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Conjunctivitis (phlyctenular)

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

  • this is a delayed hypersensitivity reaction to microbial proteins - e.g. the tubercle bacillus, staphylococcus, chlamydia yeasts and Candida albicans. It occurs in undernourished children living in overcrowded, unhygienic conditions

  • clinical features:
    • the major feature are phlyctens - raised hard red, 1-3mm, nodules near the limbus and accompanied by a zone of hyperemia. There is a tendency to ulcerate and dissappear, but frequently, the lesion is superceded by another
    • symptoms are mild but once the cornea is involved (corneal phlycenules develop as a grey amorphous infiltrate), there is pain, lacrimation and photophobia. These are most marked in tuberculo-protein induced disease


  • seek expert advice
  • steroid drops may provide symptomatic relief but it is more important to treat the underlying disease and improve the diet and surroundings of the patient
  • when found should be further investigated to discover an underlying pathology. Tuberculosis should always be excluded. Specialist centre referral may be required

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