Diagnosing and Treating Conjunctivitis

The conjunctiva is a thick, translucent membrane of tissue that lies over the white sclera of your eye. It attaches at the cornea and is continuous from the eyeball to the eyelid margin, forming a pocket of tissue in the fornices, the deep recesses between the eyelid and the surface of the eye. This tissue, like any other tissue in our body, is exposed to many outside forces. It may undergo changes in the case of infection, inflammation, or mechanical injury.

Conjunctivitis is diagnosed by a careful examination of the ocular surface to determine the cause of the eye redness. Various tests can help assist in the diagnosis and differentiation between the various forms of the conjunctivitis.


The conjunctiva may undergo infection with either a bacteria or a virus. Here are some of the common symptoms and clinical signs of each:

Viral Conjunctivitis

This is the infectious process that presents as a red, watery eye without mucopurulent discharge. Often, people have a recent history of upper respiratory infection or skin rashes. They may also have swollen lymph nodes under their jaw and in front of the ear. Vision may be affected. There are two common forms of viral conjunctivitis: adenoviral or herpetic. Adenoviral usually have the upper respiratory symptoms, while the herpetic lesions are more common with skin lesions. Herpes viral conjunctivitis is treated with Viroptic, while adenoviral types are treated just to relieve patient discomfort (i.e. tears, cold compress, decongestant, chicken noodle soup, etc.)

Bacterial Conjunctivitis

These patients usually have mucopurulent "pus" debris, red eyes, itching or burning, all of which have started within the last few days to a week. Bacterial conjunctivitis may be diagnosed by appearance and history. A thorough examination must be preformed to rule out the risk of serious and visually threatening corenal infections that often arise from bacterial infections. Typical treatments include proper hygiene instruction. Fluorescein is usually used to rule out ulcers, etc. They are usually given either topical and/or oral antibiotics.

Allergic Conjunctivitis

People are allergic to many things. Since the conjunctiva is constantly exposed to the outside elements, it is often contaminated with pollen, dander and other irritants. The allergic reaction that occurs in your body creates itching, burning, selling, and redness of the ocular surface. The reason for the irritation is the formation of follicles, "bumps," on the conjunctiva that lines the inside of the eyelid.

Seasonal allergies to pollen are treated very differently then perennial allergies, which are due to a more constant exposure of things like skin damage. People can have general allergies and no ocular problems or vice-versa. Treatment usually includes a combination of topical steroids drops, anti-inflammatory agents, antihistamines, cold compresses, and occasionally systemic antihistamines such as Benadryl, oral antihistamines or nasal inhalers.

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