Key Concepts Ophthalmia neonatorum is conjunctivitis in the first month of life. Chemical etiologies present in the first 24–48 hours after birth. Gonococcal etiologies present in the first 2–5 days after birth. Chlamydial infections are the most common, presenting 5–14…
Key Concepts In trachoma, repeated infections with serovars A–C of Chlamydia trachomatis cause a chronic follicular conjunctivitis and subsequent cicatricial conjunctivitis, followed by entropion, trichiasis, and corneal opacity. Neonatal inclusion conjunctivitis is caused by serovars D–K of C. trachomatis infection…
Key Concepts DNA viruses are frequently associated with vision-threatening complications, while RNA viruses usually cause more benign forms of conjunctivitis. Adenovirus is the most common etiology of viral conjunctivitis. Laboratory testing is rarely necessary for diagnosis; however, identification of the…
Key Concepts The majority of acute conjunctivitis cases are difficult to distinguish from adenoviral conjunctivitis. Bacterial conjunctivitis is typically benign with a mild and self-limited course; therefore, no antibiotic use is recommended. Urgent treatment of gonorrheal conjunctivitis is necessary to…
Key Concepts The morphology, type of exudate, and principally affected areas help define the etiology of conjunctivitis. Chronicity plays a key role in classifying conjunctivitis. Acute conjunctivitis is typically infectious in etiology. Masquerade syndromes must be considered in cases of…
Key Concepts Epiphora, or chronic overflow of tears, is caused by overproduction, outflow obstruction, or failure of the tear pump. Chronic ocular surface irritation is a common source of tear overproduction. The lacrimal pump is mediated by contraction of the…
Key Concepts Dacryoadenitis may be infectious (e.g., Staphylococcus aureus , Streptococcus pneumoniae ) or noninfectious (nonspecific orbital inflammation) in etiology. Those with infectious dacryoadenitis usually feel unwell and are febrile in contrast to those in the noninfectious group who generally…
Key Concepts Meibomian gland dysfunction is the major cause of evaporative dry eye and often occurs in conjunction with aqueous deficiency dry eye. Expression of the meibomian gland with examination of the expressed secretion is critical to clinical diagnosis and…
Key Concepts Aqueous deficiency dry eye (ADDE) refers to a deficiency of aqueous production by either the lacrimal system or the accessory glands. Any lacrimal acinar destruction or dysfunction can lead to tear hyperosmolarity and ultimately signs and symptoms of…
Key Concepts Although dry eye disease is clinically classified as primarily aqueous-deficient versus evaporative, there is significant overlap of these and other subtypes of ocular surface disease, often leading to poor correlation between signs and symptoms. Subjective dry eye symptoms…