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Conjunctivitis

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The Infected Eye

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Abstract

Infectious conjunctivitis is a leading cause of pink eye. Infection of the conjunctiva can manifest with signs and symptoms other than simple redness, such as papillary or follicular reaction, conjunctival scarring, and corneal involvement. While most infectious conjunctivitis is self-limiting, sequelae include membrane/pseudomembrane formation, cicatrization, and extension of the disease to the cornea and the lacrimal system. Guidelines for treatment of conjunctivitis vary based on the characteristics of a given patient population, such as adults versus neonates and the presence or absence of specific risk factors.

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References

  1. Lindquist T. Conjunctivitis: an overview and classification. In: Krachmer JH, Mannis MJ, Holland EJ, editors. Cornea. China: Mosby; 2011. p. 509–20.

    Chapter  Google Scholar 

  2. Faraj HG, Hoang-Xuan T. Chronic cicatrizing conjunctivitis. Curr Opin Ophthalmol. 2001;12:250–7.

    Article  CAS  PubMed  Google Scholar 

  3. Duke-Elder S. System of ophthalmology. St. Louis: Mosby; 1965. p. 159–61.

    Google Scholar 

  4. Landers J, Kleinschmidt A, Wu J, Burt B, Ewald D, Henderson T. Prevalence of cicatricial trachoma in an indigenous population of Central Australia: the Central Australian Trachomatous Trichiasis Study (CATTS). Clin Experiment Ophthalmol. 2005;33:142–6.

    Article  PubMed  Google Scholar 

  5. Alvarenga L, Scaarpi M, Mannis M. Viral conjunctivitis. In: Krachmer JH, Mannis MJ, Holland EJ, editors. Cornea. China: Mosby; 2011. p. 535–44.

    Chapter  Google Scholar 

  6. Arffa RC, Grayson M. Grayson’s diseases of the cornea. 4th ed. St. Louis: Mosby; 1997. p. 125–56.

    Google Scholar 

  7. Kaufman HE. Adenovirus advances: new diagnostic and therapeutic options. Curr Opin Ophthalmol. 2011;22:290–3.

    Article  PubMed  Google Scholar 

  8. Udeh BL, Schneider JE, Ohsfeldt RL. Cost effectiveness of a point-of-care test for adenoviral conjunctivitis. Am J Med Sci. 2008;336:254–64.

    Article  PubMed  Google Scholar 

  9. Smith AF, Waycaster C. Estimate of the direct and indirect annual cost of bacterial conjunctivitis in the United States. BMC Ophthalmol. 2009;9:13.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Gilger BC. Immunology of the ocular surface. Vet Clin North Am Small Anim Pract. 2008;38:223–31, v.

    Article  PubMed  Google Scholar 

  11. Dawson CR. How does the external eye resist infection. Invest Ophthalmol. 1976;15:971–4.

    CAS  PubMed  Google Scholar 

  12. Selinger DS, Selinger RC, Reed WP. Resistance to infection of the external eye: the role of tears. Surv Ophthalmol. 1979;24:33–8.

    Article  CAS  PubMed  Google Scholar 

  13. Williams RC, Gibbons RJ. Inhibition of bacterial adherence by secretory immunoglobulin A: a mechanism of antigen disposal. Science. 1972;177:697–9.

    Article  CAS  PubMed  Google Scholar 

  14. Stuchell RN, Farris RL, Mandel ID. Basal and reflex human tear analysis. II. Chemical analysis: lactoferrin and lysozyme. Ophthalmology. 1981;88:858–61.

    Article  CAS  PubMed  Google Scholar 

  15. Ford LC, DeLange RJ, Petty RW. Identification of a nonlysozymal bactericidal factor (beta lysin) in human tears and aqueous humor. Am J Ophthalmol. 1976;81:30–3.

    Article  CAS  PubMed  Google Scholar 

  16. Chandler JW, Gillette TE. Immunologic defense mechanisms of the ocular surface. Ophthalmology. 1983;90:585–91.

    Article  CAS  PubMed  Google Scholar 

  17. Soukiasian SaB J. Bacterial conjunctivitis. In: Krachmer JH, Mannis MJ, Holland EJ, editors. Cornea. China: Mosby; 2011. p. 521–34.

