A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination – including blood pressure, pulse, body temperature, body weight, body height; further:
- Inspection (viewing).
- Skin and mucous membranes
- Eyes [redness of the eye with annular conjunctival swelling, epiphora (“watering”; lacrimation)]
- Ophthalmic examination: slit lamp microscopic examination shows:
- Redness and swelling of the conjunctiva, in some cases evidence of pseudomembranes.
- Plica and caruncle swelling (seen in all patients), is diagnostically conclusive
- Edematous eyelid swelling in the primary affected eye and associated inflammatory ptosis (drooping of the upper eyelid).
- From the 4th day of illness: disease of the cornea (cornea): small epithelial punctatae with enlargement tendency; after healing of the acute phase: flat confluent so-called nummuli (small coin-shaped infiltrates in the superficial corneal stroma).
- Within three to six weeks healing of the acute phase: Nummuli can persist (visual impairment in the primary affected eye).
- Inspection (viewing).
Square brackets [ ] indicate possible pathological (pathological) physical findings.