Conjunctivitis is called inflammation of the mucous membrane of the eye - the conjunctiva, which causes various infections, viruses and allergens. We will understand how bacterial conjunctivitis manifests itself in children. Treatment will also be described in detail in this article.
Functions and structural features of the conjunctiva
The conjunctiva is a thin mucous tissue that covers the front of the eye and the inner surface of both eyelids, forming a kind of pocket on the upper and lower arch. A large number of glands in the tissues around the eyes produce tear fluid and a special protein compound - mucin. Together, they form a strong protective and moisturizing tear-like environment that provides the eyeball with visual ability and mobility.
Despite the relative subtlety, the conjunctiva is a complex multilayer organic tissue that passes into the corneal epithelium. The vessels of the eyelids and eyelashes supply blood to the conjunctiva, the network of lymphatic vessels forms a layer of protective lymphoid tissue, the lacrimal and ocular nerves provide the shell with high sensitivity. Thus, not only the condition of the eyes, but also visual acuity depends on the normal composition and functioning of all the tissues of the conjunctiva. Therefore, bacterial conjunctivitis is so dangerous. Symptoms and treatment in children require special attention.
The conjunctiva is the first protective barrier to the eyes and the most vulnerable part for exposure to various external irritants, bacteria and allergens.
In addition, not only a lacrimal fluid descends through the nasolacrimal canal , which absorbs dust and bacteria trapped from the air, but the reverse process is also triggered when an infection, viruses or allergic pathogens rise into the arch of the eyeball and irritate the conjunctiva from the inside. There is bacterial conjunctivitis (a photo in children of the manifestations of this disease you see in our article).
It is useful to know that during seasonal viral epidemics or in contact with patients with dangerous viral infections (for example, measles or rubella), a protective mask does not help, since viruses freely penetrate the body through the nasolacrimal canal through the eyes.
Symptoms of conjunctivitis
So, how is bacterial conjunctivitis manifested in children? Treatment is selected according to the symptoms.
In a normal healthy state, the conjunctiva provides the eye with sufficient moisture, freedom of movement in the lacrimal pocket, puts a transparent protective barrier that does not reduce the visual and light-perceptive ability of the eye.
In the case when itching, burning, increased lacrimation begins in the eyes, a network of dilated blood vessels appears on the surface of the cornea, foreign inclusions and soreness are felt during eye movement, eyelids or skin integument swell around the eyes, it can be concluded that inflammatory processes occur in the eye arch . Conjunctivitis is the most common disease that affects the mucous membrane of the eye.
How to treat bacterial conjunctivitis in a child? This issue will be considered below.
Types of conjunctivitis
Depending on the nature and source of infection, three types of conjunctivitis are distinguished, which require completely different approaches to diagnosis, treatment and prevention.
1. Bacterial conjunctivitis - caused by various bacteria, such as staphylococci, chlamydia, etc. They enter the mucous membrane of the eye both from the external environment with insufficient hygiene, mechanical damage or weakening of the immune functions of the conjunctiva, and from the pathogenic microflora of the body itself during the period of transmission of infectious diseases. If bacterial conjunctivitis has occurred in children, treatment should be aimed at the destruction of pathogenic microorganisms.
2. Viral conjunctivitis - affects the conjunctiva on the background of adenoviral and enterovirus infections, influenza, herpes, rubella, chickenpox. Often, the viral type of inflammation is accompanied by rhinitis, pharyngitis, or a parallel bacterial form of conjunctivitis.
3. Allergic conjunctivitis accompanies almost all forms of allergic reactions of the body to chemical, food, biological allergens and is a concomitant inflammation in allergic rhinitis, dermatitis and asthma.
Bacterial conjunctivitis in children. Causes
Conjunctivitis in children is a very common disease and up to 5 years of age is diagnosed in 30% of all eye pathologies. This is due to the characteristics of the children's body and the immune system, which is actively formed and does not protect the body from the effects of adverse factors. Equally important is the specificity of children's groups and living conditions.
There is a high risk of infection on the mucous membrane of the child’s eyes, which still attaches little importance to hygiene and basic sanitary standards, activity of children during the incubation period, when a sick child continues to communicate with peers and becomes a source of further spread of the infection, the psychophysical characteristics of the life of young children - all this contributes to the frequent occurrence of infectious inflammation, including the eyes. So there is bacterial conjunctivitis in children.
