Materiały źródłowe

• #1 Diagnosing Conjunctivitis | NYU Langone Health

  https://nyulangone.org/conditions/conjunctivitis/diagnosis

  Often, your ophthalmologist can diagnose conjunctivitis simply by examining your eye. Based on your symptoms, he or she can usually determine whether the inflammation is due to a viral or bacterial infection. He or she may perform the following tests to confirm a diagnosis: […] Your ophthalmologist can rule out many causes of conjunctivitis simply by asking about your symptoms and how they came about. He or she also asks whether you’ve been in close contact with other people who have conjunctivitis and if any irritant has come into contact with your eye. […] Most of the time, your doctor can diagnose conjunctivitis by using a slit lamp—an instrument that consists of a microscope and a high-energy beam of light. During a slit-lamp exam, your ophthalmologist shines a thin beam of light into your eye. This beam allows your doctor to examine the entire eye, including the conjunctiva; the sclera, or the white of the eye; the iris; and the cornea.

• #1 Pink eye (conjunctivitis) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pink-eye/diagnosis-treatment/drc-20376360

  In most cases, your healthcare professional can diagnose pink eye by asking about your recent health history and symptoms and examining your eyes. […] Rarely, your care professional may take a sample of the liquid that drains from your eye for laboratory analysis, called a culture. A culture may be needed if your symptoms are severe or if your care professional suspects a high-risk cause, such as: […] What kinds of tests do I need? […] Your healthcare professional is likely to ask you a number of questions. Being ready to answer them may allow time later to cover points you want to address. You may be asked:

• #1 Conjunctivitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK541034/

  Conjunctivitis refers to the inflammation or infection of the conjunctiva. Conjunctivitis, the inflammation or infection of the conjunctiva, represents the most prevalent cause of eye redness in both primary care and the emergency department. This condition places a substantial burden on the healthcare system. Conjunctivitis is the most prevalent etiology of eye redness and discharge. More than 80% of all acute cases are generally diagnosed by non-ophthalmologists, such as internists, primary care providers, pediatricians, and nurse practitioners. While conjunctivitis is typically a temporary condition that does not often lead to vision loss, ruling out other potential sight-threatening causes of red-eye during evaluation is crucial. […] When diagnosing conjunctivitis, conducting a comprehensive history and physical examination is essential to identify the underlying cause and determine the appropriate treatment. The ocular exam should focus on visual acuity, extraocular motility, visual fields, discharge type, shape, size and response of pupil, the presence of proptosis, corneal opacity, foreign body assessment, tonometry, and eyelid swelling. In cases of conjunctivitis, the redness typically affects the entire surface of the conjunctiva, including both the bulbar and tarsal conjunctiva. This visible redness helps to rule out more severe conditions like keratitis, iritis, and angle-closure glaucoma, which only affect the bulbar conjunctiva and spare the tarsal conjunctiva.

• #1 Pink Eye (Conjunctivitis): Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/primary-care/conjunctivitis-pink-eye/treatment

  Diagnosing pink eye (conjunctivitis) is usually determined by the typical signs and symptoms, including redness and swelling, burning, and itching eyes. A doctor can diagnose whether the cause of pink eye is viral, bacterial, or allergen-related. […] Though not typical, a doctor may send a sample of the eye discharge to a laboratory for examination. Knowing the cause of the infection determines which treatment course will be used. […] Your primary care physician can evaluate you and advise consultation with an ophthalmologist if medically indicated. Ophthalmologists, doctors who specialize in eye conditions, usually use a slit lamp to examine the eye. A slit lamp is a microscope that emits a high-energy light beam that allows the doctor to examine the whole eye. […] Sometimes, the doctor will use a drop of fluorescein, a yellow dye, to accentuate any damage to the eye. […] A doctor can diagnose pink eye after examining a patient and considering their symptoms.

