DIAGNOSIS OF

CONJUCTIVITIS
AHSAN ALI
ROLL NO: 260
• TYPES OF CONJUNCTIVITIS:
1. INFECTIVE CONJUNCTIVITIS
• BACTERIAL
• VIRAL
• FUNGAL
• CHLAMYDIAL
• 2. NON INFECTIVE CONJUNCTIVITIS
• ALLERGIC - Acute or Chronic
- Seasonal or Perineal Conjunctivitis
- Vernal keratoconjunctivitis
- Atopic Conjunctivitis
• AUTOIMMUNE – Cicatricial pemiphegoid
- Stevens Johnson Syndrome
1. BACTERIAL CONJUNCTIVITIS-
CAUSES
• Staph. Aureus, Strep. Pnemoniae , Hemophillus influenza, Gonorrhea,
Corynaebacterium diph.
STAINING: Gram Staining
CULTURING: Mannitol Salt Agar medium, Blood Agar, Theyer Martin, Loeffler medium
OTHERS: Caltalase positive , Coagulase positive , On Microscopy grape like structures.
Optochin sensitive ,alpha hemolytic, On Microscopy lancit shaoe diplococci.
Metachromatic granules are seen. On Microscopy club shape bacilli.

CLINICAL FEATURES: Redness, Burning Sensation, Sticking Of eyelids, Mucopurulant

discharge.
In gonococcal Conjunctivitis, there is purulant discharge , preauricular
Lymphadenopathy, Preocular edema ,chemosis and corneal ulceration
In Diphtherioid Conjunctivitis, Serous discharge, True Whitish Membrane on
palpebral and forniceal conjunctiva.

2. VIRAL CONJUNCTIVITIS:
CAUSES:
Adenovirus , Picornavirus, Herpes Simplex
STAINING: Giemsa Staining show Mononuclear cells ,
Immunoglobulins( increased titre) ,FAT to detect Antigens.
IMMUNOFLUORESENCE TEST

CLINICAL FEATURES:In EKC:Redness, Watery discharge , Photophobia, Follicles

in Tarsal and Forniceal Conjuctiva, Keratitis follows by Subepithelial
Opacities,Chemosis, Pseudomembrane Formation, Lymphadenopathy
In Pharyngeocinjunctival fever, Same clinical features with fever and
Pharyngitis.
In Herpes Simplex Conjunctivitis, Keratitis without Subepithelial
Opacities which progress to Multiple Dendritic Figures , Decreased
Corneal Sensation.
In Molluscum Contagiosum, Mucoid discharge with Unilateral nodules
on Iris.
3. CHLAMYDIAL CONJUNCTIVITIS:
STAINING: Giemsa Staining for Inclusion bodies,
Microimmunofluorescence Test, On Histology, Large multinucleated cells(
Leber Cells).
PCR
ELISA
CULTURING: McCoy culture
Clinical Features: Stage1: Subclinical stage
Stage 2: Follicles, Papillae, Corneal Pannus , Keratitis
Stage 3: Conjunctival Scarring , Follicle necrosis, Herbert Pits, Arlt’s Lines
Stage 4: Inactive Stage
4. ALLERGIC CONJUNCTIVITIS:
In Acute Allergic, Acute Itching of Eyes , Watering .
In seasonal or perennial , signs and symptoms present in spring and
summer and throughout the year respectively.
In Vernal Conjunctivitis, occurs in Young boys . It is of three types
1. Palpebral form: Diffuse papillary hypertrophy, Cobblestone app.
Ropy secretions , Hyperemia and Ptosis may occur.
2. Limal form: Gelatinous Papillae, Trantas Dots.
3. Mixed Form: Features of both above forms with Keratoconus,
corneal erosion and scarring occur.
In Atopic Conjunctivitis, Similar to VKC features but more severe and
in chronic form. It can also occur in adulthood .
5. AUTOIMMUNE CONJUNCTIVITIS:
In Cicatricial pemiphegoid Conjunctivitis
STAINING: Immunohistochemical staining
BIOPSY: Conjunctival biopsy is done.
CLINICAL FEATURES: Red eye, Subepithelial Bullae leading to fibrosis
which appear as fine grey white linear opacities, dry eye,
symblepheron,corneal vascularization and keratinization,
blepharitis,trichiasis and entropion.
In Steven Johnson Syndrome, Redness, Watery discharge, papillary
reaction , Pseudomembrane, keratopathy, hemorrhagic crusting in lid
margins. Systemic signs are Bullae and erosions always present in oral
mucosa . On lips there is characteristic hemmorhagic crusting . Target
lesions on Skin.
Thanks