During slit lamp examination, which conjunctival sign should you watch for?

• A. Injection
• B. Chemosis
• C. Pinguecula or pterygium
• D. Conjunctivochalasis

Answer: (A)

Conjunctival injection, the redness from dilated conjunctival vessels, is the sign to watch during a slit lamp exam. This vascular response directly reflects inflammation or irritation on the ocular surface and can change with treatment, making it the most informative indicator of active conjunctival status. Other signs describe structural changes rather than current inflammatory activity: chemose is swelling from fluid, pinguecula or pterygium are fixed degenerative lesions at the limbus, and conjunctivochalasis is loose conjunctiva forming folds. These may be visible, but they don’t provide the immediate readout of inflammation that injection offers.