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Chronic conjunctivitis: causes, symptoms, diagnosis, treatment
Last reviewed: 20.11.2021
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Chronic conjunctivitis is a conjunctivitis associated with abnormalities of refraction, with diseases of the paranasal sinuses, gastrointestinal tract with chronic course. In these pathologies, there are very few objective data: slight congestion hyperemia, slight roughness of its surface, which causes a feeling of contamination of the eyes.
What causes chronic conjunctivitis?
Chronic conjunctivitis is often associated with poor sanitation, such as dust and smoke in poorly ventilated rooms, insufficient lighting; it can be caused by refractive anomalies (especially hypermetropia and astigmatism) and poorly selected lenses. Often chronic conjunctival catarrh is caused by a decline in diet, anemia, metabolic diseases, etc.
It is necessary to bear in mind the professional conjunctivitis arising from the impact of coal and wood dust: they are also often found in milling, wool, paper industries, hot shop workers, loaders exposed to coal tar (foam), electric welders.
To clarify the causes of chronic conjunctivitis, it is important to investigate the state of the tear ducts, nasal and pharyngeal cavities, teeth, and accessory nasal cavities.
Chronic conjunctivitis is often formed after acute conjunctivitis.
Symptoms of chronic conjunctivitis
The course of chronic conjunctivitis is long and persistent; improvements are often imputed to exacerbations. Patients complain of a feeling of heaviness in the eyelids, a feeling of sand in the eyes, burning, tingling and rapid fatigue of the eyes during work.
On the part of the conjunctiva, there is more or less redness; its surface loses its shine and becomes velvety. Detachable is usually a little, and it has a mucous or muco-purulent character; sometimes almost absent and only in the morning is found in small numbers in the corners of the eyelids.
What do need to examine?
How to examine?
Treatment of chronic conjunctivitis
First of all, it is necessary to eliminate the cause that causes chronic conjunctivitis. The consultation of the ophthalmologist for the correct selection of corrective glasses is shown, especially with astigmatism and presbyopia. With abundant detachable, they resort to the same remedies as with acute conjunctivitis. If the amount of detachable is insignificant, astringents are used.
In chronic conjunctivitis, baths and lotions are also used, for which a 2% solution of borax, 2% solution of boric acid, 0.25% solution of acetic alum, and aromatic waters are used: infusion of chamomile, etc. Bury, 0 , A 25% zinc sulfite solution 3-4 times a day for 7-10 days; instill artificial tears.
Chronic allergic conjunctivitis
Allergic conjunctivitis often proceeds chronically: moderate burning of the eyes is observed, a slight discharge, and until the disease is detected and untested, the treatment brings only a temporary improvement. The atopic nature of this suffering can be assumed on the basis of a positive allergic anamnesis of the patient and his relatives, which is confirmed by eosinophilia when examining a smear or scraping. When looking for an allergen, complicated by unconvincing skin tests, the observation of the patient is very important. For the treatment of the patient's condition, periodic drops of dimedrolum, 1% solution of epinephrine, etc. Are appointed. For such patients, usually the elderly, heating of drops before instillation is especially important, the appointment of weak sedatives (preparations of bromine, valerian, etc.) the attentive and tactful attitude of the medical personnel, the suggestion to the patients at every visit of the doctor of thought and complete safety of the illness for sight and general health, its curability under certain conditions are emphasized.
[7], [8], [9], [10], [11], [12], [13], [14]
Parasitic chronic conjunctivitis
Onchocerciasis - one of the types of helminths, characterized by eye damage.
The causative agent is the filaria. The disease is transmitted by biting Moss. Onchocerciasis occurs in the habitat of midges - in the West, less often - in Central Africa, Central America,
For onchocerciasis is characterized by a highly itchy polymorphic rash, "filariasis scabies". The mechanism of skin lesions is central to the allergic component.
Chronic conjunctivitis is found in almost every patient. A frequent finding are spot skin surface opacities of the cornea. They either disappear without a trace, the necks increase in size, forming large foci. There is a prodromal period of the disease, characterized by conjunctival-corneal syndrome, in which there are only subjective data - itchy eyelids, lacrimation, photophobia, and structural changes in the eye are not yet detected.
The disease is due to the presence of microfilariae in the cornea in the anterior chamber, detectable by biomicroscopy. The purity of their detection varies in different onchocirculatory zones.
Diagnosis is established based on anamnesis (living in epidemic areas), characteristic clinical symptoms, detection of microfilariae. As a diagnostic test, the allergic reaction that occurs when a single dose of diethyl carbamidine is administered at a dose of 50 mg is used (Mazotty test). The reaction begins already after 15-20 minutes and is manifested primarily by itching, which is the more intense the more microfilariae. Allergic reaction can be accompanied by eyelid swelling, swelling and flushing of the skin. Often there is a general reaction: a fever, headaches, muscle pains. The reaction reaches a maximum after 24 hours, and then subsides for 48 hours. Specific antiparasitic treatment involves the sequential or simultaneous use of the ditrazine acting on the microfilaria and the antikrol affecting adult helminths.
Treatment of onchocerciasis remains a difficult task in connection with allergic reactions that occur in the mass death of the parasite and in connection with the toxicity of the drugs. The frequency of severe adverse reactions reaches 30% or more, deaths are described. In connection with this important principle of antiparasitic therapy is the simultaneous use of antihistamines and corticosteroids and antihistamine therapy.