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To the Editor.–The recent report by Leibowitz et al (Archives 94:1747-1756, 1976) that laboratory tests such as bacterial cultures and scrapings stained with Gram or Giemsa cannot be correlated with the clinical diagnosis of conjunctivitis is very disturbing.
As the authors have pointed out, it is difficult to make a specific clinical diagnosis in certain cases. Indeed, many of the clinical diagnoses made in Leibowitz et al's study may be erroneous, since the laboratory results conflict directly with a substantial number of clinical diagnoses. In their group of bacterial conjunctivitides, three patients showed a predominance of eosinophils and 24 showed a predominance of lymphocytes; in their group of viral conjunctivitides, eight patients demonstrated a predominance of polymorphonuclear leukocytes, and one showed many eosinophils. In addition, in the 32 cases listed as allergic conjunctivitis, only two patients showed a predominant number of eosinophils.
The laboratory tests failed to yield
O'Connor GR, Smolin G, Okumoto M. Diagnostic Test for Conjunctivitis. Arch Ophthalmol. 1977;95(2):332. doi:10.1001/archopht.1977.04450020133022