• #1 Conjunctivitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK541034/

  When identifying the cause of conjunctivitis, the type of discharge is a crucial factor. Bacterial conjunctivitis is usually linked to either purulent discharge, which forms again after being removed from the eye, or mucopurulent discharge, which is thicker and adheres to the eyelashes. Compared to other causes of bacterial conjunctivitis, Neisseria gonorrhoeae has a hyperacute presentation, consisting of copious purulent discharge, sudden onset, and rapid progression. In both viral and allergic conjunctivitis, the discharge is typically watery. […] Determining the cause of conjunctivitis can be challenging as its symptoms are not specific. For instance, itching is usually linked to allergic conjunctivitis, especially when accompanied by watery discharge and a history of atopy. However, results from a study found that 58% of patients with bacterial conjunctivitis (confirmed through culture testing) also reported itchy eyes.

• #1 Conjunctivitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK541034/

  While conjunctivitis often presents similarly, a thorough systematic history and physical exam can safely rule out any acute sight-threatening diagnoses and elucidate the likely cause of conjunctivitis. The classic findings of the 3 most common types of conjunctivitis are: Bacterial – Findings include conjunctival redness, having the sensation of a foreign body in the eye, morning matting of the eyes, white-yellow purulent or mucopurulent discharge, conjunctival papillae, and infrequently preauricular lymphadenopathy. Viral – Findings include eye itching, watery discharge, tearing, a history of recent upper respiratory tract infection, inferior palpebral conjunctival follicles, and tender preauricular lymphadenopathy. Allergic: Findings include eye itching and burning, watery discharge, history of allergies/atopy, edematous eyelids, conjunctival papillae, and no preauricular lymphadenopathy.

• #1 Conjunctivitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK541034/

  Labs and cultures are rarely indicated to confirm conjunctivitis diagnosis. Eyelid cultures and cytology are usually reserved for recurrent conjunctivitis, those resistant to treatment, suspected gonococcal or chlamydial infection, suspected infectious neonatal conjunctivitis, and adults presenting with severe purulent discharge. Rapid antigen testing is available for adenoviruses and can be used to confirm suspected viral causes of conjunctivitis to prevent unnecessary antibiotic use. […] When treating viral or bacterial conjunctivitis, educating the patient to reduce the spread of the infection is important. Bacterial conjunctivitis, while typically self-limiting, can be treated to help reduce the duration of symptoms. No significant outcome difference has been observed in trials comparing different types of ophthalmic antibiotic drops.

• #1 Pink Eye (Conjunctivitis): Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/pink-eye-conjunctivitis

  Pink eye (conjunctivitis) is when your eyes look pink because the membrane that covers the sclera, the white of your eye, is inflamed. […] Pink eye can be acute (short-term), meaning it lasts under four weeks. Or it can be chronic (long-term), meaning it lasts more than four weeks. […] Eye care specialists usually arent the ones to diagnose conjunctivitis. Instead, 80% of diagnoses come from primary care providers and pediatricians. Urgent care and emergency room providers also diagnose many cases. […] Providers may also recommend taking a swab to test for bacterial infections. To do that, theyll use a soft-tipped swab to collect some of the fluid oozing from your eye for lab testing. Your provider can use the results to guide your treatment. […] Pink eye is treatable, regardless of the cause. Some treatments are more specific, while others help many types of pink eye or its most common symptoms.

• #1 Diagnosing Conjunctivitis | NYU Langone Health

  https://nyulangone.org/conditions/conjunctivitis/diagnosis

  Doctors also check to see if conjunctivitis has affected your vision by conducting a visual acuity test. This test checks to see how well you can read letters or symbols from 20 feet away, while covering one eye at a time. […] If you have had conjunctivitis for more than two or three weeks and it has not gone away on its own or with the help of home treatments, your doctor may want to perform an eye culture. During this test, your doctor takes a sample of the cells on the inside of your eyelids with a cotton swab and sends it to a laboratory to be examined by a pathologist. […] A pathologist, who studies diseases under a microscope, can determine whether your conjunctivitis is caused by viruses or bacteria. This helps your doctor determine the most effective treatment.

