Conjunctivitis epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [2]

Overview

Conjunctivitis accounts for 1% of all primary care and emergency room visits. The incidence of viral conjunctivitis is approximately 80,000 per 100,000 cases with acute conjunctivitis. Viral conjunctivitis more commonly affects adults while bacterial conjunctivitis more commonly affects children.

Epidemiology and Demographics

Prevalence and Incidence

  • The prevalence and incidence of conjunctivitis varies according to the underlying cause, which may be influenced by the patient’s age, as well as the season of the year.[1]

Infective Conjunctivitis

  • The incidence of viral conjunctivitis is approximately 80,000 per 100,000 cases with acute conjunctivitis.
  • The incidence of viral conjunctivitis caused by adenoviruses approximately ranges from 65,000 to 90,000 cases per 100,000 cases with viral conjunctivitis .
  • The incidence of viral conjunctivitis caused by herpes simplex virus (HSV) ranges from 1,300 to 4,800 cases per 100,000 cases with acute conjunctivitis.[2]
  • The incidence of bacterial conjunctivitis was estimated to be 1,350 cases per 100,000 cases with acute conjunctivitis.[3]

Neonatal Conjunctivitis

Allergic Conjunctivitis

Keratoconjunctivitis Sicca

Age

  • Viral conjunctivitis commonly affects adults, and bacterial conjunctivitis commonly affects children.
  • The incidence of infective conjunctivitis is higher in children <1 year old (8,000 cases per 100,000 patient) than in children >4 years of age (1,200 cases per 100,000 patient).[8]
  • Vernal keratoconjunctivitis (VKC), an allergic conjunctivitis subtype, commonly affects young males.[9]
  • Keraroconjunctivitis sicca commonly affects patients older than 40 years.[10]
  • Superior limbic keratoconjunctivitis (SLK) commonly affects middle-aged people (around the sixth decade of life).[11]

Gender

  • Infective Conjunctivitis occurs equally in males and females.[12]
  • The incidence of neonatal conjunctivitis does not vary by gender.[13]
  • Women are more commonly affected with keratoconjunctivitis sicca associated with Sjögren's syndrome than men. The female to male ratio is approximately 9 to 1.[14]
  • Women are more commonly affected with Superior limbic keratoconjunctivitis (SLK) than men. The female to male ratio is approximately 3 to 1.[15]

Race

  • The prevalence of Infective conjunctivitis does not vary by race.[16]
  • Vernal keraroconjunctivitis commonly affects dark-skinned individuals from Africa and India.[17]
  • Keraroconjunctivitis sicca usually affects individuals of the Hispanic and Asian populations.[18]

Developed Countries

Prevalence of neonatal conjunctivitis has decreased significantly in developed countries since the abandonment of silver nitrate as topical prophylaxis. Current prevalence of neonatal conjunctivitis in developed countries are 5 per 1,000 live births.[19]

  • In Belgium and the Netherlands, the prevalence of neonatal conjunctivitis due to gonococcal infection was estimated 0.04 per 1,000 live births.[20]
  • In the United States, the prevalence of neonatal conjunctivitis due to gonococcal infection was estiamted 0.3 per 1,000 live births.
  • In the United States, the prevalence of neonatal conjunctivitis caused by chlamydial infection was estimated 5 to 60 cases per 1,000 live births.
  • In the United Kingdom, the prevalence of neonatal conjunctivitis caused by chlamydial infection was estimated 4 cases per 1,000 live births.[21]
  • In the United States, the incidence of bacterial conjunctivitis is 23,000 per 100,000 cases (in the 0-2 year age range), 28,000 per 100,000 cases (in the 3-9 year range), 13,000 per 100,000 cases (in the 10-19 year range) with the remaining 36,000 per 100,000 cases (in adults).[22]

Developing Countries

  • In developing countries, the incidence of bacterial conjunctivitis is continuing to decrease.
  • In the Africa, the incidence of neonatal conjunctivitis is still high.[21]

