Conjunctivitis

Conjunctivitis

(Covering conjunctivitis in children and adults, and not newborn)

What is it?

Conjunctivitis is an inflammation of the mucous membrane of the eye (the conjunctiva). There are numerous causes of conjunctiviits, namely; infective, allergic, chemical, etc. The most commonly encountered types are the infective and the allergic conjunctivitis.

(Images – Allergic Conjunctivitis, Viral Conjunctivitis

What are the symptoms?

Typically conjunctivitis begins with a foreign body sensation in the eye, followed by redness, watering, discharge, pain around the eye, and may be associated with a runny nose, or sore throat, mild fever. As the inflammation increases the swelling may progress to closure of the eyes.

Different types of conjunctivitis

 

Agent History Onset Discharge Infectivity
Allergic Associated with Hay-fever, allergic dermatitis, symptoms begining
in the spring
Acute or chronic White, ropy or watery Not infective but may occur in more than one family member.
Viral Upper respiratory infection, fever, skin erruptions (in herpes),
multiple cases with similar history at the office, school/college,
home.
Acute Watery Highly infective
Bacterial Purulent skin infections, seborrheic dermatitis, rosacea, upper
respiratory infection, foreign body in the eye.
Acute or chronic Yellow, yellow-white, or green-yellow. Usually thick discharge.
Heave collection in the morning (on waking up)
Infective
Chlamydial Urinary tract symptoms(burning), multiple sexual contacts, veneral
disease
Sub-acute Mucopurulent, yellow-white or white Infective
Fungal Debilitation, chemotherapy, HIV, alcoholism, immunosuppressive therapy,
trauma to the eye with organic matter (like sticks, leaves)
Chronic Variable Not infective in persons with normal body resistance
Parasitic Leishmaniasis, trichinosis, pediculosis, etc. Chronic Variable Not usually infective

The treatment of conjunctivitis

It is beyond the purview of this article to dwell into the details ofantibiotic agents used in the treatment of conjunctivitis for the simpel reason that the infective/causative agent has first to be identified and then a specific sensitivity deteremined before starting the specific antibiotic agent. There is no panacea which can treat conjunctivitis as such. Although
some forms of conjunctivitis like viral conjunctivitis are limited to a few days duration, untreated cases can go into complications, like corneal ulcers. So it is better to consult an ophthalmologist.

Personal hygeine is extremely important, washing hands and face, clearing accumulated discharge with a soft cotton wisp dipped in drinking water and wearing dark-glasses (goggles). For the pain, apart from prescribed drugs, warm fomentations help in reducing the swelling as well.

Preventing (the spread) conjunctivitis

Conjunctivitis spreads using one of the following routes:

  1. Upper respiratory – sneezing, coughing, talking, oral contact, tissues,
    etc.
  2. Ocular secretions – direct droplet infections, using the same hanky
    or tissue, etc.
  3. Fomites – napkins, towels, hankies, tissues, pillow-covers, etc.

To prevent the spread therefore (if you are infected):

  1. Stay away from work for a week or so (or school, college, etc)
  2. Avoid using the same fomites (as above)
  3. Don’t get too close to people
  4. Cover your mouth while you sneeze or cough, talk
  5. Wear dark-glasses (more comfortable in sunlight as well)
  6. Contact lenses and conjunctivitis
  7. If you are using contact lenses please remove them, secretions can
    accumulate under the lens and scratch your cornea may lead to CORNEAL
    ULCERS/EROSIONS.
  8. The contact lens itself can get infected and re-infect your eyes.
  9. DON’T instill antibiotic drops over the contact lens, preservatives
    in the eye drops damage lenses permanently.
  10. DISINFECT your lenses with whatever method recommended by your contact
    lens manufacturer, if not contraindicated, clean and boil both the lens
    case and the contact lenses and store in a fresh solution till your
    eyes are completely normal.
  11. If after your eyes are normal and you feel discomfort on wearing contact
    lenses please visit your ophthalmologist. It is recommended that you
    get a new pair of lenses.