• #1 Viral Conjunctivitis (Pink Eye): Practice Essentials, Background, Etiology

  https://emedicine.medscape.com/article/1191370-overview

  Viral conjunctivitis, or pinkeye (see the image below), is a common, self-limiting condition that typically is caused by adenovirus. […] Generally, a diagnosis of viral conjunctivitis is made on the clinical features alone. Laboratory tests typically are unnecessary, but they may be extremely helpful in some cases, particularly when an epidemic of adenoviral keratoconjunctivitis threatens a community or clinic. […] A rapid point-of-service immunoassay is readily available to guide the clinicians recommendations upon initial presentation (Adenoplus, RPS, Sarasota, FL). Approximately 1 in 4 patients with acute conjunctivitis have confirmed adenoviral conjunctivitis. Adenoplus detects all known serotypes of adenoviral conjunctivitis. […] Treatment of adenoviral conjunctivitis is supportive.

• #1 Diagnosis and Management of Red Eye in Primary Care | AAFP

  https://www.aafp.org/pubs/afp/issues/2010/0115/p137.html

  Bacterial conjunctivitis is highly contagious and is most commonly spread through direct contact with contaminated fingers. […] Chlamydial conjunctivitis should be suspected in sexually active patients who have typical signs and symptoms and do not respond to standard antibacterial treatment. Polymerase chain reaction testing of conjunctival scrapings is diagnostic, but is not usually needed.

• #1 Pink Eye (Conjunctivitis): Symptoms, Causes, Treatment

  https://www.webmd.com/eye-health/eye-health-conjunctivitis

  Pink eye diagnosis involves your eye doctor asking questions about your symptoms, such as: […] They may also give you an eye exam and use a cotton swab to remove fluid from your eyelid to test in a lab. Test results will show bacteria or viruses that may have caused conjunctivitis, including those that can cause an STD. Then, your doctor can prescribe the right treatment. […] Don’t assume that all red, irritated, or swollen eyes are pink eye (viral conjunctivitis). Your symptoms could also be caused by seasonal allergies, a stye, iritis, chalazion (an inflammation of the gland along the eyelid), or blepharitis (an inflammation or infection of the skin along the eyelid). These conditions aren’t contagious.

• #1 Conjunctivitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK541034/

  Patients with moderate to severe pain, vision loss, corneal involvement, severe purulent discharge, conjunctival scarring, recurrent episodes, lack of response to therapy, or herpes simplex virus keratitis should receive a prompt referral to an ophthalmologist. In addition, those requiring steroids, contact lens wearers, and patients with photophobia should also be referred. […] Complications of acute conjunctivitis are rare. However, patients who fail to show improvement within 5 to 7 days should have a referral to an ophthalmologist for further evaluation. Patients with herpes simplex conjunctivitis are at the highest risk of complications.

• #1 Clinical Overview of Pink Eye (Conjunctivitis) | Conjunctivitis (Pink Eye) | CDC

  https://www.cdc.gov/conjunctivitis/hcp/clinical-overview/index.html

  Contact lens wearers with bacterial conjunctivitis are at higher risk of bacterial keratitis. They should be asked to remove their contact lenses; treated with topical antibiotics; and promptly evaluated by an ophthalmologist. […] Advise patients to remain home if they have viral or bacterial conjunctivitis with systemic signs of illness, especially if they cannot avoid close contact with others. Patients may return to work or school if they receive clinician approval and after any indicated therapy is implemented.

• #1 Pediatric Conjunctivitis: A Review of Clinical Manifestations, Diagnosis, and Management

  https://www.mdpi.com/2227-9067/10/5/808

  Pediatric conjunctivitis, commonly called „pink eye”, refers to inflammation or infection of the conjunctiva. The classification of pediatric conjunctivitis is typically by etiology, broadly categorized into infectious and non-infectious causes. Most cases of pediatric conjunctivitis are infectious, either bacterial or viral. […] When a child presents with „pink eye”, the evaluation should first start with a review of the history, signs, and symptoms to determine the etiology. […] The physical examination should always begin with a vision measurement, testing each eye separately with a Snellen chart. […] A thorough history and physical exam can give clues to the etiology and management of „pink eye”. […] However, it is important to note that clinical presentation is often non-specific.

