Conjunctival inflammation (conjunctivitis) is common and causes a red eye with the injection maximal towards the fornix (the fold between globe and lid). Other causes of a red eye are shown in the Disorders hox. Conjunctivitis is often accompanied by photophobia and excessive lacrimation. Infective causes arc associated with a sticky yellow discharge which glues the lashes together. Lymph follicles may be seen as sago-like lumps on the tarsal conjunctiva and are particularly characteristic of chlamydial conjunctivitis. Allergic inflammation is characterised by itch, a white discharge anil conjunctival oedema (dhemosis). Other causes of chemosis include alcoholism, chronic respiratory failure and superior vena cava obstruction.

Subconjunctival haemorrhage (Fig. 7.6) causes an alarming bright-red splash of blood which usually occurs spontaneously but may appear in whooping cough or labour or as a result of local trauma or bleeding disorders. Pingueculae arc triangular yellow deposits beneath the conjunctiva between the canthus and the edge of the cornea. They develop with advancing years and are of no clinical significance. Pterygium is a triangular fold of conjunctiva in the same area which may encroach upon the cornea, particularly in tropical countries. Foreign bodies stuck under the upper lid cause severe irritation and photophobia. They are easily removed on everting the lid.

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