    Chapter  Google Scholar 

  18. Schemann JF, Sacko D, Malvy D, Momo G, Traore L, Bore O, et al. Risk factors for trachoma in Mali. Int J Epidemiol. 2002;31:194–201.

    Article  PubMed  Google Scholar 

  19. Givner LB, Rennels MB, Woodward CL, Huang SW. Chlamydia trachomatis infection in infant delivered by cesarean section. Pediatrics. 1981;68:420–1.

    CAS  PubMed  Google Scholar 

  20. Woodland RM, Darougar S, Thaker U, Cornell L, Siddique M, Wania J, et al. Causes of conjunctivitis and keratoconjunctivitis in Karachi, Pakistan. Trans R Soc Trop Med Hyg. 1992;86:317–20.

    Article  CAS  PubMed  Google Scholar 

  21. Jhanji V, Chan TC, Li EY, Agarwal K, Vajpayee RB. Adenoviral keratoconjunctivitis. Surv Ophthalmol. 2015;60:435–43.

    Article  PubMed  Google Scholar 

  22. Ariga T, Shimada Y, Shiratori K, Ohgami K, Yamazaki S, Tagawa Y, et al. Five new genome types of adenovirus type 37 caused epidemic keratoconjunctivitis in Sapporo, Japan, for more than 10 years. J Clin Microbiol. 2005;43:726–32.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Darougar S, Grey RH, Thaker U, McSwiggan DA. Clinical and epidemiological features of adenovirus keratoconjunctivitis in London. Br J Ophthalmol. 1983;67:1–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Pettit TH, Holland GN. Chronic keratoconjunctivitis associated with ocular adenovirus infection. Am J Ophthalmol. 1979;88:748–51.

    Article  CAS  PubMed  Google Scholar 

  25. Uchio E, Takeuchi S, Itoh N, Matsuura N, Ohno S, Aoki K. Clinical and epidemiological features of acute follicular conjunctivitis with special reference to that caused by herpes simplex virus type 1. Br J Ophthalmol. 2000;84:968–72.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Azari AA, Barney NP. Conjunctivitis: a systematic review of diagnosis and treatment. JAMA. 2013;310:1721–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Slobod KS, Sandlund JT, Spiegel PH, Haik B, Hurwitz JL, Conley ME, et al. Molecular evidence of ocular Epstein-Barr virus infection. Clin Infect Dis. 2000;31:184–8.

    Article  CAS  PubMed  Google Scholar 

  28. Brown HH, Glasgow BJ, Holland GN, Foos RY. Cytomegalovirus infection of the conjunctiva in AIDS. Am J Ophthalmol. 1988;106:102–4.

    Article  CAS  PubMed  Google Scholar 

  29. Hara J, Fujimoto F, Ishibashi T, Seguchi T, Nishimura K. Ocular manifestations of the 1976 rubella epidemic in Japan. Am J Ophthalmol. 1979;87:642–5.

    Article  CAS  PubMed  Google Scholar 

  30. Wheaton AF, Timothy NH, Dossett JH, Manders EK. The surgical treatment of Molluscum contagiosum in a pediatric AIDS patient. Ann Plast Surg. 2000;44:651–5.

    Article  CAS  PubMed  Google Scholar 

  31. Zabawski Jr EJ, Cockerell CJ. Topical and intralesional cidofovir: a review of pharmacology and therapeutic effects. J Am Acad Dermatol. 1998;39:741–5.

    Article  PubMed  Google Scholar 

  32. Musso D, Nilles EJ, Cao-Lormeau VM. Rapid spread of emerging Zika virus in the Pacific area. Clin Microbiol Infect. 2014;20:O595–6.

    Article  CAS  PubMed  Google Scholar 

  33. Summers DJ, Acosta RW, Acosta AM. Zika virus in an American recreational traveler. J Travel Med. 2015;22:338–40.

    Article  PubMed  Google Scholar 

  34. Hovding G. Acute bacterial conjunctivitis. Acta Ophthalmol. 2008;86:5–17.

    Article  PubMed  Google Scholar 

  35. Sattar SA, Dimock KD, Ansari SA, Springthorpe VS. Spread of acute hemorrhagic conjunctivitis due to enterovirus-70: effect of air temperature and relative humidity on virus survival on fomites. J Med Virol. 1988;25:289–96.

