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Reactive arthritis is highly associated with HLA-B27.
If due to splash injury, it is often present in only the lower conjunctival sac.Bacterial conjunctivitis due to common pyogenic (pus-producing) bacteria causes marked grittiness/irritation and a stringy, opaque, greyish or yellowish mucopurulent discharge that may cause the lids to stick together, especially after sleep.Severe crusting of the infected eye and the surrounding skin may also occur.Bacterial conjunctivitis causes the rapid onset of conjunctival redness, swelling of the eyelid, and mucopurulent discharge.Typically, symptoms develop first in one eye, but may spread to the other eye within 2–5 days.Pseudomembranes consist of a combination of inflammatory cells and exudates, and are loosely adherent to the conjunctiva, while true membranes are more tightly adherent and cannot be easily peeled away.
Cases of bacterial conjunctivitis that involve the production of membranes or pseudomembranes are associated with Neisseria gonorrhoeae, β-hemolytic streptococci, and C. Corynebacterium diphtheriae causes membrane formation in conjunctiva of non-immunized children.
If this is combined with rhinitis, the condition is termed "allergic rhinoconjunctivitis".
The symptoms are due to release of histamine and other active substances by mast cells, which stimulate dilation of blood vessels, irritate nerve endings, and increase secretion of tears.
Though very rare, hyperacute cases are usually caused by Neisseria gonorrhoeae or N. Chronic cases of bacterial conjunctivitis are those lasting longer than 3 weeks, and are typically caused by Staphylococcus aureus, Moraxella lacunata, or gram-negative enteric flora.
Conjunctivitis may also be caused by allergens such as pollen, perfumes, cosmetics, smoke, Conjunctivitis is part of the triad of reactive arthritis, which is thought to be caused by autoimmune cross-reactivity following certain bacterial infections.
Conjunctival scrapes for cytology can be useful in detecting chlamydial and fungal infections, allergy, and dysplasia, but are rarely done because of the cost and the general lack of laboratory staff experienced in handling ocular specimens.