Diagnosis and differential diagnosis of red eye disease

The release date:2019-10-17

Red eye disease can be seen in the examination of eyelid swelling, conjunctival congestion is bright red, especially in the eyelid and dome conjunctiva, serious conjunctiva surface can be covered with a layer of pseudomembrane which is easy to rub off, so it is also called pseudoconjunctivitis; conjunctiva of different degrees of congestion and edema, loss of transparency, cornea and conjunctiva surface, blepharon and other parts are covered with mucous or purulent secretion, if it is kochwe The infection of eksbacter or pneumococcus can cause conjunctival hyperemia and edema, accompanied by scattered small spot bleeding. Corneal complications are mainly caused by kochweeksacter, which is characterized by catarrhal corneal limbic infiltration or ulcer. The lesions begin to show shallow spot corneal infiltration, which is located at the inner side of the corneal limbic, and then infiltrates and fuses with each other to form a shallow arched ulcer, which can leave clouds after recovery Nebula.

1. Diagnosis of red eye disease

Generally speaking, the onset of red eye disease is 3-4 days, the disease is climax, then gradually reduced, about 10-14 days can be cured, the disease is more serious caused by kochweeks and pneumococcus infection, sometimes accompanied by systemic symptoms such as temperature rise and general discomfort, the disease can last for 2-4 weeks, red eye disease often occurs in both eyes at the same time or 1-2 days apart.

2. Identification of red eye disease

1. Epidemic keratoconjunctivitis (EKC)

This disease should be distinguished from red eye disease. The epidemic or sporadic cases of small-scale acute epidemic hemorrhagic conjunctivitis (AHC) should be distinguished from the epidemic keratoconjunctivitis (EKC) caused by adenovirus.

The main symptom of epidemic keratoconjunctivitis is long incubation period, usually 5-7 days, and AHC is 1 day; the peak of conjunctivitis is a few hours after AHC onset, and the course of disease is less than 1 week. The disease peaked in a few days after onset and lasted for 2-3 weeks; subconjunctival hemorrhage was a characteristic manifestation in the early stage of AHC, but rare in EKC; supraconjunctival follicular deposition was common in EKC, and supracorneal pannus was often left after conjunctivitis subsided. Transient keratitis can occur in AHC without sequelae.

2. Acute catarrhal conjunctivitis

(1) acute catarrhal conjunctivitis is characterized by marked conjunctival hyperemia, with the dome and palpebral conjunctiva as the most important.

(2) conjunctival secretions are many, which are serous in the early stage, and then become mucopurulent, often making the upper and lower eyelids and eyelashes stick together, smear or culture can detect bacteria. Antibacterial treatment is effective.

3. Swimming pool conjunctivitis (including body conjunctivitis)

(1) caused by a strain of Chlamydia trachomatis. The patient had a history of swimming in public swimming pool, conjunctival hyperemia, significant papillary hypertrophy and follicular hyperplasia, especially in the dome below the follicular.

(2) in the early stage, there were more secretions, systemic symptoms, fever, fatigue and upper respiratory tract inflammation.

(3) inclusion body can be seen in conjunctival scraping.

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