The conjunctiva is the mucous membrane that lines the eyelids. Conjunctivitis is an inflammation of the conjunctiva.

Some of the common causes of conjunctivitis include: bacteria, viruses, allergies, chemicals, or associated systemic diseases. Chronic conjunctivitis is bacterial in nature, and occurs with nasolacrimal duct obstruction, chronic blepharitis, and chronic inflammation of the lacrimal gland.

The symptoms of active conjunctivitis may include: a scratching or burning sensation, sensation of a foreign body, itching, and sensitivity to light. The signs usually present include: redness of the eye or eyes; tearing; exudation (in the morning the eyelids may be stuck together); edema of the conjunctiva around the cornea; granulomas; and preauricular lymph node swelling. Generally, signs and symptoms remain somewhat similar for conjunctivitis caused by viral, chemical, allergic or systemic diseases.

Causative organisms of acute or chronic bacterial conjunctivitis may be identified by microscopic examination of conjunctival scrapings and cultures. Studies of antibiotic sensitivity may also be done.

The specific antibacterial treatment of bacterial conjunctivitis depends on the causative organism. Conjunctival sac saline irrigations may be done, and instruction on prevention of disease is often indicated. Antiviral therapy, systemic or topical, may be used for herpes and varicella conjunctivitis. Chemical acid burns will need profuse irrigations immediately to prevent corneal scarring. In Graves' disease (see diagnostic code: 7900 hyperthyroidism, including, but not limited to, Graves' disease) where the conjunctiva could be exposed between the eyelids, there may be a need for protective treatment such as, the use of ointment or the sewing of the eyelids together (tarsorrhaphy).

Staphylococcal conjunctivitis may proceed to a chronic bacterial condition. Untreated gonococcal conjunctivitis may lead to corneal perforation and endophthalmitis (see diagnostic code: 6000 choroidopathy, including uveitis, iritis, cyclitis, and choroiditis). Chronic bacterial conjunctivitis may recur and be troublesome.

• Consider service connection on a presumptive basis as a condition associated with mustard gas exposure (38 CFR 3.316).

• Consider entitlement to Auto and auto adaptive equipment under 38 CFR 3.308 if there is permanent impairment of vision in both eyes consisting of central visual acuity of 20/200 or less in the better eye, with corrective glasses, or central visual acuity of more than 20/200 if there is a field defect in which the peripheral field has contracted to such an extent that the widest diameter of visual field subtends an angular distance no greater than 20° in the better eye.

• Consider entitlement to specially adapted housing under 38 U.S.C. 2101(a)(2)(A)(i) if there is visual impairment to the degree specified in 38 CFR 3.809(b)(2).

• Review for potential entitlement to special monthly compensation under 38 CFR 3.350 when there is loss/loss of use of one or both eyes, light perception only; visual acuity 5/200 or less; the vision field is reduced to 5 degree concentric contraction in both eyes; or blindness with no light perception in one or both eye.

• Evaluate on the basis of either visual impairment due to the particular condition or on incapacitating episodes, whichever results in a higher evaluation.

• For the purposes of evaluation under 38 CFR 4.79, an incapacitating episode is an eye condition severe enough to require a clinic visit to a provider specifically for treatment purposes.

• Examples of treatment may include but are not limited to: Systemic immunosuppressants or biologic agents; intravitreal or periocular injections; laser treatments; or other surgical interventions.

• For the purposes of evaluating visual impairment due to the particular condition, refer to 38 CFR 4.75, 38 CFR 4.76, 38 CFR 4.77, 38 CFR 4.78,  and  38 CFR 4.79, diagnostic codes 6061-6091.