Abstract: . . .  The findings are similar to that seen in viral conjunctivitis , and so the history is important. Treatment: The person should be told to stop instilling the substance that has caused the reaction. Tetracycline eye ointment can be soothing and will prevent secondary bacterial infection. Health education: People should not instill anything in their eyes that has not been prescribed for them, and they should throw away eye drops after the bottle has been open for one month or more. Summary Conjunctivitis is common but is only rarely sight threatening. However, accurate diagnosis and prompt treatment at the primary level is very important as it instills confidence in the community, and reduces the risk that people may first try traditional remedies, which can, and do, lead to blindness. ‘ Conjunctivitis is common, but is only rarely sight threatening’ • Visual acuity chart • Torch • Clean swabs for cleaning eyes • Tetracycline eye ointment • Povidone iodine eye drops Equipment needed at the primary level to diagnose and manage conjunctivitis Fig 5. Eversion of the upper tarsus shows marked conjunctival papillae in vernal keratoconjunctivitis Tissa Senaratne Table 2. Clinical features of conjunctivitis , by cause Cause of conjunctivitis Unilateral (U) or bilateral (B) Discharge Redness Other symptoms or signs Treatment Viral, epidemic form B Watery , conj. haemorrhage Fever, sore throat Tetracycline eye ointment; povidone iodine eye drops Viral – herpes U Watery Vesicles on the eyelid Topical antiviral Viral – molluscum U Watery Molluscum on lid Remove molluscum Bacterial – non-gonococcal U or B Purulent None Tetracycline eye ointment or other antibiotic Bacterial – gonococcal B Purulent ﯯ ﯯ Marked lid swelling. May have corneal ulcer Frequent antibiotic REFER Chlamydia – babies B Purulent Lid swelling Tetracycline eye ointment Chlamydia – trachoma B Purulent Signs on everted upper lid Tetracycline eye ointment, or azithromyin Chlamydia – adults U or B Purulent None Tetracycline eye ointment Allergy – acute B Watery ﯯ Minimal Marked swelling of lids and conjunctiva None – reassure Allergy – chronic B Thick and stringy Signs on everted upper lid. Discoloration of eye Tetracycline eye ointment to eye lids – REFER Chemical U or B  . . .
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