SELECTED ARTICLES FROM THE RECENT LITERATURE 2007

September 15, 2007

Differential diagnosis of conjunctivitis

Summary
Background - Allergic conjunctivitis (AC) must be differentiated from other types of inflammatory conjunctivitis (Conj) that cause symptoms such as red eyes and tearing.

Findings - The differential diagnosis of AC was discussed by Bielory of the New Jersey Medical School. AC usually occurs in concert with other allergic manifestations, particularly rhinitis.

AC is usually manifest by itching, tearing and local swelling. However, prominent ocular pain (particularly in the absence of ocular discharge) suggests deeper inflammation (iritis, scleritis). Ocular injection forming a ring of erythema at the limbal junction of the cornea suggest iritis/uveitis. Follicles in an inflamed conjunctiva suggests chronicity. In acute AC visual impairmen; is unusual although the conjunctiva may be milky and swollen in appearance. Dark circles may form under the lower eyelids (allergic shiners) due to vascular congestion.

Reference
Annals Allergy Asthma & Immunology 2007;98:105-15

Editor's Comments
Space does not permit an extensive discussion of this very good review by one of the most active clinical investigators of AC. I suggest that you read the whole article.

 

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