So, on exam for conjunctivitis, you need to do a full head, eyes, ears, nose, throat exam.
You're gonna ask about, how many eyes are affected? Is it unilateral or bilateral?
What is the patients discharge? Is it thinner? Is it watery? Is it stringy or thick and purulent?
The type of discharge can help you figure out what's causing this.
You're gonna look for subconjunctival hemorrhages, and this is just from irritation.
Some of these patients will rub their eyes and break these small vessels in their eyes.
It's not serious. Does the patient have any lymphadenopathy?
And this can indicate an infection. You're gonna do a fluorescein stain exam.
And this is where if a patient has pain, you're first gonna numb their eye with a numbing drop
and then you use fluorescein stain which is a sort of yellowish orange dye
and you could see that being done in the picture.
And you basically put it in the eye. The patient will blink a few times.
And then you use a Wood's lamp to see if there's any increased areas of uptake
that can look for cornea, ulcerations or breakdowns.
You also wanna evert the eyelid and you're looking for a foreign body
or a stye or another thing that could be causing their eye irritation.
And finally, you'll do a slit lamp exam and this is the most comprehensive way to evaluate the eye.
You also wanna do a cardiac and respiratory exam.
So, to diagnose this, you need to get the patient's whole health history
and again do their comprehensive eye exam and this includes a visual acuity.
On the right, you'll see some Snellen charts. And this is how we test that.
In kids, we have options to use pictures or directions of ease.
If it's a child who can read, you can use the normal Snellen chart.
You're gonna do a conjunctival and external eye exam.
You're gonna look at the inner structures of the eye,
and again that's with your ophthalmoscope or you can use a slit lamp.
And then there's supplemental testing, but cultures and smears are not routinely indicated.