Pseudomembranous conjunctivitis

In animal studies, low ricin concentrations caused irritation and the development of conjunctivitis. In ocular exposure, pseudomembranous conjunctivitis occurred following... 

Erythema multiforme minor is comparatively benign. SJS or EMM involves the ocular tissues and produces the classic signs of a catarrhal pseudomembranous conjunctivitis. Erythema multiforme occurs more frequently in men than in women. 

In a placebo-controlled study of the efficacy of cidofovir 1% eye-drops with and without ciclosporin 1% eye-drops four or ten times a day for acute adenovirus keratoconjunctivitis in 34 patients, the frequency of severe corneal opacities was lower with cidofovir (3). However, cidofovir caused conjunctival pseudomembranes, conjunctivitis, and erythematous inflammation of the skin of the eyelids, and the trial was stopped as a result. 

Ricin is severely irritating to the eye. In animal studies, pseudomembranous conjunctivitis occurred following application of ricin solutions in concentrations of 1 1000 - 1 10000 (Grant and Schuman, 1993). 

S. pneumoniae is a common cause of acute bacterial conjunctivitis in children (Figure 25-5). Concurrent upper respiratory tract infections and otitis media, especially in children younger than 4 years, are common. In moderate climates S. pneumoniae is often the cause of acute bacterial conjunctivitis epidemics. This condition commonly presents with diffusely scattered petechial hemorrhages, especially on the superior bulbar conjunctiva, a mucopurulent discharge in the lower fornix, and transient marginal corneal infiltrates. Pseudomembranes may form. 

Topical steroids are not indicated for most cases of acute bacterial conjunctivitis. The exception is acute conjunctivitis accompanied by severe inflammation or pseudomembranes or true membranes. Concurrent topical antibiotic-steroid therapy hastens resolution of inflammatory response however, caution is prudent in cases in which the infectious agent has not been definitively identified and until the infection has clearly responded to antibiotic therapy. 

Chlamydial ophthalmia neonatorum is characterized by the onset of a mild to moderate unilateral or bilateral mucopurulent conjunctivitis 5 to 14 days postpartum (Figure 25-20). Eyelid edema, chemosis, and conjunctival membrane or pseudomembrane formation may also accompany this condition. Corneal findings occasionally include punctate opacities and micropannus formation. Ophthalmia neonatorum secondary to C. trachomatis was once considered a benign and self-limited condition. However, systemic chlamydial infection, especially pneumonitis, is now well recognized in patients with chlamydial conjunctivitis. More than 50% of infants who develop chlamydial pneumonitis may also have ophthalmia neonatorum. 

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