STUDY - Technical - New Dacian's Medicine
Conjunctival
injection (Classical / Allopathic Medicine)
A common ocular
sign associated with inflammation, and conjunctival injection
is nonuniform redness of the conjunctiva from hyperemia. This
redness can be diffuse, localized, or peripheral, or it may
encircle a clear cornea.
Conjunctival
injection usually results from bacterial or viral
conjunctivitis, but it can also signal a severe ocular
disorder that, if untreated, may lead to permanent blindness.
In particular, conjunctival injection is an early sign of
trachoma, a leading cause of blindness in third-world
countries and among Native Americans living in the
southwestern United States.
The conjunctival
injection can also result from minor eye irritation due to
inadequate sleep, overuse of contact lenses, environmental
irritants, and excessive eye rubbing.
ALERT:
If the patient with conjunctival injection reports a chemical splash to the eye:
- remove contact lenses, if appropriate
- irrigate the eye with copious amounts of normal saline solution
- evert the lids, and wipe the fornices with a cotton-tipped applicator to remove any foreign body particles and as much of the chemical as possible.
If the patient's condition permits, perform a focused assessment.
If the patient with conjunctival injection reports a chemical splash to the eye:
- remove contact lenses, if appropriate
- irrigate the eye with copious amounts of normal saline solution
- evert the lids, and wipe the fornices with a cotton-tipped applicator to remove any foreign body particles and as much of the chemical as possible.
If the patient's condition permits, perform a focused assessment.
HISTORY:
Ask the patient if he has associated pain. If so, when did the pain begin and where is it located? Is it constant or intermittent?
Ask the patient about itching, burning, photophobia, blurred vision, halo vision, excessive tearing, or a foreign body sensation in the eye.
Review the patient's medical history for eye disease, allergies, and trauma.
Ask the patient if he has associated pain. If so, when did the pain begin and where is it located? Is it constant or intermittent?
Ask the patient about itching, burning, photophobia, blurred vision, halo vision, excessive tearing, or a foreign body sensation in the eye.
Review the patient's medical history for eye disease, allergies, and trauma.
PHYSICAL
ASSESSMENT:
Determine the location and severity of conjunctival injection. Is it circumoral or localized? Peripheral or diffuse? Note conjunctival or lid edema, ocular deviation, conjunctival follicles, ptosis, or exophthalmos. Also, note the type and amount of any discharge, if present.
Test the patient's visual acuity to establish a baseline. Note if the patient has had vision changes. Is his vision blurred or his visual acuity markedly decreased?
Test pupillary reaction to light.
Determine the location and severity of conjunctival injection. Is it circumoral or localized? Peripheral or diffuse? Note conjunctival or lid edema, ocular deviation, conjunctival follicles, ptosis, or exophthalmos. Also, note the type and amount of any discharge, if present.
Test the patient's visual acuity to establish a baseline. Note if the patient has had vision changes. Is his vision blurred or his visual acuity markedly decreased?
Test pupillary reaction to light.
SPECIAL
CONSIDERATIONS:
Because most forms of conjunctivitis are contagious, the infection can easily spread to the other eye or to family members. Stress the importance of hand washing and of not touching the affected eye to prevent contagion.
Because most forms of conjunctivitis are contagious, the infection can easily spread to the other eye or to family members. Stress the importance of hand washing and of not touching the affected eye to prevent contagion.
PEDIATRIC
POINTERS:
An infant can develop self-limiting chemical conjunctivitis at birth from the ocular instillation of silver nitrate.
An infant may develop bacterial conjunctivitis 2 to 5 days after birth due to contamination of the birth canal.
An infant with congenital syphilis has prominent conjunctival injection and grayish-pink corneas.
An infant can develop self-limiting chemical conjunctivitis at birth from the ocular instillation of silver nitrate.
An infant may develop bacterial conjunctivitis 2 to 5 days after birth due to contamination of the birth canal.
An infant with congenital syphilis has prominent conjunctival injection and grayish-pink corneas.
PATIENT
COUNSELING:
If the patient complains of photophobia, tell him to keep the room dark or wear sunglasses. If the patient's visual acuity is markedly decreased, orient him to his environment to ensure his comfort and safety.
If the patient complains of photophobia, tell him to keep the room dark or wear sunglasses. If the patient's visual acuity is markedly decreased, orient him to his environment to ensure his comfort and safety.
Bibliography:
1. Rapid Assessment, A
Flowchart Guide to Evaluating Signs & Symptoms, Lippincott
Williams & Wilkins, 2004.
2. Professional Guide to
Signs and symptoms, Edition V, Lippincott
Williams & Wilkins, 2007.
3. Guide to common
symptoms, Edition V, McGraw - Hill, 2002.
Dorin,
Merticaru (2010)