• #1 Pediatric Conjunctivitis: A Review of Clinical Manifestations, Diagnosis, and Management

  https://www.mdpi.com/2227-9067/10/5/808

  A multi-center study of adults with bacterial conjunctivitis demonstrated that the symptoms can widely vary. […] The majority of cases of bacterial conjunctivitis are self-limiting, lasting 7 to 10 days without treatment. […] The treatment of most cases is supportive with topical lubricants; however, antibiotics are indicated on an individual basis for cases of bacterial conjunctivitis, depending on patient and family preference and the clinician’s approach to treatment. […] Although certain symptoms and clinical exam findings tend to correspond with specific causes of pink eye, it must be emphasized that clinical manifestations are non-specific and that considerable overlap exists in actual clinical practice.

• #1 Conjunctivitis (Pinkeye) In Kids (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/conjunctivitis.html

  Pinkeye can be diagnosed by a health care provider to learn what’s causing it and how to treat it. […] A child who complains of severe pain, changes in eyesight, swelling around the eyes, or sensitivity to light should be examined. […] If you can’t get an in-person visit, you might be able to do a „video visit” instead. […] If the pinkeye does not improve after 2 to 3 days of treatment, or after a week if untreated, call your doctor. […] Those symptoms may mean the infection has started to spread beyond the conjunctiva and will need more treatment.

• #1 Bacterial Conjunctivitis (Pink Eye): Treatment and More

  https://www.verywellhealth.com/bacterial-conjunctivitis-overview-5097431

  An eye care provider can usually determine what type of pink eye you have by asking about your medical history and symptoms and by performing an eye exam. […] They may also be able to diagnose your condition by phone based on a discussion about your symptoms. […] As part of the eye exam, your eye care provider may also flip your upper lids to examine the palpebral conjunctiva (the lining of the eyelids). […] They may also use special drops or dye to examine the cornea and other tissues for damage and inflammation and determine if the cause is viral or bacterial. […] Some tests your healthcare provider may use to determine the cause of your pink eye include: […] Eye culture: If you have had conjunctivitis for more than two or three weeks and it has not gone away on its own or with the help of home treatments, your eye care provider may want to perform an eye culture. […] During this test, your eye care provider takes a sample of the cells on the inside of your eyelids with a cotton swab and sends it to a laboratory to be examined by a pathologist.

• #2 Pink eye (conjunctivitis) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pink-eye/diagnosis-treatment/drc-20376360

  In most cases, your healthcare professional can diagnose pink eye by asking about your recent health history and symptoms and examining your eyes. […] Rarely, your care professional may take a sample of the liquid that drains from your eye for laboratory analysis, called a culture. A culture may be needed if your symptoms are severe or if your care professional suspects a high-risk cause, such as: […] What kinds of tests do I need? […] Your healthcare professional is likely to ask you a number of questions. Being ready to answer them may allow time later to cover points you want to address. You may be asked:

• #2 Diagnosing Conjunctivitis | NYU Langone Health

  https://nyulangone.org/conditions/conjunctivitis/diagnosis

  Often, your ophthalmologist can diagnose conjunctivitis simply by examining your eye. Based on your symptoms, he or she can usually determine whether the inflammation is due to a viral or bacterial infection. He or she may perform the following tests to confirm a diagnosis: […] Your ophthalmologist can rule out many causes of conjunctivitis simply by asking about your symptoms and how they came about. He or she also asks whether you’ve been in close contact with other people who have conjunctivitis and if any irritant has come into contact with your eye. […] Most of the time, your doctor can diagnose conjunctivitis by using a slit lamp—an instrument that consists of a microscope and a high-energy beam of light. During a slit-lamp exam, your ophthalmologist shines a thin beam of light into your eye. This beam allows your doctor to examine the entire eye, including the conjunctiva; the sclera, or the white of the eye; the iris; and the cornea.

