Confirming diagnosis Examination of Giemsa-stained conjunctival scraping reveals cytoplasmic inclusion bodies in conjunctival epithelial cells, and is effective in detecting chlamydial infection in infants. The direct fluorescent monoclonal antibody and enzyme-linked immunosorbent assay are most effective in adults.
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Source: Professional Guide to Diseases (Eighth Edition), 2005
Conjunctival injection:
History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))
When you take the patient’s history, always ask if he has associated pain. If so, when did the pain begin, and where is it located? Is it constant or intermittent? Also, ask about itching, burning, photophobia, blurred vision, halo vision, excessive tearing, or a foreign body sensation in his eye. Does the patient have a history of eye disease or trauma? If he has suffered ocular trauma, avoid touching the affected eye. Test his visual acuity and intraocular pressure (IOP) only if his eyelids can be opened without applying pressure. Place a metal shield over the affected eye to protect it, if necessary.
If the patient’s condition permits, examine the affected eye. First, determine the location and severity of conjunctival injection. Is it circumcorneal or localized? Peripheral or diffuse? Note any conjunctival or lid edema, ocular deviation, conjunctival follicles, ptosis, or exophthalmos. Also note the type and amount of any discharge.
Test the patient’s visual acuity to establish a baseline. Note if the patient has had vision changes: Is his vision blurred or his visual acuity markedly decreased? Next, test pupillary reaction to light.
Perform IOP measurements. To gauge increased IOP without a tonometer, gently place your index finger over the closed eyelid; if the globe feels rock-hard, IOP is elevated.
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Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Conjunctivitis:
Diagnosis
(Handbook of Diseases)
Physical examination reveals injection of the bulbar conjunctival vessels. In children, systemic signs and symptoms may include sore throat and fever.
Monocytes are predominant in stained smears of conjunctival scrapings if conjunctivitis is caused by a virus. Polymorphonuclear cells (neutrophils) predominate if conjunctivitis stems from bacteria; eosinophils, if it’s allergy related. Culture and sensitivity tests help identify the causative bacterial organism and indicate appropriate antibiotic therapy.
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Source: Handbook of Diseases, 2003
Inclusion conjunctivitis:
Diagnosis
(Handbook of Diseases)
Signs and symptoms and a history of sexual contact with an infected person suggest inclusion conjunctivitis. Examination of stained conjunctival scraping reveals cytoplasmic inclusion bodies in conjunctival epithelial cells, many polymorphonuclear leukocytes, and a negative culture for bacteria.
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Source: Handbook of Diseases, 2003
Conjunctival injection:
History
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
When you take the patient’s history, always ask if he has associated pain. If so, when did the pain begin, and where is it located? Is it constant or intermittent? Also, ask about itching, burning, photophobia, blurred vision, halo vision, excessive tearing, or a foreign body sensation in his eye. Does the patient have a history of eye disease or trauma? If he has suffered ocular trauma, avoid touching the affected eye.
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Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Conjunctival injection:
History and physical examination
(Nursing: Interpreting Signs and Symptoms)
When you take the patient's history, always ask if he has associated pain. If so, when did the pain begin, and where is it located? Is it constant or intermittent? Also, ask about itching, burning, photophobia, blurred vision, halo vision, excessive tearing, or a foreign body sensation in his eye. Does the patient have a history of eye disease or trauma? If he has suffered ocular trauma, avoid touching the affected eye. Does he wear contact lenses? If so, ask how often they're removed or changed if they're disposable. Test his visual acuity and intraocular pressure (IOP) only if his eyelids can be opened without applying pressure. Place a metal shield over the affected eye to protect it if needed.
If the patient's condition permits, examine the affected eye. First, determine the location and severity of conjunctival injection. Is it circumcorneal or localized? Peripheral or diffuse? Note any conjunctival or lid edema, ocular deviation, conjunctival follicles, ptosis, or exophthalmos. Also note the type and amount of any discharge.
Test the patient's visual acuity to establish a baseline. Note if the patient has had vision changes: Is his vision blurred or his visual acuity markedly decreased? Next, test pupillary reaction to light.
Perform IOP measurements. To gauge increased IOP without a tonometer, gently place your index finger over the closed eyelid; if the globe feels rock-hard, IOP is elevated.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
PALLOR OF THE FACE, NAILS, OR CONJUNCTIVA:
Approach to the Diagnosis
(Differential Diagnosis in Primary Care)
The approach to the diagnosis of pallor is obviously to check for
anemia first; then to examine for the other chronic disorders. Chest x-ray,
electrocardiogram (ECG), sedimentation
rate, and a check for rheumatoid factor are all appropriate in specific
cases.
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Source: Differential Diagnosis in Primary Care, 2007
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