Conjunctivitis (also called pink eye or madras eye) is inflammation of the conjunctiva (the outermost layer of the eye and the inner surface of the eyelids).It is swelling (inflammation) or infection of the membrane lining the eyelids (conjunctiva).
CLASSIFICATION
Classification can be either by cause or by extent,
By cause-Allergic conjunctivitis
-Bacterial conjunctivitis
-Viral conjunctivitis
-Chemical conjunctivitis
-Neonatal conjunctivitis is often defined separately due to different organisms
By extent of involvement
-Blepharoconjunctivitis is the dual combination of conjunctivitis with blepharitis (inflammation of the eyelids).
-Keratoconjunctivitis is the combination of conjunctivitis and keratitis (corneal inflammation).
CAUSES
There are many causes of conjunctivitis. Viruses are the most common cause. Viral conjuctivitis is referred to as "pink eye." Pink eye can spread easily among children.
Other causes include:
•Allergies (allergic conjunctivitis)
•Bacteria
•Certain diseases
•Chemical exposure
•Chlamydia
•Fungi
•Parasites (rarely)
•Use of contact lenses (especially extended-wear lenses)
Newborns can be infected by bacteria in the birth canal. This condition is called ophthalmia neonatorum, and it must be treated immediately to preserve eyesight.
SIGNS AND SYMPTOMS
Viral
Viral conjunctivitis is often associated with an infection of the upper respiratory tract, a common cold, and/or a sore throat. Its symptoms include excessive watering and itching. The infection usually begins with one eye, but may spread easily to the other.Viral conjunctivitis, commonly known as pink eye, shows a fine, diffuse pinkness of the conjunctiva, which is easily mistaken for the ciliary injection of iritis, but there are usually corroborative signs on microscopy, particularly numerous lymphoid follicles on the tarsal conjunctiva, and sometimes a punctate keratitis.
Bacterial
When an allergen irritates the conjunctiva, common symptoms that occur in the eye include: ocular itching, eyelid swelling, tearing, photophobia, watery discharge, and foreign body sensation (with pain).Itching is the most typical symptom of ocular allergy and more than 75% of patients report this symptom when seeking treatment.Symptoms are usually worse for patients when the weather is warm and dry, whereas cooler temperatures and rain tend to assuage symptoms.
Conjunctivitis resolves in 65% of cases without treatment, within two to five days. The prescription of antibiotics is not necessary in most cases.
Allergic; For the allergic type, cool water poured over the face with the head inclined downward constricts capillaries, and artificial tears sometimes relieve discomfort in mild cases. In more severe cases, nonsteroidal anti-inflammatory medications and antihistamines may be prescribed. Persistent allergic conjunctivitis may also require topical steroid drops.
Bacteria; Bacterial conjunctivitis usually resolves without treatment. Antibiotics, eye drops, or ointment may only be needed if no improvement is observed after three days. In people receiving no antibiotics, recovery was in 4.8 days, with immediate antibiotics it was 3.3 days, and with delayed antibiotics 3.9 days. No serious effects were noted either with or without treatment. As they do speed healing in bacterial conjunctivitis, their use is also reasonable.When appropriate, the choice of antibiotic varies, differing based on the cause (if known) or the likely cause of the conjunctivitis. For acute cases, 3rd or 4th generation fluoroquinolones, sodium sulfacetamide, or trimethoprim/polymyxin may be used, typically for 7–10 days.Cases of meningococcal conjunctivitis can be treated with systemic penicillin, as long as the strain is sensitive to penicillin.The number of bacterial eye infections related to sexually transmitted disease is steadily rising. Chlamydial eye infections are the world's leading cause of blindness, and these cases will not resolve without antibiotics. If the conjunctivitis is known to be caused by gonorrhea, then it may be treated with a one-time injection of ceftriaxone, followed by 2-3 weeks of oral tetracycline or erythromycin.
Viral; The new treatment for viral eye infection involves a single treatment of Iodine solution (Betadine 2.5% - 5% concentration). After ocular anaesthetization, made necessary by the Iodine solution's irritating nature to the eye, a series of drops are instilled in the patient's eye
Chemical; Conjunctivitis due to chemicals is treated via irrigation with Ringer's lactate or saline solution. Chemical injuries (particularly alkali burns) are medical emergencies, as they can lead to severe scarring and intraocular damage. People with chemically induced conjunctivitis should not touch their eyes, regardless of whether or not their hands are clean, as they run the risk of spreading the condition to another eye.
COMPLICATION
Reinfection within a household or school may occur if you don't follow preventive measures.
CLASSIFICATION
Classification can be either by cause or by extent,
By cause-Allergic conjunctivitis
-Bacterial conjunctivitis
-Viral conjunctivitis
-Chemical conjunctivitis
-Neonatal conjunctivitis is often defined separately due to different organisms
By extent of involvement
-Blepharoconjunctivitis is the dual combination of conjunctivitis with blepharitis (inflammation of the eyelids).
-Keratoconjunctivitis is the combination of conjunctivitis and keratitis (corneal inflammation).
CAUSES
There are many causes of conjunctivitis. Viruses are the most common cause. Viral conjuctivitis is referred to as "pink eye." Pink eye can spread easily among children.