    Article  CAS  PubMed  Google Scholar 

  36. Mannis MJ. Bacterial conjunctivitis. In: Tasman W, Jaeger E, editors. Duane’s clinical ophthalmology, vol. 4. Philadelphia: JB Lippincott; 1990. p. 1–8.

    Google Scholar 

  37. Valenton MJ, Okumoto M. Toxin-producing strains of Staphylococcus epidermidis (albus). Isolates from patients with staphylococcic blepharoconjunctivitis. Arch Ophthalmol. 1973;89:186–9.

    Article  CAS  PubMed  Google Scholar 

  38. Gigliotti F, Williams WT, Hayden FG, Hendley JO, Benjamin J, Dickens M, et al. Etiology of acute conjunctivitis in children. J Pediatr. 1981;98:531–6.

    Article  CAS  PubMed  Google Scholar 

  39. Brook I. Anaerobic and aerobic bacterial flora of acute conjunctivitis in children. Arch Ophthalmol. 1980;98:833–5.

    Article  CAS  PubMed  Google Scholar 

  40. Kestelyn P, Bogaerts J, Stevens AM, Piot P, Meheus A. Treatment of adult gonococcal keratoconjunctivitis with oral norfloxacin. Am J Ophthalmol. 1989;108:516–23.

    Article  CAS  PubMed  Google Scholar 

  41. Lee JS, Choi HY, Lee JE, Lee SH, Oum BS. Gonococcal keratoconjunctivitis in adults. Eye (Lond). 2002;16:646–9.

    Article  CAS  Google Scholar 

  42. Control CfD. Antibiotic-resistant strains of Neisseria gonorrhoeae. Policy guidelines for detection, management, and control. MMWR. 1987:244.

    Google Scholar 

  43. Rothenberg R, Voigt R. Epidemiologic aspects of control of penicillinase-producing Neisseria gonorrhoeae. Sex Transm Dis. 1988;15:211–6.

    Article  CAS  PubMed  Google Scholar 

  44. Wright HR, Turner A, Taylor HR. Trachoma. Lancet. 2008;371:1945–54.

    Article  PubMed  Google Scholar 

  45. Lietman T, Porco T, Dawson C, Blower S. Global elimination of trachoma: how frequently should we administer mass chemotherapy? Nat Med. 1999;5:572–6.

    Article  CAS  PubMed  Google Scholar 

  46. Bowman RJ, Jatta B, Cham B, Bailey RL, Faal H, Myatt M, et al. Natural history of trachomatous scarring in The Gambia: results of a 12-year longitudinal follow-up. Ophthalmology. 2001;108:2219–24.

    Article  CAS  PubMed  Google Scholar 

  47. Prevention CfDCa. Recommendations for the prevention and management of Chlamydia trachomatis infections. MMWR. 1993:RR-12.

    Google Scholar 

  48. Stenberg K, Mardh PA. Genital infection with Chlamydia trachomatis in patients with chlamydial conjunctivitis: unexplained results. Sex Transm Dis. 1991;18:1–4.

    Article  CAS  PubMed  Google Scholar 

  49. Hammerschlag MR. Chlamydial infections. J Pediatr. 1989;114:727–34.

    Article  CAS  PubMed  Google Scholar 

  50. Singal N, Rootman D. Chlamydial infections. In: Krachmer JH, Mannis MJ, Holland EJ, editors. Cornea. China: Mosby; 2011. p. 545–52.

    Google Scholar 

  51. Carithers HA. Cat-scratch disease. An overview based on a study of 1,200 patients. Am J Dis Child. 1985;139:1124–33.

    Article  CAS  PubMed  Google Scholar 

  52. Tobin EH, McDaniel H. Oculoglandular syndrome. Cat-scratch disease without the cat scratch. Postgrad Med. 1992;91:207–8, 10.

    Article  CAS  PubMed  Google Scholar 

  53. Ridder GJ, Boedeker CC, Technau-Ihling K, Sander A. Cat-scratch disease: otolaryngologic manifestations and management. Otolaryngol Head Neck Surg. 2005;132:353–8.

    Article  PubMed  Google Scholar 

  54. Gruzensky W. Parinaud’s oculoglandular syndrome. In: Krachmer JH, Mannis MJ, Holland EJ, editors. Cornea. China: Mosby; 2011. p. 559–66.