• #2 Diagnosis and Management of Red Eye in Primary Care | AAFP

  https://www.aafp.org/pubs/afp/issues/2010/0115/p137.html

  Red eye is the cardinal sign of ocular inflammation. Conjunctivitis is the most common cause of red eye. Because there is no specific diagnostic test to differentiate viral from bacterial conjunctivitis, most cases are treated using broad-spectrum antibiotics. The cause of red eye can be diagnosed through a detailed patient history and careful eye examination, and treatment is based on the underlying etiology. […] A thorough patient history and eye examination may provide clues to the etiology of red eye. The history should include questions about unilateral or bilateral eye involvement, duration of symptoms, type and amount of discharge, visual changes, severity of pain, photophobia, previous treatments, presence of allergies or systemic disease, and the use of contact lenses. […] Laboratory tests to identify bacteria and sensitivity to antibiotics are performed only in patients with severe cases, in patients with immune compromise, in contact lens wearers, in neonates, and when initial treatment fails.

• #2 Conjunctivitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK541034/

  When identifying the cause of conjunctivitis, the type of discharge is a crucial factor. Bacterial conjunctivitis is usually linked to either purulent discharge, which forms again after being removed from the eye, or mucopurulent discharge, which is thicker and adheres to the eyelashes. Compared to other causes of bacterial conjunctivitis, Neisseria gonorrhoeae has a hyperacute presentation, consisting of copious purulent discharge, sudden onset, and rapid progression. In both viral and allergic conjunctivitis, the discharge is typically watery. […] Determining the cause of conjunctivitis can be challenging as its symptoms are not specific. For instance, itching is usually linked to allergic conjunctivitis, especially when accompanied by watery discharge and a history of atopy. However, results from a study found that 58% of patients with bacterial conjunctivitis (confirmed through culture testing) also reported itchy eyes.

• #2 Bacterial conjunctivitis: diagnosis and management – The Pharmaceutical Journal

  https://pharmaceutical-journal.com/article/ld/bacterial-conjunctivitis-diagnosis-and-management

  Bacterial conjunctivitis is a common presentation in community pharmacy so it is important to be able to recognise signs and symptoms, as well as identify causes and risk factors for all types of infection. […] After reading this learning article, you should be able to: […] Identify the symptoms of bacterial conjunctivitis and know how to conduct an appropriate diagnostic examination; […] A basic examination and a focused ocular history is usually all that is required to diagnose bacterial conjunctivitis. Symptoms can often overlap, however, so there is not always a clear correlation to a cause. A combination of bilateral sticking of the eyelids on waking, absence of itching and no prior conjunctivitis is suggestive of bacterial conjunctivitis. […] Conjunctival swabs for culture and/or polymerase chain reaction are reserved for recurrent, treatment resistant, severely purulent or otherwise suspected STI origin.

• #2 Viral Conjunctivitis (Pink Eye): Practice Essentials, Background, Etiology

  https://emedicine.medscape.com/article/1191370-overview

  Viral conjunctivitis, or pinkeye (see the image below), is a common, self-limiting condition that typically is caused by adenovirus. […] Generally, a diagnosis of viral conjunctivitis is made on the clinical features alone. Laboratory tests typically are unnecessary, but they may be extremely helpful in some cases, particularly when an epidemic of adenoviral keratoconjunctivitis threatens a community or clinic. […] A rapid point-of-service immunoassay is readily available to guide the clinicians recommendations upon initial presentation (Adenoplus, RPS, Sarasota, FL). Approximately 1 in 4 patients with acute conjunctivitis have confirmed adenoviral conjunctivitis. Adenoplus detects all known serotypes of adenoviral conjunctivitis. […] Treatment of adenoviral conjunctivitis is supportive.

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