In newborns, conjunctivitis, which arose during the passage through the birth canal of the mother with untreated sexually transmitted diseases - gonorrhea or chlamydia, occupies a special place. Such conjunctivitis manifests itself within a few days after birth and can have serious consequences, up to blindness and loss of the eye, if the appropriate treatment is not done on time.
With age, the indicator of eye pathologies in children begins to shift towards various refractive disorders, such as myopia, hyperopia, astigmatism.
Diagnosis of bacterial conjunctivitis in children
Very popular today are the methods of diagnosis, treatment and hygiene of various diseases in children from the famous pediatrician Yevgeny Olegovich Komarovsky. His school, which has television and print versions, has been widely recognized by the audience and all responsible parents. The simple, understandable, confidential manner of presenting information and the effectiveness of the methods of the famous doctor help to raise the conscious and cultural level of the population educating the younger generation.
A scientific approach to explaining the most common problems with children's health and the availability of the proposed solutions give parents the opportunity to independently study all aspects of complex medical reports and assess the need to seek help from specialists.
The distribution, activity and periods of exacerbation of bacterial conjunctivitis in children is difficult to accurately determine, since the frequency of processes, the relative ease in most cases of getting rid of inflammation, the positive experience of previous treatments - these factors cause a rare visit to doctors.
Diagnosis depends on how bacterial conjunctivitis manifests itself in children. Symptoms can be varied.
Diagnosis of bacterial conjunctivitis is usually possible without appropriate qualifications, since its course is nonspecific and the main difference from other species is the presence of mucopurulent or purulent secretions along the edges of the eyelids or frequent dried-up crusts on the eyes. Redness of the eyelids and corneas of the eyes, swelling of the skin, increased lacrimation, and itching can also be related signs.
Children complain of burning in the eyes, often rub their eyes with their hands, become lethargic, tearful. Perhaps a slight increase in body temperature. These signs already in the early stages of inflammation give signals to attentive parents and allow you to quickly and independently stop the spread of infection.
If, with other unpleasant symptoms, the characteristic signs of a bacterial species of conjunctivitis are not observed, you should analyze all the circumstances in which the child could get inflammation.
For example, attending public events, new food, animal hair, dirty toys, washing powder, swimming in the pool, long walks that cause hypothermia or large amounts of dust in the eyes - these factors will help establish signs of allergic or viral conjunctivitis.
If more dangerous symptoms appear (eye pain, photophobia, blurred vision, vesicles appear on the eyelids), contacting a pediatrician or family doctor will help you begin treatment faster and avoid irreversible effects. To establish an accurate diagnosis, the doctor finds out all the possible circumstances and symptoms of the course of the disease, examines the organs of vision, skin and mucous membranes, if necessary, gives a referral to a narrow specialist - an ophthalmologist.
Taking a smear from the conjunctiva for cytological examination and biomicroscopy can make an unambiguous conclusion and select the necessary drugs for treatment.
There are also specific research methods - for example, the Gram and Giemsa methods, which are highly likely to classify inflammation as one of the varieties of conjunctivitis. Thus, the detected neutrophilia in scraping of the mucosa indicates the bacterial nature of inflammation, lymphocytosis will clearly confirm the viral nature of conjunctivitis, and eosinophilic inclusions are allergic.
So, the child has revealed bacterial conjunctivitis. Treatment in children Komarovsky advises to carry out under the supervision of specialists.
Varieties of bacterial conjunctivitis
Recent studies prove that the formation of microflora of the mucous membrane of the eye occurs after birth, and not during the passage of the birth canal, as previously thought. In addition to bacteria characteristic of normal microflora, a certain amount of pathogenic microorganisms, such as staphylococci and diphtheroids, are present in the eye.
Despite the fact that the tear fluid contains numerous protective components (immunoglobulins, lysozyme, lactoferrin), epidermal staphylococcus has successfully adapted to overcome this barrier and is stably present in the conjunctival mucosa. As a result, bacterial conjunctivitis occurs. Treatment in children Komarovsky recommends using antibiotics.
Treatment
The use of broad-spectrum antibacterial drugs - ciprofloxacin, erythromycin, gentamicin - in most cases gives quick positive results. However, the frequent occurrence of allergic reactions and strains resistant to such antibiotics is an argument for a more accurate isolation of the microorganism that caused conjunctive inflammation and the selection of a drug with a narrower spectrum of action. So serious can be bacterial conjunctivitis in a child. Treatment reviews are positive.
