Eye conjunctivitis in adults

Conjunctivitis – an inflammatory process arising in the mucosa of the eye. The term "conjunctivitis"is not complete name pathology with no mention of the cause or nature of the infectious lesion, for example,"chronic conjunctivitis"or"allergic conjunctivitis". It is a full name used in the history of the disease.

There are several grounds for classification of the disease based on the cause or nature of inflammation.

Types of conjunctivitis depending on its cause:

• Bacterial – provoking factor is the pathogenic and conditionally pathogenic bacteria (streptococci, staphylococci, pneumococci, gonococci, diphtheria and Pseudomonas aeruginosa);
• Chlamydia is caused due to contact with chlamydia on mucosa;

• Viral and provoke herpes viruses, adenoviruses, etc.;

• Fungal – occurs as a manifestation of systemic infections (aspergillosis, candidiasis, actinomycosis, sporotrichosis), or provoked by pathogenic fungi;
• Allergic – occurs after introduction into the body of the allergen or irritant of the mucous membrane of the eye (dust, hair, lint, nail, paint, acetone, etc.);
• Dystrophic – develops as a result of the damaging effect of occupational hazards (chemicals, paint, varnish, gasoline vapor and other substances, gases).

Chlamydial conjunctivitis, as well as angle (which restores) can be varieties of bacterial forms of the disease.

Types of conjunctivitis depending on the type of inflammation of the mucous membrane:

• The acute form;
• A chronic form.

Pink eye (cause - Bacillus Koch-weeks) is a special case of the acute form of the disease.

Types of conjunctivitis depending on the morphology of the conjunctiva and the nature of syptomatic:

• Purulent – purulent discharge is formed;
• Catarrhal – formed a large amount of mucus, pus is absent;
• Papillary (appears as a manifestation of Allergy) – the mucous membrane of the upper eyelid formed seal in the form of small grains;
• Follicular (develops 1 type of allergic reaction) – eye formed follicles;
• Hemorrhagic mucosa of the eye are formed hemorrhage;
• Filmy – developingagainst SARS.

Any kind or form of conjunctivitis has specific signs and typical symptoms.

The content of the article:

• Causes of conjunctivitis
• The symptoms of different types of conjunctivitis
• Temperature conjunctivitis
• General principles of treatment all types of conjunctivitis
• Treatment of conjunctivitis at home
• Drugs used in conjunctivitis
• Conjunctivitis treatment of folk remedies
• What is rehabilitation treatment after conjunctivitis?

Causes of conjunctivitis

Group of factors causing conjunctivitis:

1. Infectious:

   • The introduction of pathogenic or opportunistic bacteria (gonococcus, diphtheria or Pseudomonas aeruginosa, Streptococcus, Staphylococcus, meningococcus, etc.);

   • Viruses, including adenoviruses the virus herpes;

   • Chlamydia;
   • Pathogenic fungi (Aspergillus, Candida, actinomycetes, sporotrichiella);
   • Exposure to allergens (drug, allergic, seasonal forms of conjunctivitis, the use of contact lenses);

2. Other factors (occupational hazards, chemicals, gases). Getting precipitating factors to the mucous membrane of the eye are airborne (viruses, allergens), by ascending from the nasopharynx, middle ear, throat, and also in simple transfer them with dirty hands.

The symptoms of different types of conjunctivitis

Nonspecific symptoms common to all types of conjunctivitis:

• Redness of the eyelids and conjunctiva;

• Swelling of the eyelids and mucous membrane of the eye;

• Photophobia;
• Watery eyes;
• Foreign body sensation in the eye;
• Purulent, mucous or Muco-purulent discharge.

If the conjunctivitis occurring in the background of SARS, with catarrh of the upper respiratory tract, possible symptoms suchas flushing, headache, signs of toxicity (pain in muscles and joints, weakness and fatigue).

Specific symptoms attributed to the various types of conjunctivitis and depend on their causing factors. Knowing the main symptoms, you can put an approximate diagnosis without laboratory studies.

