hyalosis.

Examine the patient on the slit lamp for:

 - Tobacco dust in anterior vitreous? (high mag / small slit – ant vitreous)

- Then using a 60D or similar lens through a dilated pupil look for Weis ring (definite signs of posterior vitreous detachment)