8
Diagnosis
Care Process
Î The initial evaluation of a patient should include the relevant aspects
of the comprehensive medical eye evaluation. (II++, G, S)
Î Some elements of the evaluation may be deferred in patients with
symptoms and signs suggestive of infectious conjunctivitis. (III, I, D)
Î The initial eye examination includes measurement of visual acuity, an
external examination, and slit-lamp biomicroscopy. (III, I, D)
ÎThe external examination should include regional lymphadenopathy, skin,
abnormalities of the eyelids and adnexae, and conjunctiva. (III, I, D)
Î The slit-lamp biomicroscopy should include careful evaluation of the
eyelid margins, eyelashes, lacrimal puncta and canaliculi, tarsal and
forniceal conjunctiva, bulbar conjunctiva/limbus, cornea, anterior
chamber/iris and dye-staining pattern. (III, I, D)
Î Fluorescein, rose bengal, or lissamine green dyes may be used to
assess the ocular surface. (III, I, D)
Î Lissamine green dye is NOT recommended for evaluating corneal
epithelial disease. (III, I, D)
Î Cultures of the conjunctiva are indicated in all cases of suspected
infectious neonatal conjunctivitis. (II+, M, S)
Î Bacterial cultures also may be helpful for recurrent or severe purulent
conjunctivitis in any age group and in cases where the conjunctivitis
has not responded to medication. (III, I, D)
Î Viral cultures are not routinely used to establish a diagnosis. (III, I, D)
Figure 1. Conjunctivitis
© 2014 American Academy of Ophthalmolog y