Acute (epidemic) conjunctivitis

The full name of this form of inflammation of mucous membrane – acute epidemic conjunctivitis Koch-weeks. The cause – Bacillus Koch-weeks. This fact gives grounds to relate it to bacterial types of conjunctivitis. However, the rapid spread in the human population and lose at the same time a large number of people allows to allocate it in a particular form.

The distribution of acute conjunctivitis, the Caucasus, the countries of Asia. It is very rare in Northern regions, is shown seasonally, often in autumn and summer, in the form of outbreaks. Infection with Bacillus Koch-weeks occurs by droplet infection through casual contact, utensils, household items, water, food.

The incubation period is 1-2 days, followed by a rapid and acute onset of symptoms in both eyes. There is a strong swelling and redness of the mucous membrane both of the eyelids, eyeball, transitional folds. Most strongly affects the lower eyelid, taking the form of a roller. On the mucosa a few days appear petechial hemorrhages, begins to separate pus and mucus. The mucous membrane is not damaged, but it formed a thin film of brown color, easily detached from the mucosa. The patient feels pain, foreign body sensation in the eye, there is photophobia, lacrimation. The entire surface of the eyeball becomes red.

With adequate treatment, the disease ends in recovery in 5-20 days.

Bacterial conjunctivitis

The reason for the appearance – the introduction in the mucous membrane of the eyes of pathogenic bacteria. This form of conjunctivitis always occurs with severe symptoms. Regardless of the bacteria that triggered the inflammatory process, the primary symptoms are the same - the mucous membrane suddenly appears turbid, grayish-yellow discharge, eyelids sticking together in the morning. Additional signs are pain and stinging, dryness of the mucosa and skin of the eyelids. Almost alwaysaffects one eye, but failure to comply with the rules of hygiene the disease passes to the other.

Form of bacterial conjunctivitis the most common causative agents:

• Staphylococcal conjunctivitis – severe swelling and redness of the eyelids, profuse purulent discharge, gluing the lids after sleep, intense itching and burning. Additionally, there is photophobia, feeling of a foreign body under the eyelids. Affects both eyes alternately. With antibiotic treatment the symptoms disappear in 3-5 days.
• Gonococcal conjunctivitis (gnobleniya) – occurs in newborns during passage through the birth canal of the mother, gonorrhea. Symptoms – rapidly emerging dense swelling of the eyelids and mucous membranes. From the age of jet released copious purulent discharge the color of "meat slops". After some time the amount is reduced, discharge becomes liquid acquires a greenish tint. All symptoms disappear within 2 months from the beginning of infection. Gnobleniya treatment antibiotic therapy local action, applies to final recovery.

• Pneumococcal conjunctivitis is diagnosed in children. Starts abruptly, in one eye, and then goes to the second. Symptoms – the secretion of large amounts of pus, photophobia, severe eyelid edema, petechial hemorrhages. Film formed on the conjunctiva, are easily removable and do not damage the mucous membranes of the eyes.

• Pseudomonas conjunctivitis – all the symptoms of pronounced (a large amount of pus, pain, redness, swelling, tearing, photophobia).
• Difterence conjunctivitis is a complication of diphtheria, is manifested the strongest seal and edema of the eyelids, of not being able to open my eyes. Detachable muddy, sukrovichnye. In the mucosa there are dirty gray film that cannot be removed. After the forced removal at their place are still the bleeding defects of the mucous membrane. In the second week of the disease the film is easy to depart themselves, puffiness disappears, increasing the amount of discharge. After 2 weeks the disease ends in recovery, although it may become chronic. Possible complications entropion, defects and scarring of the conjunctiva.

Chlamydial conjunctivitis

The onset is acute, the main symptoms – severe photophobia accompanied by redness and rapid swelling of the mucosa. During the night the eyelids are glued together with a small amount of Muco-purulent discharge. Most strongly affects the lower eyelid. The disease starts only in one eye, but poor hygiene spreads to both eyes.