Other causes include:
•Allergies (allergic conjunctivitis)
•Bacteria
•Certain diseases
•Chemical exposure
•Chlamydia
•Fungi
•Parasites (rarely)
•Use of contact lenses (especially extended-wear lenses)
Newborns can be infected by bacteria in the birth canal. This condition is called ophthalmia neonatorum, and it must be treated immediately to preserve eyesight.
SIGNS AND SYMPTOMS
Viral
Viral conjunctivitis is often associated with an infection of the upper respiratory tract, a common cold, and/or a sore throat. Its symptoms include excessive watering and itching. The infection usually begins with one eye, but may spread easily to the other.Viral conjunctivitis, commonly known as pink eye, shows a fine, diffuse pinkness of the conjunctiva, which is easily mistaken for the ciliary injection of iritis, but there are usually corroborative signs on microscopy, particularly numerous lymphoid follicles on the tarsal conjunctiva, and sometimes a punctate keratitis.
Bacterial
Bacterial conjunctivitis causes the rapid onset of conjunctival redness, swelling of the eyelid, and mucopurulent discharge. Typically, symptoms develop first in one eye, but may spread to the other eye within 2-5 days. Bacterial conjunctivitis due to common pyogenic (pus-producing) bacteria causes marked grittiness/irritation and a stringy, opaque, greyish or yellowish mucopurulent discharge that may cause the lids to stick together, especially after sleep. Severe crusting of the infected eye and the surrounding skin may also occur, but, contrary to popular belief, discharge is not essential to the diagnosis. The gritty and/or scratchy feeling is sometimes localized enough for patients to insist they must have a foreign body in the eye. The more acute pyogenic infections can be painful.Bacteria such as Chlamydia trachomatis or Moraxella can cause a non-exudative but persistent conjunctivitis without much redness.
Chemical
Chemical eye injury is due to either an acidic or alkali substance getting in the eye.Alkalis are typically worse than acidic burns.Mild burns will produce conjunctivitis while more severe burns may cause the cornea to turn white.Irritant or toxic conjunctivitis show primarily marked redness. If due to splash injury, it is often present only in the lower conjunctival sac. With some chemicals, above all with caustic alkalis such as sodium hydroxide, there may be necrosis of the conjunctiva with a deceptively white eye due to vascular closure, followed by sloughing of the dead epithelium. This is likely to be associated with slit-lamp evidence of anterior uveitis.
Allergic
When an allergen irritates the conjunctiva, common symptoms that occur in the eye include: ocular itching, eyelid swelling, tearing, photophobia, watery discharge, and foreign body sensation (with pain).Itching is the most typical symptom of ocular allergy and more than 75% of patients report this symptom when seeking treatment.Symptoms are usually worse for patients when the weather is warm and dry, whereas cooler temperatures and rain tend to assuage symptoms.
TESTS
•Examination of the eyes
•Swab of conjunctiva for analysis
PREVENTION
Good hygiene can help prevent the spread of conjunctivitis:Change pillowcases frequently.Do not share eye cosmetics.Do not share towels or handkerchiefs.Handle and clean contact lenses properly.Keep hands away from the eye.Replace eye cosmetics regularly.Wash your hands often.
MANAGEMENTConjunctivitis resolves in 65% of cases without treatment, within two to five days. The prescription of antibiotics is not necessary in most cases.
Allergic; For the allergic type, cool water poured over the face with the head inclined downward constricts capillaries, and artificial tears sometimes relieve discomfort in mild cases. In more severe cases, nonsteroidal anti-inflammatory medications and antihistamines may be prescribed. Persistent allergic conjunctivitis may also require topical steroid drops.
Bacteria; Bacterial conjunctivitis usually resolves without treatment. Antibiotics, eye drops, or ointment may only be needed if no improvement is observed after three days. In people receiving no antibiotics, recovery was in 4.8 days, with immediate antibiotics it was 3.3 days, and with delayed antibiotics 3.9 days. No serious effects were noted either with or without treatment. As they do speed healing in bacterial conjunctivitis, their use is also reasonable.When appropriate, the choice of antibiotic varies, differing based on the cause (if known) or the likely cause of the conjunctivitis. For acute cases, 3rd or 4th generation fluoroquinolones, sodium sulfacetamide, or trimethoprim/polymyxin may be used, typically for 7–10 days.Cases of meningococcal conjunctivitis can be treated with systemic penicillin, as long as the strain is sensitive to penicillin.The number of bacterial eye infections related to sexually transmitted disease is steadily rising. Chlamydial eye infections are the world's leading cause of blindness, and these cases will not resolve without antibiotics. If the conjunctivitis is known to be caused by gonorrhea, then it may be treated with a one-time injection of ceftriaxone, followed by 2-3 weeks of oral tetracycline or erythromycin.
Viral; The new treatment for viral eye infection involves a single treatment of Iodine solution (Betadine 2.5% - 5% concentration). After ocular anaesthetization, made necessary by the Iodine solution's irritating nature to the eye, a series of drops are instilled in the patient's eye
Chemical; Conjunctivitis due to chemicals is treated via irrigation with Ringer's lactate or saline solution. Chemical injuries (particularly alkali burns) are medical emergencies, as they can lead to severe scarring and intraocular damage. People with chemically induced conjunctivitis should not touch their eyes, regardless of whether or not their hands are clean, as they run the risk of spreading the condition to another eye.
COMPLICATION
Reinfection within a household or school may occur if you don't follow preventive measures.
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