The conjunctiva is the mucous membrane of the eye lining the posterior surface of the eyelid and the eye itself. At its core, it is a thin film, the main task of which is the secretion of lacrimal fluid, as well as protecting the eyes from the penetration of bacteria and foreign bodies into it. Acute conjunctivitis (ICD code 10 H10.3) is usually called an inflammation process that affects the mucous membrane of the eye. Conjunctivitis can have the most diverse etiology, in connection with which this disease is conditionally classified into several groups. This pathology is equally common not only in adults, but also in children.
Causes of the development of the disease
The main causes of acute conjunctivitis include:
- Drug susceptibility.
- Eye diseases, for example, hyperopia, myopia, astigmatism.
- Avitaminosis.
- Exposure to protozoa, for example, chlamydia.
- Eye strain.
- Allergic reactions that develop under the influence of dust, chemistry, smoke, pollen.
- Hypothermia.
- Use of cosmetics that have expired.
- Chronic inflammation localized in the lacrimal ducts and sinuses.
- A variety of metabolic disorders.
- Wrong technique of using contact optics.
- "Snow blindness."
- Exposure to a variety of viral organisms.
- Swimming in polluted water.
- Exposure to fungal organisms.
- Exposure to bacteria, for example, gonococci, streptococci, staphylococci.
- Hematogenous infection, characterized by the spread of infections such as measles and chickenpox, through the blood.
Before considering the treatment of acute conjunctivitis, let's talk about the types of ailment.
Types of conjunctivitis, symptoms
The clinical course of conjunctivitis depends on the etiology of the disease. It is customary to distinguish several varieties of conjunctivitis, each of which is characterized by specific symptoms. According to the form of the clinical course, there are:
- Acute conjunctivitis, which is characterized by a sudden and rapid development of symptoms, expressed in redness of the eyeballs, the occurrence of pinpoint hemorrhages, discharge from the eye of the discharge, swelling of the eyelids. Symptoms of acute conjunctivitis are rather unpleasant.
- Chronic conjunctivitis. A characteristic sign of this form of the disease - the lesion spreads immediately to both eyes. It flows sluggishly, the growth of the clinic is gradual. Most often, the chronic form of conjunctivitis accompanies other pathologies with a chronic form of the course.
Each type of disease has a standard set of symptoms, which includes swelling of the eyelids, redness of the eyes, lacrimation, photophobia. In addition, each variety has its own, characteristic only for it, set of symptoms. Currently, experts classify conjunctivitis, taking into account the causative agent that caused them.
Allergic conjunctivitis
This type of conjunctivitis in patients causes unbearable itching in the eyes, pain (in some cases), swelling of the eyelids. Quite often, allergic conjunctivitis is accompanied by allergic rhinitis, bronchial asthma. Symptoms of this type of conjunctivitis can be diverse and completely depend on the allergen that provoked it.
Viral conjunctivitis
Quite often, it occurs in parallel with a general infection of a viral nature, for example, herpes. Viral conjunctivitis has the following specific symptoms: itching, excessive lacrimation occurs, a non-purulent discharge is secreted. The process of inflammation spreads quite quickly from one affected eye to another. Common symptoms include sore throat, subfibrillation, runny nose.
Medicinal conjunctivitis
It is a fairly common phenomenon, common among patients taking a large number of drugs. Its development occurs within 6 hours after taking the drugs. Clinical symptoms increase rapidly, mucous discharge, itching and burning sensation join.
Bacterial conjunctivitis
This type of disease occurs under the influence of staphylococci, streptococci, gonococci, pneumococci. Distinctive features are the presence of a discharge having a viscous consistency and a dull yellow or gray color. Clumping of the eyelids is also noted, in particular, after sleep. Quite often, damage to the skin located around the eyes, dryness of the conjunctiva develops. Inflammation can be localized both on both eyes, and on one.
Fungal and chlamydial conjunctivitis
This type of conjunctivitis is formed under the influence of various types of fungus. Such fungi can get into the eyes through dirty hands, unwashed vegetables, from the soil. Most often, mold and yeast-like types of fungi negatively affect the eyes.
Most often, chlamydial conjunctivitis affects newborns who become infected from sick mothers. It is usually asymptomatic, and therefore has a chronic form. Over time, the patient develops moderate swelling of the eyelids, the conjunctiva itself becomes denser, and scanty discharge is noted.
Purulent conjunctivitis
Purulent acute conjunctivitis in children and adults develops under the influence of gram-negative microorganisms, such as Pseudomonas aeruginosa, Escherichia coli, Proteus, Klebsiella. This conjunctivitis compared with other types is the most dangerous, since in the absence of timely treatment, corneal damage can occur. A characteristic symptomatology is the presence of purulent, viscous discharge, redness of the eyes, swelling, burning. Subsequently, ocular discomfort joins, which makes the person constantly squint, as photosensitization develops.