Occurs in the form ofoutbreaks in swimming pools and baths.

Viral conjunctivitis

The cause of the infection – the viruses of smallpox, measles, herpes, adenovirus, SARS virus of trachoma. Highly contagious conjunctivitis, triggered by adenoviruses and herpes viruses, patients in need of these forms in isolation from the others.

The main symptoms – severe redness of the eyelids and the eye, infiltrates and follicles of the mucous membrane, the formation of easily removable films. Additionally there is blepharospasm, lacrimation, photophobia.

Forms adenoviral conjuctiva:

• Catarrhal – inflammation and slight redness, minimal discharge.
• Filmy – on the mucosal surface are formed of a thin film, they can be easily removed, and can be tightly attached to the surface of the eyeball. Formed in the thickness of the conjunctiva seals and hemorrhage, regenerating after recovery.
• Follicular – the conjunctiva formed small bubbles.

Additionally, the patient experiences pain in the throat, marked hyperthermia, which provide the basis for the term "denotationally fever".

Find out more: Viral conjunctivitis

Allergic conjunctivitis

Clinical forms of allergic conjunctivitis:

• Vernal keratoconjunctivitis;
• Pollinozy conjunctivitis (Allergy to pollen flowering plants);
• Chronic conjunctivitis;
• Drug conjunctivitis Allergy drugs for the treatment of eye diseases;
• Allergic conjunctivitis resulting from wearing contact lenses.

Symptoms – severe itching and burning of the eyelids and mucous membrane, severe swelling and redness, lacrimation and photophobia. The diagnosis is the result of the diagnosis and study of anamnesis, it is important for the effectiveness of the treatment.

Learn more: Allergic conjunctivitis: symptoms and treatment

Chronic conjunctivitis

Flowsfor a long time, is characterized by multiple subjective complaints. Symptoms – feeling of "sand" in eyes, itching, heaviness of the eyelids, soreness and fatigue when reading. Visually during the inspection recorded a slight redness of the conjunctiva, enlarged nipples, scanty discharge.

The emergence of chronic conjunctivitis occurs when the eye irritation dust, smoke, gases. Most of the victims are workers in the chemical, textile, cement, bricks, saw mills. Another category of risk group – patients with a history of gastrointestinal disease, nasopharyngeal, anaemia, avitaminosis. Treatment – eliminate the causes of inflammation of the eyes, the restoration of its functions.

Which restores conjunctivitis

This form of conjunctivitis is called "the angle", often becomes chronic. Her appearance provokes bacterium of Morax-Aksenfeld. Symptoms – pain and itching in corners of eyes, more likely to be felt in the evening. The skin around the eyes is red, covered with cracks. The reddish mucous membrane of the eye appears a small amount of viscous mucus. It accumulates in the corners of your eyes for the night, taking on the appearance of a dense clump. Timely diagnosis and treatment will quickly relieve the symptoms, otherwise it will become a chronic process.

Purulent conjunctivitis

Belongs to the bacterial types of conjunctivitis the main symptom – a large number of purulent discharge. Pathogens – gonococcus, pneumococcus, Staphylococcus aureus, Pseudomonas aeruginosa. Treatment always includes antibiotics of local action.

Catarrhal conjunctivitis

Observed with viral, allergic and chronic form of the disease. Symptoms – moderate redness and swelling of the mucosa of the eyelids and the eyeball, Muco-purulent discharge, slight photophobia. Not diagnosed hemorrhages, the appearance of follicles and films, increase of the papillae. The course of treatment is not more than 10 days, complications do not arise.

Papillary conjunctivitis

The clinical form of allergic conjunctivitis, has a long duration. Symptoms the mucous membrane of the eye becomes uneven and rough due to the increase of the papillae on its surface, appear itching and burning, pain, scant mucous discharge. A frequent cause of this form of wearing contact lenses, ocular prosthesis, eye foreign body.

