9
Î Suspected cases of adult and neonatal chlamydial conjunctivitis can
be confirmed by laboratory testing. (II+, G, D)
Î Smears for cytology and special stains (e.g., Gram, Giemsa) are
recommended in cases of suspected infectious neonatal conjunctivitis,
chronic or recurrent conjunctivitis, and in cases of suspected
gonococcal conjunctivitis in any age group. (II-, I, D)
Î Directed conjunctival biopsy may be both vision-saving and lifesaving.
(III, I, D)
Î Conjunctival biopsy and immunofluorescent staining diagnostic
tests may be helpful to establish the diagnosis of diseases such as
ocular mucous membrane pemphigoid (OMMP) and paraneoplastic
syndromes. (II-, I, D)
Î A biopsy of bulbar conjunctiva should be performed and a sample
should be taken from an uninvolved area in an eye with active
inflammation when OMMP is suspected. (II-, I, D)
Î In cases of suspected sebaceous carcinoma, a full-thickness lid biopsy
is indicated. (III, I, D)
Î When considering a biopsy, a preoperative consultation with the
pathologist is advised to ensure proper handling and staining of
specimens. (III, I, S)
Î Confocal microscopy may be helpful as a non-invasive tool to
evaluate some forms of conjunctivitis (e.g., atopic, superior limbic
keratoconjunctivitis [SLK]). (II-, M, D)
Î Thyroid function tests are indicated for patients with SLK who do not
have known thyroid disease. (III, I, D)