Diphtheria and gonococcal varieties of conjunctivitis require specific local therapy. Widespread antibiotic fluoroquinolones, which have proven effective in the fight against bacterial varieties of conjunctivitis, except for streptococcal and pneumococcal. It is worth noting that the resistance of a number of bacteria to these drugs also increases rapidly. Here is such a difficult treatment for the diagnosis of bacterial conjunctivitis in children. Drops in therapy are used quite often, more on this below.
Application of drops
An effective system of suppressing inflammation is the combined use of polymyxin-B in the form of drops and ointments. Drops are prescribed with an interval of 2-3 hours, 2-3 drops in each eye, ointments - 3-4 times a day, and are used until the child has fully recovered, that is, for 5-7 to 10-14 days.
When pneumococcus is established by the causative agent of infection, washing with a solution of boric acid is prescribed, since these bacteria multiply in an alkaline environment, so acidification of the eye microflora will stop the development of pathological bacteria. Some types of bacilli are affected by 0.25% -0.5% zinc sulfate solutions, which are used 4-6 times during the day. This is the treatment with a diagnosis of bacterial conjunctivitis in children.
An effective way to treat chronic forms of conjunctivitis is the combinatorial use of a steroid and antibiotic. But given the high percentage of complications after the use of such drugs, they are prescribed only for severe inflammation, and are not used in case of acute conjunctivitis. In any case, if within 2-3 days the clinical picture from the use of drugs does not change for the better, treatment should be stopped and the hidden causes of negative consequences should be sought.
Bacterial conjunctivitis caused by other purulent-septic diseases, such as otitis media, tonsillitis, pyoderma, in addition to local treatment, certainly requires the treatment of infections that provoked this type of conjunctivitis, and usually disappears with its end.
Tips from Dr. Komarovsky
If diagnosed with bacterial conjunctivitis, the symptoms and treatment in children are interrelated.
At the first signs of conjunctivitis, the child must be isolated from other children, refuse to attend children's educational institutions. After prescribing treatment by an ophthalmologist or pediatrician, adhere to the prescription and methodology of drugs as accurately as possible. You can not apply blindfolds or prolonged compresses to the eyes, as this prevents normal blinking, which means washing the mucous membrane with a tear and removing purulent deposits from the tissues around the eyes.
Eye washing with infusions of chamomile, calendula, solutions of boric acid or furatsilina is carried out 5-8 times during the day, with cotton buds, plentifully moistened with disks, different for each eye. Wipe from the outer edge of the eye to the inside. It is advisable to add droplet solutions with a rounded pipette without touching the eyelid or cornea of the eye in order to avoid infection in the pipette.
Also, without contact, an ointment prescribed for treatment should be placed under the lower eyelid. With bacterial conjunctivitis, drops are prescribed with chloramphenicol, albucid, tetracycline or erythromycin ointment.
Since almost all varieties of bacterial conjunctivitis are accompanied by dry eye syndrome, dry skin around the eyes, which are only intensified when using antimicrobials, it is useful to use tear substitutes, for example, Systein and Vidisik, to maintain stable moisture in the mucous membrane of inflamed eyes. So you can defeat bacterial conjunctivitis in a child of 6 years. Treatment, of course, must be agreed with the pediatrician.
Prevention of conjunctivitis in children
The most effective prevention of an unpleasant disease is to constantly teach children about personal hygiene. Frequent washing of hands for babies, processing toys and the interior for disinfection of surfaces, a food culture explaining the importance of pretreating fruits and vegetables, cutlery during meals will help get rid of frequent relapses of eye infection.
It is useful to teach older children to instill eyes and apply ointment on their own, since children are intolerant of any effects on painful areas, especially eyes, so personal participation of a child in treatment will speed up the healing process. You need to be careful about activities aimed at a general increase in immunity: walking, playing sports, eating a balanced diet, consuming vitamins while weakening immunity, and tempering procedures.
Expectant mothers need to conduct a prenatal examination for urogenital infections and, if necessary, undergo a course of treatment with antiseptic treatment of the birth canal, take care of the examination and special treatment of the baby’s eyes immediately after birth.