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Conjunctivitis
Medical expert of the article
Last reviewed: 23.04.2024
Conjunctivitis often occurs in children, less often in older people, and even less often in people of working age.
Usually the agent of conjunctivitis gets into the eye from the hands. Inflammation of the conjunctiva occurs with infection, allergy or irritation. Symptoms include conjunctival hyperemia and detachable from the eye and, depending on the etiology, discomfort and itching. The diagnosis is established clinically; sometimes the sowing of flora is shown. Treatment depends on the etiology and may include local antibiotics, antihistamines, mast cell membrane stabilizers and glucocorticoids.
Inflammation of the conjunctiva (conjunctivitis) can cause any agent of a purulent infection. Kokki (primarily staphylococci) most often cause the development of conjunctivitis, the infection proceeds more favorably.
[What causes conjunctivitis?
Infectious conjunctivitis is most often viral or bacterial. Rarely, the conjunctiva can be mixed or unexplained etiology. Numerous factors can cause allergic conjunctivitis. Irritation of the non-allergic conjunctiva can be the result of exposure to foreign bodies, wind, dust, smoke, child, chemical fumes and other types of air pollution, as well as intense ultraviolet radiation from electric arcs, sunlight and reflection from snow.
Conjunctivitis, as a rule, is acute, but also infectious, and allergic conditions can be chronic. Diseases that cause chronic conjunctivitis include eversion, eyelid twisting, blepharitis and chronic dacryocystitis.
The most dangerous pathogens are Pseudomonas aeruginosa and gonococcus, which cause severe conjunctivitis, which often affects the cornea. Acute infectious conjunctivitis can be caused by various microorganisms; Dicococcus, streptococcus, Koch-Wicks stick, Lefler's wand.
Symptoms of conjunctivitis
Any source of inflammation causes an increase in conjunctival vessels and lacrimation or discharge. Dense detachable can reduce vision.
Itching and serous discharge predominate in allergic conjunctivitis. Chemosis and papillary hyperplasia also suggest allergic conjunctivitis. Irritation or sensation of a foreign body, photophobia or purulent discharge testify to infectious conjunctivitis. The severe pain in the eye suggests the scleritis.
Acute conjunctivitis of various origins has many common symptoms - the beginning without prodromal phenomena, first on one, and then on the other eye. Waking up in the morning, the patient can not open his eyes - the eyelids are glued apart. The mucus produced by the goblet cells of the conjunctiva during inflammation first increases in quantity - a large amount of mucous discharge appears. But soon the separated becomes mucopurulent, and in severe cases - purely purulent. The detachable drains over the edge of the eyelid onto the skin, withers on the eyelashes and glues the eyelids overnight.
Simultaneously with the discharge, the redness of the conjunctiva, the transitional folds and the eyeball appears. The conjunctiva of the eyelids and transitional folds becomes brick-red in color, swells and becomes turbid, so that the pattern of meibomian glands fades, and the edematic transitional fold protrudes from under the cartilage. On conjunctiva of the eyeball, often develops a superficial conjunctival injection, most pronounced at the arch and decreasing towards the cornea. The conjunctiva of the eyeball swells and in severe cases rises around the cornea with a roller, acquiring a glassy yellow tint. Sometimes the swelling is so great that the conjunctiva protrudes from the eye gap and is infringed between the eyelids when they close.
The transfer of the eye from the patient to the healthy by means of personal items (handkerchief, towels, pillows, etc.) and hands causes infection with acute conjunctivitis of other people. Acute conjunctivitis occurs if the treatment is started in a timely and correct manner, shortly and without complications. Recovery occurs in 5-6 days. Sometimes with improper treatment develops superficial inflammation of the cornea. Along the limbus line of the cornea shell, there appear point gray colors - infiltrates. This causes photophobia, lacrimation and blepharism - signs of a corneal disease. In the future, infiltrates or completely dissipate, or disintegrate with the formation of small sores. Superficial sores heal too without a trace. Deeper defects of the cornea, which already seize her stroma, heal with replacement of the defect with a connective tissue and therefore leave behind light haze.
Where does it hurt?
What's bothering you?
Diagnosis of conjunctivitis
Usually anamnesis and examination allow a diagnosis. However, it is recommended that crops be planted with severe symptoms, in patients with immunosuppression, from vulnerable eyes (for example, after corneal transplantation, exophthalmos due to Graves' disease) and with unsuccessful primary therapy.
What do need to examine?
How to examine?
Treatment of conjunctivitis
Even without treatment, simple conjunctivitis usually lasts for 10-14 days, so laboratory tests usually do not perform. Before the treatment of conjunctivitis, it is very important to clean the eyelids and remove the discharge. Until the discharge is separated, during the day it is necessary to use antibiotics of a wide spectrum of action in the form of drops and before bedtime - in the form of ointments.
First of all, it is necessary to remove the detachable from the conjunctival cavity by frequent washing. For washing, it is best to use potassium permanganate solution 1: 5000, 0,02% solution of furacilin, 2% solution of boric acid. Before washing, the eyelids are wiped with a swab soaked in a solution of potassium permanganate, after which they are spread out with the thumb and forefinger of the left hand, and the right of the rubber can is washed with a jet of potassium permanganate solution and the conjunctival cavity is washed.
After washing in the conjunctival cavity, antibiotic solutions are instilled every 2-3 hours (penicillin - 30 000 units in 1 ml of physiological solution, 0.5% solution of ampicillin, 0.3% solution of gentamicin, 0.5% solution of levomycetin, bacitracin - 10 000 units in 1 ml) or sulfanilamidnyh preparations (20-30% solution of sulfacyl-sodium), vigabakt, fucitamik, at night lay for eyelids ointment (1% tetraniklinovuyu, 0,5% levomipetinovuyu, 0.5% erythromycin), floxal.
Effective forcing the instillation of antibiotics (instillation of drops into the conjunctival cavity every 5-10 minutes for 1 hour and every 3 hours).
In acute course, eye drops, tobrex, okacin, and floxal are prescribed up to 4-6 times a day. With edema and pronounced irritation of the conjunctiva, instillations of antiallergic or anti-inflammatory drops (alomide, lekrolin or tilt, diclof) are added twice a day.
You should remember about the possibility of an allergic reaction to eye drops, especially antibiotics. In such cases, it is necessary to cancel the drug that caused allergic dermatitis, and to prescribe desensitizing agents (dimedrol at 0,05 g, dicrasyl - 0,025 g, tavegil - 0,001 g: ketotifen - 0,001 g), locally glucocorticoids (1% hydrocortisone solution, 0.1% solution of dexamethasone, 0.3% solution of prednisolone).
In case of acute conjunctivitis, one should not tie and glue the eye, since under the bandage favorable conditions for the multiplication of bacteria are created, the threat of inflammation of the cornea increases.
How to prevent conjunctivitis?
Prevention of acute conjunctivitis is the observance of personal hygiene rules for both patients and members of his family, since acute conjunctivitis is very contagious; it is necessary to exclude contacts with the healthy and people in dormitories, boarding schools, kindergartens and school classes.
Most infectious conjunctivitis are highly contagious and spread by airborne droplets, through objects and by touching the eyes. To avoid transmission of infection, the doctor should thoroughly wash his hands and disinfect the equipment after examining the patient. The patient should wash hands thoroughly after touching the eyes or separated from the nose, avoid touching the uninfected eye after touching the infected eye, avoid sharing towels or pillows and not swimming in the pool. The eyes should be cleaned from the discharge and be under the bandage. Small children who are diagnosed with conjunctivitis should not attend school in order to avoid the spread of the disease.