Follicular conjunctivitis

In the mucosa of the eyes appear infiltrates in the form of papillae and follicles gray-pink in color. Manifested by severe redness, slight swelling of the eyelids and conjunctiva. Characteristic symptom – blepharospasm (closure of eyelids) and severe tearing.

Possible reason for the appearance –viral or bacterial lesion. The disease lasts in an active form 2-3 weeks, subsiding – are still 1-3 weeks, only 2 to 3 months.

Temperature conjunctivitis

The fever is not peculiar to conjunctivitis, this symptom is almost never found among the symptoms of the disease. Hyperthermia can join manifestations of the disease, if inflammation of the mucous membrane of the eyes occurs on the background of ARVI, bronchitis, cold, laryngitis, sinusitis, pharyngitis.

General principles of treatment all types of conjunctivitis

Important in treating all forms of the disease eliminating the causes of negative symptoms of the inflammatory process. Used for this purpose is drug therapy.

Symptomatic treatment that eliminates the symptoms of conjunctivitis, is the use of drugs local action. They are administered to the mucous eye.

Pain appearing with the first signs of conjunctivitis, stop the introduction of drops of local anesthetic action (Lidocaine, Trimekain, Piromekain). Hygienic treatment ciliary edges of the eyelids and mucous membrane of the eye is carried out with solutions of antiseptics (Furacillin, Dimexide, Exilant, potassium permanganate, brilliant green).

After the relief of pain and hygienic treatment of the eyes begin to treatment the cause of the disease, is injected into the eye antibiotics, antihistamines, antivirals, sulfonamides. They are used depending on the factors that caused the disease. In the treatment of bacterial conjunctivitis antibiotics used in viral conjunctivitis antiviral agents (Florenal, Serecid), allergic – antihistamines (Dimedrol, Dibazol).

This algorithm is followed until, until all clinical signs of conjunctivitis. All this time prohibited the imposition of any eye patches so as not to create favorable conditions for bacteria and other pathogens, does not cause relapses and complications.

Treatment of conjunctivitis at home

Viral conjunctivitis. For the treatment of adenoviral conjunctivitis using drugs interferon with antiviral effect (Laferon, Interferon). They are used in the form of instillation of the drug solution to the mucosa.

• The first 2-3 days – inteferon 6-8 p./day;
• To extinctionsymptoms interferon 4-5 p./day;
• Ointments with antiviral effect (bonaftonovaya, tebrofenovaya, florenalevaya) – 2-4 p./day;
• If a strong inflammation – diclofenac 3-4 p./day;
• For the prevention of dry eye syndrome substitute tears Vidisic, Oftagel, Systane.

Herpes virus. The herpes virus destroys the interferon solutions prepared from the lyophilisate immediately before instillation in the eye. The first 2-3 days they are administered 6-8 times a day, and then 4-5 times. Treatment continued until the disappearance of clinical symptoms. In severe inflammation, itching and burning are administered Diclofenac. Prevention of relapse or complications used R-R silver nitrate or Pikloksidina 3-4 times a day.

Bacterial. For fast relief of inflammation 2-4 times a day buried Diclofenac. Hygienic treatment of the eyes is carried out with solutions of antiseptics (Furacillin 1:1000, 2% boric acid). The destruction of pathogenic bacteria carried out with sulfonamides and antibiotics in the form of ointments and drops (Eritromicina, Tetracycline, Gentamicine ointment, Sulfacetamide drops, Ciprofloxacin, Ofloxacin). First, they bury or lay 4-6 times a day, using 2-3 days, to 2-3 times per day until until the symptoms. To prevent a recurrence at the same time use Peroxides drops 3 times a day.

Chlamydia. The treatment of conjunctivitis, triggered by protozoan micro-organisms, conduct systemic drugs. Most often, this is Levofloxacin (1 tab. daily for 7 days).