Adenoviral conjunctivitis
Its development is noted immediately before, or in parallel with the defeat of the upper respiratory system. Its onset is acute, characterized by lacrimation and redness, swelling, and hemorrhage. In this case, the discharge from the eyes is scarce, on the lower part of the conjunctiva, the formation of small follicular rashes occurs.
Conjunctivitis, which develops as a result of contact with the eyes of chemical agents or toxic substances, also happens. With this type of conjunctivitis, soreness is noted, and other characteristic signs of the disease are absent.
Acute conjunctivitis is especially dangerous (ICD code 10).
Conjunctivitis in children
Most often, the development of conjunctivitis occurs in newborns that infect during childbirth during passage through the birth canal. Infection can occur with various bacterial infections, as well as viruses. Typical symptoms allow you to determine the type of pathology in an infant without consulting a doctor.
Komarovsky has a definite opinion on the treatment of conjunctivitis in a child. We will consider it below.
However, it is important to consider the clinical course of conjunctivitis in infants :
- If purulent discharge is present, then we can conclude that conjunctivitis has a bacterial etiology.
- If eye irritation, redness, but pus is absent, this indicates a viral or allergic nature of the disease.
- In the absence of a therapeutic effect from the use of antibiotic agents, we can talk about the non-bacterial nature of conjunctivitis. Or it is provoked by a stable form of the microorganism to this antibiotic.
It should be noted that 40% of diagnosed conjunctivitis in newborns are chlamydial in nature.
How to treat conjunctivitis in adults and children, we consider below.
Diagnosis of conjunctivitis
The diagnosis is made by the doctor, taking into account the patient's complaints. In addition, the ophthalmologist performs an objective examination, studies and collects an anamnesis in order to determine the cause of the disease, selects appropriate therapy. If there is doubt that the diagnosis is accurate, additional studies may be prescribed: cytological, allergy tests, bacteriological, virological.
Treatment of acute conjunctivitis
Before starting conjunctivitis therapy, it is important to accurately determine the cause of its occurrence. This will avoid complications and make the treatment most effective. It is necessary to treat this pathology exclusively with an ophthalmologist, since self-medication can aggravate the disease. The main dosage form of medications used in the treatment of conjunctivitis is eye drops. Thus, we can say that the treatment of acute conjunctivitis is carried out locally.
In case of a viral illness, antiviral drops should be used, the most popular among them are drugs that are part of the interferon group. With a generalized viral infection, the use of antiviral medication tablets may be required. It is possible to eliminate itching in the eyes by using drops of a group of corticosteroids. The severity of symptoms can eliminate an artificial tear. When bacterial agents are added, complex therapy is recommended, including including taking antibiotics. Especially if it is an acute purulent conjunctivitis.
In the allergic variant of the disease, antihistamines in the form of drops are prescribed to stop the itching. In more complex cases, steroid drugs may be used. NSAIDs will help eliminate the inflammatory process, and dry conjunctiva is an artificial tear. In addition, it is important to take systemic antiallergic drugs, such as Tavegil, Suprastin, Claritin. An ophthalmologist may also recommend the use of hormones containing hydrocortisone or prednisone.
The medicine for acute conjunctivitis should be selected by the doctor. In order to treat bacterial conjunctivitis, antibiotics in the form of drops and ointments containing fluoroquinolone, erythromycin, gentamicin, and tetracycline should be used.
Features of the treatment of childhood conjunctivitis
The treatment of acute conjunctivitis in children has some features that are important to consider in order to avoid complications. The most important points are:
- Before a visit to the ophthalmologist, one should not conduct any self-medication.
- If it is not possible to immediately visit a doctor, it is permissible to instill eyes with albucid (if there is a suspicion that the nature of conjunctivitis is bacterial or viral).
- If you suspect an allergic etiology of the disease, it is recommended that your child receive antihistamines.
- If the bacterial or viral etiology of conjunctivitis is confirmed, then every 2 hours, the child should be washed with furacilin or a decoction of chamomile.
- Rinsing is important to carry out movements directed from the temple to the nose, and not vice versa.
- With the formation of crusts (often noted if the conjunctivitis is purulent), they should be removed with sterile gauze napkins. Moreover, for each eye it is important to use a separate napkin.
- Do not flush the eyes of the child if conjunctivitis is allergic.
- If inflammation is localized in only one eye, treatment is carried out in both eyes.
- The use of blindfolds is prohibited, as this can provoke increased reproduction of microorganisms and injure the inflamed eyelid.
- During therapy, only those drops recommended by the doctor are allowed. Self-medication replacement is unacceptable.
- If the ophthalmologist recommended the use of drugs in the form of eye ointments, then they should be placed behind the lower eyelid.
Quite in detail about the features of the treatment of conjunctivitis in a child, Komarovsky tells. It is recommended that each parent familiarize themselves with the material - this will help to recognize the disease in the early stages and take the necessary treatment measures without harming the child.
We examined how to treat conjunctivitis in adults and children.