Discoloration of conjunctiva

Discoloration of conjunctiva( ONE OF THE SYMPTOMATIC CONDITIONS OF CONJUNCTIVA) : Normal conjunctiva is a thin transparent structure. In the bulbar region, underlying sclera and a fine network of episcleral and conjunctival vessels can be easily visualized. In the palpebral region and fornices, it looks pinkish because of underlying fibrovascular tissue.

Causes. Conjunctiva may show discoloration in various local and systemic diseases given below:
1. Red discoloration. A bright red homogeneous discoloration suggests

ECCHYMOSIS OF CONJUNCTIVA

Ecchymosis or subconjunctival haemorrhage (one of SYMPTOMATIC CONDITIONS OF CONJUNCTIVA) is of very common occurrence. It may vary in extent from small petechial haemorrhage to an extensive one
spreading under the whole of the bulbar conjunctiva and thus making the white sclera of the eye invisible. The condition though draws the attention of the patients immediately as an emergency but is most of the time trivial.

Etiology. Subconjunctival haemorrhage may be associated with following conditions:
1. Trauma. It is the most common cause of
subconjunctival haemorrhage. It may be in the
form of (i) local trauma to the conjunctiva including

SIMPLE HYPERAEMIA OF CONJUNCTIVA

Simple hyperaemia of conjunctiva (one of SYMPTOMATIC CONDITIONS OF CONJUNCTIVA) :  means congestion of the conjunctival vessels without being associated with any of the established diseases.

Etiology. It may be acute and transient, or recurrent
and chronic.
1. Acute transient hyperaemia. It results due to temporary irritation caused by: (i) Direct irritants such as a foreign body, misdirected cilia, concretions, dust, chemical fumes, smoke, stormy wind, bright light, extreme cold, extreme heat and simple rubbing of eyes with

GRANULOMATOUS CONJUNCTIVITIS

Granulomatous conjunctivitis "granulomatous conjunctivitis contacts" is the term used to
describe certain specific chronic inflammations of the
conjunctiva, characterised by proliferative lesions
which usually tend to remain localized to one eye and
are mostly associated with regional lymphadenitis.

Common granulomatous conjunctival inflammations
are:

• Tuberculosis of conjunctiva
• Sarcoidosis of conjunctiva
• Syphilitic conjunctivitis
• Leprotic conjunctivitis
• Conjunctivitis in tularaemia
• Ophthalmia nodosa

Parinaud's oculoglandular syndrome
It is the name given to

CONTACT DERMOCONJUNCTIVITIS

Contact dermoconjunctivitis is an allergic disorder, involving conjunctiva and
skin of lids along with surrounding area of face.

Etiology
It is in fact a delayed hypersensitivity (type IV)
response to prolonged contact with chemicals and
drugs. A few common topical ophthalmic medications

known to produce contact

Phlyctenular keratitis.

Corneal involvement may occur secondarily from extension of conjunctival
phlycten; or rarely as a primary disease. It may present in two forms: the 'ulcerative phlyctenular keratitis' or 'diffuse infiltrative keratitis'.

A. Ulcerative phlyctenular keratitis may occur in the following three forms:
1. Sacrofulous ulcer is a shallow marginal ulcer formed due to breakdown of small limbal phlycten. It differs from the catarrhal ulcer in that there is no clear space between the ulcer and the limbus and its

PHLYCTENULAR KERATOCONJUNCTIVITIS

Phlyctenular keratoconjunctivitis is a characteristic nodular affection occurring as an allergic response of the conjunctival and corneal epithelium to some endogenous allergens to which they have become sensitized. Phlyctenular conjunctivitis is of worldwide distribution. However, its incidence is higher in developing countries.
Etiology
It is believed to be a delayed hypersensitivity (Type IV-cell mediated) response to endogenous microbial proteins.
I. Causative allergens
1. Tuberculous proteins were considered, previously, as the most common cause.
2. Staphylococcus proteins are

GIANT PAPILLARY CONJUNCTIVITIS (GPC)

Giant papillary conjunctivitis is the inflammation of conjunctiva with formation of very large sized papillae.

Etiology. It is a localised allergic response to a physically rough or deposited surface (contact lens, prosthesis, left out nylon sutures). Probably it is

Atopic keratoconjunctivitis (AKC)

Atopic  keratoconjunctivitis (AKC) can be thought of as an adult equivalent of vernal keratoconjunctivitis and is often associated with atopic dermatitis. Most of the patients are young atopic adults, with male predominance.

Symptoms include:

• Itching, soreness, dry sensation.
• Mucoid discharge.
• Photophobia or blurred vision.

Signs

• Lid margins are chronically inflamed with

VERNAL KERATOCONJUNCTIVITIS

vernal keratoconjunctivitis (vkc) or spring catarrh
It is a recurrent, bilateral, interstitial, self-limiting, allergic inflammation of the conjunctiva having a periodic seasonal incidence.

Etiology
It is considered a hypersensitivity reaction to some exogenous allergen, such as grass pollens. VKC is thought to be an atopic allergic disorder in many
cases, in which IgE-mediated mechanisms play an important role. Such patients may give personal or family history of

SIMPLE ALLERGIC CONJUNCTIVITIS

Simple allergic conjunctivitis is a mild, non-specific allergic conjunctivitis
characterized by itching, hyperaemia and mild papillary response. Basically, it is an acute or sub acute urticarial reaction.

Etiology
It is seen in following forms:
1. Hay fever conjunctivitis. It is commonly associated with hay fever (allergic rhinitis). The common allergens are pollens, grass and