At the same time 4-5 times a day used drugs with antibiotics with local effect (a drop of Lomefloxacin Eritromicina or ointment). They are used from 3 weeks to 3 months to complete relief of the symptoms of conjunctivitis. Treatment of inflammation is carried out by the drug Diclofenac 2 times a day for a long time. When the ineffectiveness of Dexamethasone used with the same frequency. Prevention of dry eye syndrome is carried out with artificial tears (Axial, Oftagel).

Purulent. In this form of conjunctivitis it is important to promptly and thoroughly remove purulent discharge with antiseptic solutions (Furacillin, 2% boric acid, potassium permanganate solution). To eliminate the cause of the inflammation is applied 2-3 times a day Gentamicine, Erythromycinbuy or Tetracycline ointment, drops Lomefloxacin to full recovery. Swelling Diclofenac cropped.

Allergic. Treatment is antihistamines, local action (Allergical, Spersallerg), andalso drugs that reduce the degranulation of mast cells. (Alamid 1%, Lekrolin 2%, Custrom 4%). They are used for a long time, introducing the 2 times a day. The ineffectiveness of these tools additionally use Maxidex, Diclofenac, Decalex. In the treatment of severe forms of allergic conjunctivitis using eye drops with corticosteroids and antibiotics (Tobradex. Maxitrol).

Chronic. Treatment of this form of conjunctivitis is successful, if timely to identify the cause of the disease. Apply a drop of 0.25-0.5% R-RA zinc sulfate and 1% p-p of resorcinol. Alternative medicines – the introduction of R-RA of Collargol Protargolum or 2-3/day, lay in the eye before bedtime yellow mercury ointment.

Drugs used in conjunctivitis

The basic formulations of drugs for the treatment of pink eye ointment and eye drops

Ointments to treat conjunctivitis

Name	Quick instructions
Eritromicina ointment	Pharmacological actions: antibiotic with bacteriostatic action. Contraindications: jaundice, hepatic failure, hypersensitivity to antibiotics from the macrolides Side effects: itching, redness, allergies, candidiasis, tachycardia, tinnitus, disorders of the gastrointestinal tract Dosage: 0.2-0.3 g 4-5 p/day
Tetracycline ointment	Pharmacological actions: antibiotic with bactericidal action Contraindications: pregnancy, lactation, liver failure, fungal infections, leukopenia, children age up to 8 years Side effects: disorders of the gastrointestinal tract, itching, redness, swelling Kwinke Dosage: 0,2-0,4 g 3-5 times a day
Gentamicina ointment	Pharmacological actions: antibiotic with bactericidal effect Contraindications: viral and fungal infections of the eye, increased intraocular pressure, epitheliopathy of the cornea, increased sensitivity Side effects: local allergic reaction, burningin the eyes Dosage: stripe 1 cm to lay in the cavity of the century 2-3 times a day
Yellow mercury ointment	Pharmacological action: antiseptic Contraindications: eczema, allergies Side effects: kidney damage, disorders of the Central nervous system, skin irritation, disorders of the gastrointestinal tract Dosage: once at night

