Conjunctivitis is an inflammation of the mucous membrane of the eye (conjunctiva).
Depending on the cause, bacterial, viral, chlamydial , fungal, allergic conjunctivitis are distinguished .
The causative agents of bacterial forms are staphylococci, pneumococci, streptococci, Escherichia coli, gonococci, diphtheria and Koch sticks, etc. Adenoviral, herpetic and measles are the most common viruses.
Allergic conjunctivitis can be caused by various allergens – infectious agents, drugs (atropine, quinine, morphine, antibiotics, physostigmine, ethyl morphine, etc.), cosmetics, household chemicals, physical and chemical factors in the chemical, textile, flour mills, at sawmills, brick factories, as well as light energy and ionizing radiation in the electrical industry, film production, in the operation of X-ray installations. There are conjunctivitis, developing as a result of direct action on the conjunctiva of various physical and chemical factors.
The development of the disease may be associated with chronic diseases – inflammation of the paranasal sinuses, diseases of the gastrointestinal tract, helminthic invasion, etc.
Manifestations depend on the cause of the disease, but all forms are characterized by a number of common symptoms – swelling and redness of the conjunctiva of the eyelids, the presence of mucous or purulent discharge.
Often, for example, with adenoviral and chlamydial lesions, there is a so-called follicular form that proceeds with the appearance on the conjunctiva of small translucent formations of pale pink color – follicles.
Symptoms of the acute phase
Acute conjunctivitis begins suddenly with a slash or pain, first on one, then on the other eye. Against the background of the expressed reddening point hemorrhages are quite often observed. It appears slimy, mucous or purulent discharge -gnoynoe. The acute phase may be accompanied by general malaise, fever and headache. The duration of the acute form varies from 5-6 days to 2-3 weeks.
Sharp bacterial the form characterized by severe photophobia, tearing. Conjunctiva reddened, edematous, with dot hemorrhages.
Adenoviral form precedes or accompanies the lesion of the upper respiratory tract. The incubation period is 4-8 days. It begins acutely, there are tearing, redness and swelling of the conjunctiva, sometimes point hemorrhages appear. Discharge scanty, slimy character. Rash of small follicles on the lower transitional fold of the conjunctiva are detected. The adenoviral form usually occurs on one eye and after 1-3 days passes to the second, and the process on the second eye proceeds in a milder form.
Epidemic hemorrhagic conjunctivitis it is manifested by hemorrhages on the eyelids and the eyeball, which dissolve at different times depending on their size (pinpoint – after 3-6 days, extensive – after 2-3 weeks).
Fungal forms caused by various types of fungi (actinomycetes, molds, yeast-like, etc.). The source of pathogens is soil, some herbs, vegetables, fruits, as well as sick people and animals.
Allergic forms differ in a variety of manifestations depending on the nature of the allergen. Conjunctivitis drug is relatively common and usually develops within 6 hours after taking the medicine. There is a rapidly increasing swelling of the conjunctiva, itching, burning in the eyes, copious mucous discharge. A typical example of atopic form is conjunctivitis with pollinosis . It is characterized by seasonality of exacerbations that occur in spring and summer during the flowering period of herbs and trees, often accompanied by rhinitis. Both eyes are affected; there is a burning sensation, sharp pain, itching, tearing and photophobia, redness and swelling of the conjunctiva, copious mucous discharge.
Symptoms of the chronic phase
Chronic conjunctivitis develops gradually, characterized by persistent and long course. Patients complain of discomfort, a feeling of a foreign body in the eye. Eyelids slightly reddened.
The diagnosis is made on the basis of a characteristic clinical picture. To determine the cause of conjunctivitis , data such as, for example, contact with an allergen, dependence on sunlight, and features of the course (for example, seasonality, the presence of indisposition) are important. The most informativebacterioscopic and bacteriological studies of smears and detachable conjunctiva with the determination of the sensitivity of the pathogen to antibiotics, as well as cytological examination of scrapings from the conjunctiva.
The treatment is carried out by an ophthalmologist. In case of bacterial forms, antibiotics are prescribed in the form of drops (0.25% levomycetin solution, sodium sulfacyl ). In the presence of an abundant discharge, the conjunctival sac is washed with furatsilin solutions (1: 5,000), potassium permanganate (1: 5,000), and 1% otetrinum ointment is placed into it (2-3 times a day with a severe process, 1 time with easy).
In the treatment of viral forms, human leukocyte interferon or interferonogens ( pyrogenal , semi-dan ) are administered as infusions into the conjunctival sac 6-8 times per day, as well as 0.5% florenal , 0.05% bonafton and other eye ointments.
In conjunctivitis caused by chlamydia, treatment with antiviral drugs and tetracycline antibiotics is indicated.
When treating a fungal form locally in infusions, depending on the type of fungus, nystatin , levorin , amphotericin B, etc. are prescribed .
Treatment of allergic forms includes topical administration of hormones (hydrocortisone, prednisone, dexamethasone ), orally – antiallergic drugs (claritin, telfast, suprastin, tavegil, etc.).
The prognosis is favorable; with the involvement of the cornea may decrease visual acuity.
The prevention of conjunctivitis includes the observance of the rules of personal hygiene and sanitary-hygienic requirements in medical institutions (washing and special treatment of hands with 1% solution of bleach before eye procedures, the use of individual pipettes, etc.)