References

  1. ↑ Høvding G (2008). "Acute bacterial conjunctivitis". Acta Ophthalmol. 86 (1): 5–17. doi:10.1111/j.1600-0420.2007.01006.x. PMID 17970823.
  2. ↑ Leibowitz HM (2000). "The red eye". N Engl J Med. 343 (5): 345–51. doi:10.1056/NEJM200008033430507. PMID 10922425.
  3. ↑ Smith AF, Waycaster C (2009). "Estimate of the direct and indirect annual cost of bacterial conjunctivitis in the United States". BMC Ophthalmol. 9: 13. doi:10.1186/1471-2415-9-13. PMC 2791746. PMID 19939250.
  4. ↑ Isenberg SJ, Apt L, Wood M (1996). "The influence of perinatal infective factors on ophthalmia neonatorum". J Pediatr Ophthalmol Strabismus. 33 (3): 185–8. PMID 8771523.
  5. ↑ Leonardi A, Castegnaro A, Valerio AL, Lazzarini D (2015). "Epidemiology of allergic conjunctivitis: clinical appearance and treatment patterns in a population-based study". Curr Opin Allergy Clin Immunol. 15 (5): 482–8. doi:10.1097/ACI.0000000000000204. PMID 26258920.
  6. ↑ Rosario N, Bielory L (2011) Epidemiology of allergic conjunctivitis. Curr Opin Allergy Clin Immunol 11 (5):471-6. DOI:10.1097/ACI.0b013e32834a9676 PMID: 21785348
  7. ↑ Schaumberg DA, Sullivan DA, Buring JE, Dana MR (2003). "Prevalence of dry eye syndrome among US women". Am J Ophthalmol. 136 (2): 318–26. PMID 12888056.
  8. ↑ Rose P (2007). "Management strategies for acute infective conjunctivitis in primary care: a systematic review". Expert Opin Pharmacother. 8 (12): 1903–21. doi:10.1517/14656566.8.12.1903. PMID 17696792. Unknown parameter |month= ignored (help)
  9. ↑ Bonini S, Coassin M, Aronni S, Lambiase A (2004). "Vernal keratoconjunctivitis". Eye (Lond). 18 (4): 345–51. doi:10.1038/sj.eye.6700675. PMID 15069427.
  10. ↑ Schaumberg DA, Dana R, Buring JE, Sullivan DA (2009). "Prevalence of dry eye disease among US men: estimates from the Physicians' Health Studies". Arch Ophthalmol. 127 (6): 763–8. doi:10.1001/archophthalmol.2009.103. PMC 2836718. PMID 19506195.
  11. ↑ Watson S, Tullo AB, Carley F (2002). "Treatment of superior limbic keratoconjunctivitis with a unilateral bandage contact lens". Br J Ophthalmol. 86 (4): 485–6. PMC 1771108. PMID 11914237.
  12. ↑ Fitch CP, Rapoza PA, Owens S, Murillo-Lopez F, Johnson RA, Quinn TC; et al. (1989). "Epidemiology and diagnosis of acute conjunctivitis at an inner-city hospital". Ophthalmology. 96 (8): 1215–20. PMID 2797725.
  13. ↑ Moore DL, MacDonald NE, Canadian Paediatric Society, Infectious Diseases and Immunization Committee (2015). "Preventing ophthalmia neonatorum". Can J Infect Dis Med Microbiol. 26 (3): 122–5. PMC 4507834. PMID 26236350.
  14. ↑ "The epidemiology of dry eye disease: report of the Epidemiology Subcommittee of the International Dry Eye WorkShop (2007)". Ocul Surf. 5 (2): 93–107. 2007. PMID 17508117.
  15. ↑ Nelson JD (1989). "Superior limbic keratoconjunctivitis (SLK)". Eye (Lond). 3 ( Pt 2): 180–9. doi:10.1038/eye.1989.26. PMID 2695351.
  16. ↑ O'Brien TP, Jeng BH, McDonald M, Raizman MB (2009). "Acute conjunctivitis: truth and misconceptions". Curr Med Res Opin. 25 (8): 1953–61. doi:10.1185/03007990903038269. PMID 19552618.
  17. ↑ Bremond-Gignac D, Donadieu J, Leonardi A, Pouliquen P, Doan S, Chiambarretta F; et al. (2008). "Prevalence of vernal keratoconjunctivitis: a rare disease?". Br J Ophthalmol. 92 (8): 1097–102. doi:10.1136/bjo.2007.117812. PMID 18356259.
  18. ↑ Moss SE, Klein R, Klein BE (2000). "Prevalence of and risk factors for dry eye syndrome". Arch Ophthalmol. 118 (9): 1264–8. PMID 10980773.
  19. ↑ Azari AA, Barney NP (2013). "Conjunctivitis: a systematic review of diagnosis and treatment". JAMA. 310 (16): 1721–9. doi:10.1001/jama.2013.280318. PMC 4049531. PMID 24150468.
  20. ↑ Mallika P, Asok T, Faisal H, Aziz S, Tan A, Intan G (2008). "Neonatal conjunctivitis - a review". Malays Fam Physician. 3 (2): 77–81. PMC 4170304. PMID 25606121.
  21. ↑ 21.0 21.1 Schaller UC, Klauss V (2001). "Is Credé's prophylaxis for ophthalmia neonatorum still valid?". Bull World Health Organ. 79 (3): 262–3. PMC 2566367. PMID 11285676.
  22. ↑ Epling J (2010). "Bacterial conjunctivitis". BMJ Clin Evid. 2010. PMC 2907624. PMID 21718563.


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