Eye
Conjunctiva
Conjunctivitis
Chronic conjunctivitis
Author: Deepali Jain, M.D.
Last author update: 1 October 2014
Last staff update: 22 December 2020
Copyright: 2004-2023, PathologyOutlines.com, Inc.
PubMed Search: Chronic Conjunctivitis [title]
Table of Contents
Pathophysiology | Etiology | Clinical features | Diagnosis | Case reports | Treatment | Clinical images | Microscopic (histologic) description | Cytology description | Molecular / cytogenetics description | Differential diagnosis | Additional referencesCite this page: Jain D. Chronic conjunctivitis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/eyechronicconj.html. Accessed October 2nd, 2023.
Pathophysiology
- Conjunctivitis that persists for 4+ weeks
Etiology
- Unilateral:
- Due to keratitis, nasolacrimal duct obstruction, occult foreign body, neoplasm, tuberculosis, phthiriasis palpebrarum (due to lice, Int Ophthalmol 2012;32:467)
- Bilateral:
- Due to bacteria, tuberculosis (Int Ophthalmol 2014;34:655), virus, trachoma, other microorganisms
- Also allergic or chemical causes, inflammation of meibomian glands of eyelid
- Tarsoconjunctival crypts containing bacteria (Am J Ophthalmol 2012;154:527)
- Giant fornix syndrome (Ophthal Plast Reconstr Surg 2012;28:4)
- Vitamin A deficiency
Clinical features
- Insidious onset; slow progression of ocular discomfort, conjunctival injection, discharge
Diagnosis
- Conjunctival scrapings and culture are useful for diagnosis (Eur J Ophthalmol 1997;7:19)
Case reports
- 50 year old woman with relapsing polychondritis and obliterative microangiopathy (Cornea 2006;25:621)
- Boy with X-linked hypogammaglobulinemia and bilateral inflammation (J Paediatr Child Health 1996;32:463)
Treatment
- Antibiotics, artificial tears, topical medications
Clinical images
Images hosted on other servers:
Cause unspecified
Microscopic (histologic) description
- Two basic Patterns:
- Chronic follicular conjunctivitis (associated with cosmetics, infectious mononucleosis, molluscum contagiosum, moraxella, phthiriasis palpebrarum, psittacosis, topical medications, trachoma)
- Chronic papillary conjunctivitis (tarsal conjunctiva)
- Numerous goblet cells and papillary folds
- Chronic inflammatory cells (lymphoid follicles and plasma cells)
- Isolated islands of epithelium may form retention cysts that calcify
- Late changes are epithelial atrophy, keratinization and stromal scarring
- Note that lymphocytes are common within normal conjunctiva
Cytology description
- Scrapings may yield more specific findings than impression cytology in chronic conjunctivitis (Eur J Ophthalmol 1997;7:19)
Molecular / cytogenetics description
- PCR is gold standard for chlamydia related conjunctivitis (Semin Ophthalmol 2013;28:216)
Differential diagnosis
Additional references
