While symptoms can be very distressing, patients with
conjunctivitis general maintain good vision and recover completely without permanent sequelae. The great majority of cases of
conjunctivitis are infectious or allergic in origin. Seen with increasing frequency are external
eye diseases related to
contact lens wear or prolonged use of ophthalmic medications. The various forms of
conjunctivitis are often not associated with pathognomonic features. A thorough history and ophthalmic examination often permit a presumptive diagnosis and initiation of empiric
therapy. For example, a chronic bilateral
conjunctivitis, characterized by
itching and papillary
hypertrophy, suggests an ocular
allergy, most frequently the result of exposure to airborne
allergens. However, a number of causes, including
infections and
hypersensitivity reactions, have the potential to threaten vision or produce marked conjunctival
scarring which must be identified by the use of appropriate laboratory techniques, followed by specific
therapy. Most bacterial and
viral conjunctivitis are self-limited, but antimicrobial
therapy for the former is advocated to shorten the course, improve patient comfort, prevent recurrence, avoid complications and limit spread to other individuals.