    Chapter  Google Scholar 

  55. Archer D, Bird A. Primary tuberculosis of the conjunctiva. Br J Ophthalmol. 1967;51:679–84.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  56. Spektor FE, Eagle Jr RC, Nichols CW. Granulomatous conjunctivitis secondary to Treponema pallidum. Ophthalmology. 1981;88:863–5.

    Article  CAS  PubMed  Google Scholar 

  57. Lindquist T. Ophthalmia neonatorum. In: Krachmer JH, Mannis MJ, Holland EJ, editors. Cornea. China: Mosby; 2011. p. 553–8.

    Chapter  Google Scholar 

  58. Grosskreutz C, Smith LB. Neonatal conjunctivitis. Int Ophthalmol Clin. 1992;32:71–9.

    Article  CAS  PubMed  Google Scholar 

  59. Overall Jr JC, Glasgow LA. Virus infections of the fetus and newborn infant. J Pediatr. 1970;77:315–33.

    Article  PubMed  Google Scholar 

  60. Laga M, Plummer FA, Nzanze H, Namaara W, Brunham RC, Ndinya-Achola JO, et al. Epidemiology of ophthalmia neonatorum in Kenya. Lancet. 1986;2:1145–9.

    Article  CAS  PubMed  Google Scholar 

  61. Chandler JW, Rapoza PA. Ophthalmia neonatorum. Int Ophthalmol Clin. 1990;30:36–8.

    Article  CAS  PubMed  Google Scholar 

  62. Rours IG, Hammerschlag MR, Ott A, De Faber TJ, Verbrugh HA, de Groot R, et al. Chlamydia trachomatis as a cause of neonatal conjunctivitis in Dutch infants. Pediatrics. 2008;121:e321–6.

    Article  PubMed  Google Scholar 

  63. McCormack WM, Evrard JR, Laughlin CF, Rosner B, Alpert S, Crockett VA, et al. Sexually transmitted conditions among women college students. Am J Obstet Gynecol. 1981;139:130–3.

    Article  CAS  PubMed  Google Scholar 

  64. Gutierrez KM, Falkovitz Halpern MS, Maldonado Y, Arvin AM. The epidemiology of neonatal herpes simplex virus infections in California from 1985 to 1995. J Infect Dis. 1999;180:199–202.

    Article  CAS  PubMed  Google Scholar 

  65. Lepage P, Bogaerts J, Kestelyn P, Meheus A. Single-dose cefotaxime intramuscularly cures gonococcal ophthalmia neonatorum. Br J Ophthalmol. 1988;72:518–20.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. de Toledo AR, Chandler JW. Conjunctivitis of the newborn. Infect Dis Clin North Am. 1992;6:807–13.

    PubMed  Google Scholar 

  67. Whitley RJ. Herpes simplex virus infections of women and their offspring: implications for a developed society. Proc Natl Acad Sci U S A. 1994;91:2441–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  68. Narayana S, McGee S. Bedside diagnosis of the ‘red eye’: a systematic review. Am J Med. 2015;128:1220–4.e1.

    Article  PubMed  Google Scholar 

  69. Rietveld RP, ter Riet G, Bindels PJ, Sloos JH, van Weert HC. Predicting bacterial cause in infectious conjunctivitis: cohort study on informativeness of combinations of signs and symptoms. BMJ. 2004;329:206–10.

    Article  PubMed  PubMed Central  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Ophthalmology, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA

    Tayyeba K. Ali MD

  2. Jones Eye Institute, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Little Rock, AR, 72205, USA

    Tayyeba K. Ali MD

  3. Cornea and External Diseases, Department of Ophthalmology, Penn State College of Medicine, Penn State Health-Milton S. Hershey Medical Center, Hershey, PA, 17033, USA

    Seth M. Pantanelli MD, MS

Authors
  1. Tayyeba K. Ali MD
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  2. Seth M. Pantanelli MD, MS
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Correspondence to Tayyeba K. Ali MD .

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Editors and Affiliations

  1. Tufts University School of Medicine, Tufts Medical Center, Boston, Massachusetts, USA

    Nora V. Laver

  2. Penn State College of Medicine, Penn State Health-Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA

    Charles S. Specht

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Ali, T.K., Pantanelli, S.M. (2016). Conjunctivitis. In: Laver, N., Specht, C. (eds) The Infected Eye. Springer, Cham. https://doi.org/10.1007/978-3-319-42840-6_4

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  • DOI: https://doi.org/10.1007/978-3-319-42840-6_4

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