Find out more: Ointment conjunctivitis

Drops for treatment of conjunctivitis

Name	Quick instructions
Pikloksidina	Pharmacological action: antiseptic with antimicrobial action Contraindications: lactation, pregnancy, hypersensitivity Side effects: burning sensation, hyperemia of the mucous Dosage: 2-6 times a day 1 drop for 10 days
Sulfacetamide 20%	Pharmacological action: antibacterial with a bacteriostatic effect Contraindications: hypersensitivity to sulfonamides Side effects: burning sensation, hyperemia, mucosal edema, itching Dosage: 2-3 drops up to 6 times a day
Levomicetinom drops	Pharmacological action: antibiotic for local use Contraindications: pregnancy, individual intolerance, the neonatal period, psoriasis, eczema, fungal infections, depression of hematopoiesis Side effects: allergic Dosage: 1 drop 3-4 p/day
Diclofenac	Pharmacological action: steroidal anti-inflammatory drug with analgesic effect Contraindications: sensitivity to NSAID, 3rd trimester pregnancy, children up to age 2 years, keratitis, bronchial asthma Side effects: burning sensation, redness, swelling of the face, fever, erythema, nausea, vomiting, skin rash Dosage:1 drop 3-4 times per day
Dexamethasone	Pharmacological action: hormonal drug with anti-inflammatory, anti-allergic effect Contra-indications: trachoma, glaucoma, corneal epithelial damage, tubercular, viral, fungal eye Side effects: increased intraocular pressure, loss of visual fields, perforation of the cornea Dosage: 1-2 drops every 2-4 hours
Olopatadine	Pharmacological action: anti-allergic agent Contraindications: special sensitivity to the drug components Side effects: burning sensation, pain, conjunctival hyperemia, keratitis, iritis, swelling of eyelids, headache, rhinitis, change of taste Dosage: 1 drop 2 times a day
Suprastin	Pharmacological action: anti-histamine and anti-allergic Contraindications: lactation, pregnancy, children up to age 6 years, lactose intolerance, individual sensitivity Side effects: allergic reactions, drowsiness, headache, migraine, asthenia Dosage: orally 1 tablet 3-4 times a day, eye drops with the same name there
Fenistil	Pharmacological action: antihistamine Contraindications: lactation, 1 trimester of pregnancy, children up to age 1 month, prostatic hyperplasia, bronchial asthma, angle-closure glaucoma Side effects: anxiety, fatigue, drowsiness, gastrointestinal disorders Dosage: adults 3-6 mg/day in 3 divided doses in children from 3-10 drops to 15-20
Axial	Pharmacological action: the drug moisturizers, artificial tears Contraindications: allergic to components of the product Side effects: rarely allergic reactions Dosage: as needed or 1-2 drops 4-5 times a day
Tobradex	Pharmacological action: antibacterial and anti-inflammatory Contraindications: fungal infections, fungal eye diseases, conditions after removal of the foreign body, viral diseases of the cornea, increased sensitivity Side effects: itching and swelling of the eyelids, increased eye pressure, ulcer on the cornea Dosage: 1-2 drops every 4-6 hours

Find out more: Drops from conjunctivitis

Conjunctivitis treatment of folk remedies

Recipes of traditional medicine can be used in complex treatment of the disease. On the basis of national resources prepare solutions and for washing and eye treatment.

Effective popular recipes:

• A paste of dill, passed through a meat grinder, overcome with the help of gauze. In the resulting juice to wet a soft cotton cloth, to make a 15-20 minute application on the eyes. Apply when first signs of disease.
• A solution of honey and boiled water (in the ratio 1:2) instilled into the eyes several times a day;
• A decoction of 2 tsp. hips and 200 ml of water, infused for 30 minutes, drain. Dampen a clean washcloth or cotton pad, make application to the eye in purulent conjunctivitis.
• Pour 200 ml boiling water 10 g comminuted in a mortar psyllium, to insist 30 minutes, drain. Dampen a clean cloth in the solution, to make lotions. Flush eyes if necessary.
• Making lotions from 30 g of crushed leaves of Datura, infused with 200 ml boiling water for 30 minutes.

What is rehabilitation treatment after conjunctivitis?

The consequence of conjunctivitis may be vision disturbances induced damage to the mucous membranes. Timely treatment will help to completely eliminate discomfort. To restore the structures of the eye and the regeneration of the mucous in ophthalmology used reparants. The most effective of these is the solcoseryl gel, made from plasma of calf blood.

Solcoseryl acts at the cellular level, quickly restoring the eye tissues, activating the metabolism. After the accelerated regeneration of visual function is quickly restored, the mucous membrane of the eyes becomes normal. A full course of rehabilitation treatment Solkoserilom takes from one to three weeks.

Before using the drug should consult with an ophthalmologist.

egtyareva Marina Vitalievna, ophthalmologist, optometrist