AAO Preferred Practice Pattern 2018 for Conjunctivitis
The American Academy of Ophthalmology (AAO) has updated its 2013 Preferred Practice Pattern (PPP) guidelines for Conjunctivitis.

Conjunctivitis, or inflammation of the conjunctiva, is a general term that refers to a diverse group of diseases/disorders that affect primarily the conjunctiva. Most varieties of conjunctivitis are selflimited, but some progress and may cause serious ocular and extraocular complications.

It is important to differentiate among primary conjunctival disease and conditions in which conjunctival inflammation is secondary to systemic or ocular diseases. For example, dry eye and blepharitis are the most frequent causes of conjunctival inflammation, and the treatment for each of these entities should be directed at correcting the underlying problems.

Systemic diseases such as gonorrhea or atopy may also cause conjunctival inflammation, and treatment of conjunctivitis must include addressing the underlying systemic disease.

Highlighted findings and recommendations for care include the following:-
• Conjunctivitis rarely causes permanent visual loss or structural damage, but the economic impact of conjunctivitis is considerable and largely due to lost work or school time and the cost of medical visits, testing and treatment.

• Chronic and/or recalcitrant conjunctivitis may be indicative of an underlying malignancy, such as sebaceous or squamous cell carcinoma.

• The ophthalmologist plays a critical role in breaking the chain of transmission of epidemic adenoviral conjunctivitis, primarily by educating the patient and family about proper hygiene. Infected individuals should be counselled to wash hands frequently and use separate towels, and to avoid close contact with others during the period of contagion.

• Dilute bleach soak (sodium hypochlorite) at 1:10 concentration is an effective disinfectant for tonometers. Notably, 70% isopropyl alcohol (e.g., alcohol wipes), 3% hydrogen peroxide, and ethyl alcohol are no longer recommended for tonometer disinfection. Surfaces should be disinfected with an EPA-registered hospital disinfectant in accordance with the directions and safety precautions on the label.

• Indiscriminate use of topical antibiotics or corticosteroids should be avoided. Viral conjunctivitis will not respond to anti-bacterial agents, and mild bacterial conjunctivitis is likely to be self-limited. No evidence exists demonstrating the superiority of any topical antibiotic agent.

• In adults, conjunctivitis caused by ocular mucous membrane pemphigoid (OMMP), graft-versus-host disease (GVHD), gonococcus, and chlamydia are important to detect early because it is necessary to treat the concomitant systemic disorder. Diagnosis of superior limbic keratoconjunctivitis (SLK) may lead to further investigations that reveal a thyroid disorder. Early detection of conjunctivitis associated with neoplasms may be lifesaving.

About AAO
The American Academy of Ophthalmology (Academy) is a professional medical association of ophthalmologists. It is headquartered in San Francisco, California. The Academy's stated mission is "to protect sight and empower lives by serving as an advocate for patients and the public, leading ophthalmic education, and advancing the profession of ophthalmology."

Note: This list is a brief compilation of some of the key recommendations included in the Guidelines and is not exhaustive and does not constitute medical advice. Kindly refer to the original publication here: https://pxmd.co/wlqXh
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