Accurate conjunctivitis diagnosis prevents spread. Learn about the Slit Lamp exam, culture swabs, and how we distinguish viral from bacterial infections.
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Diagnosis and Tests
Diagnosing conjunctivitis seems simple on the surface: the eye is red. However, medical diagnosis requires determining why it is red. Is it a virus that needs to run its course? Is it bacteria requiring antibiotics? Or is it an allergy? Treating a viral infection with antibiotics is useless, and treating an infection with steroid drops can actually make it worse.
At LIV Hospital, our diagnostic process focuses on “differential diagnosis.” We act as visual detectives. We rule out dangerous conditions like uveitis, glaucoma, or corneal ulcers that can mimic simple pink eye. Our goal is to pinpoint the exact pathogen or trigger so we can prescribe the fastest, safest path to relief.
The most valuable tool in conjunctivitis diagnosis is the patient’s history. Before looking at your eye, the doctor will ask specific questions.
Even though conjunctivitis is a surface issue, we always check your vision first.
This is the gold standard for ophthalmology screening tests. The slit lamp is a high-powered microscope with a bright, thin beam of light.
To ensure the cornea is safe, we use a special dye.
For routine cases, we diagnose based on appearance. However, for severe, chronic, or neonatal cases, we need lab work.
Sometimes, “Dry Eye Syndrome” mimics conjunctivitis. A dry eye gets red, gritty, and burns. To test this, we check tear production.
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The primary test is the Slit Lamp Examination, where a microscope is used to inspect the eye’s surface. Doctors look for specific signs like follicles (viral) or papillae (allergic). In severe cases, a conjunctival swab is taken to culture bacteria or identify viruses in a lab.
Preparation is minimal. The most important step is to remove contact lenses immediately if your eye is red. Do not wear eye makeup. Bring a list of any eye drops you have used recently. The exam is painless and does not require sedation.
No, the conjunctival swab is not painful. The doctor may put a numbing drop in your eye first. The swab feels like a Q-tip gently brushing the inside of your lower eyelid for a second. It may cause a slight tickle or foreign body sensation that passes quickly.
Clinical diagnosis by an ophthalmologist is very accurate for distinguishing routine viral, bacterial, and allergic types. Rapid viral testing (like AdenoPlus) has a high accuracy rate (around 90%) for detecting Adenovirus, helping prevent unnecessary antibiotic use.
You need cultures if the infection is severe, produces copious pus, occurs in a newborn baby, or does not respond to standard treatment. Advanced imaging is rarely needed for surface conjunctivitis, but it is used if the doctor suspects the infection has spread to the orbit (eye socket).
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