Review Question - QID 105369

This patient is suffering from allergic conjunctivitis given his pruritus, edema, and hyperemia of his eyes without sick contacts and with improvement of symptoms with showers (allergen removal).

Allergic conjunctivitis is a common condition which is caused by sensitivity to pollen, dander, mold, or another allergen. It is part of a systemic reaction to an allergen, most commonly, pollen. Patients present with intense itching of both eyes, as well as redness, tearing, and edema. Many patients have other allergic symptoms as well, such as allergic rhinitis, asthma, and eczema. The treatment is allergen avoidance, topical olopatadine, and oral antihistamines (such as cetirizine).

Figure A shows the eye of a patient with allergic conjunctivitis with hyperemia of the conjunctiva, swelling of the eyelids and conjunctiva, and a watery discharge.

Incorrect Answers:
Answer 2: Bacterial conjunctivitis presents with a purulent discharge from the eye and is treated with topical antibiotics.

Answer 3: Corneal abrasion presents after trauma with unilateral eye pain. A fluorescein stain will demonstrate increased uptake in the lesion. The treatment is topical erythromycin.

Answer 4: Endophthalmitis presents after eye surgery with pain, decreased vision, erythema, and a hypopyon in the eye. Management includes aspiration for culture and intravitreal antibiotics.

Answer 5: Viral conjunctivitis is a common condition that is very contagious. Unlike allergic conjunctivitis, it begins unilaterally and then progresses to the other eye. It presents with a watery discharge, hyperemia of the conjunctiva, and eyelid swelling. Although possible, allergic conjunctivitis is the more likely cause in this patient, as he presented with bilateral symptoms, has no sick contacts, and has symptoms that improve with showers (which removes the allergen).

Bullet Summary:
Allergic conjunctivitis presents with bilateral pruritus, hyperemia, and tearing of the eye and is worsened with allergen exposure.