A Systematic Review of Diagnosis and Treatment

C onjunctiva is a thin, translucent membrane lining the anterior part of the sclera and inside of the eyelids. It has 2 parts, bulbar and palpebral. The bulbar portion begins at the edge of the cornea and covers the visible part of the sclera; the palpebral part lines the inside of the eyelids (Figure 1). Inflammation or infection of the conjunctiva is known as conjunctivitis and is characterized by dilatation of the conjunctival vessels, resulting in hyperemia and edemaof the conjunctiva, typicallywith associated discharge.1 Conjunctivitis affectsmanypeople and imposes economic and social burdens. It is estimated that acute conjunctivitis affects6million people annually in theUnited States.2 The cost of treating bacterial conjunctivitis alonewas estimated to be $377million to $857 million per year.3 Many US state health departments, irrespective of the underlying cause of conjunctivitis, require students to be treatedwith topical antibiotic eyedropsbefore returning to school.4 Amajority of conjunctivitis patients are initially treated by primary care physicians rather than eye care professionals. Approximately 1%of all primary careoffice visits in theUnitedStates are relatedtoconjunctivitis.5Approximately70%ofallpatientswithacute conjunctivitis present to primary care and urgent care.6 The prevalence of conjunctivitis varies according to the underlying cause, which may be influenced by the patient’s age, as well as the season of the year. Viral conjunctivitis is the most common cause of infectious conjunctivitis both overall and in the adult population7-13 and is more prevalent in summer.14 Bacterial conjunctivitis is the second most common cause7-9,12,13 and is responsible for the majority (50%-75%) of cases in children14; it is observed more frequently from December through April.14 Allergic conjunctivitis is themost frequent cause, affecting 15% to 40% of the population,15 and is observed more frequently in spring and summer.14 IMPORTANCE Conjunctivitis is a common problem.