Conjunctivitis Bacterial Adenoviral Vernal Follicular - chlamydia 1

Papillae consist of hyperplastic conjunctival tissue full of inflammatory cells, normally seen in the palpebral conjunctiva. Associated with bacterial, and allergic conjunctivitis Follicles consist of hyperplastic lymphoid tissue & appear as elevated lesions encircled by blood vessels. Typically seen in reaction to topical agents, adenoviral & chlamydial disease 2

Allergic Conjunctivitis SAC / PAC Acute / Toxic Allergic Conjunctivitis Atopic Vernal

Herpes simplex conjunctivitis Signs Unilateral eyelid vesicles Acute follicular conjunctivitis Treatment - topical antivirals to prevent keratitis

Epislceritis Scleritis Sight threatening disease Ocular emergency Normally idiopathic 33% of cases – systemic link Acute onset Mild ache Normally unilateral Can recur Radial vascular hyperemia Will ‘bleach’ with 2.5% Phenylephrine Hyd Sight threatening disease Ocular emergency Deep irregular vascular pattern of hyperemia 5

Flashes & Floaters Take a history to determine other causes of floaters e.g. vitreous bleed or inflammation of the eye (cyclitis or posterior uveitis) and rarely asteroid hyalosis. Examine the patient on the slit lamp for:  - Tobacco dust in anterior vitreous? (high mag / small slit – ant vitreous) - Then using a 60D or similar lens through a dilated pupil look for Weis ring (definite signs of posterior vitreous detachment)