Acute conjunctivitis to the therapist. Acute conjunctivitis of the eye: treatment of adults and children

One of the most common inflammatory eye diseases is conjunctivitis. Most people experience this disease at least once in their lives. Most often, acute conjunctivitis occurs in children attending a kindergarten or other children's groups. Inflammation is manifested by the appearance of pain, redness, swelling.

Acute inflammatory processes that affect the conjunctiva of the eye occupy a significant place in the list of ophthalmic diseases. When studying the causes of outpatient visits to an ophthalmologist, this disease accounts for approximately 30%.

Moreover, the frequency of treatment depends on the season: infectious conjunctivitis is more often diagnosed in winter and autumn, and allergic - in the warm season.

Description of the disease

The conjunctiva is the mucous membrane that lines the inner surface of the eyelids. In fact, this part of the eye "connects" the eyeball with the eyelids. With inflammation of this mucous membrane, a disease develops, which is called conjunctivitis.

Types of diseases

The inflammatory process can provoke a variety of factors. Most often, there is an infectious type of inflammation, the cause of which is the ingress of pathogens on the mucous membrane of the eye. Depending on the type of pathogen, the following types of disease are distinguished:

• bacterial caused by staphylococci, Pseudomonas aeruginosa and other types of bacteria;
• viral, this type of disease is provoked by herpes viruses, adenoviruses, etc.;
• fungal, most often the causative agent is a fungus of the genus Candida.

Advice! Infectious conjunctivitis is contagious, the infection is transmitted by contact, and the viral type of the disease can be "caught" by simply talking to the patient, since viruses are transmitted by airborne droplets.

Allergic conjunctivitis is not contagious, it is triggered by contact with a certain substance. Often this type of disease is provoked by plant pollen, poplar fluff, as well as certain types of cosmetics or medicines.

Why does inflammation develop?

All people are constantly faced with various infectious agents, but inflammation of the mucous membrane of the eye develops only in a small part of the population, since reliable protection is provided in a healthy body.

But if the immune system is weakened, the risk of infection increases significantly. The following factors can provoke the development of conjunctivitis:

• previous diseases (flu, tonsillitis, etc.);
• hypothermia;
• eye injury;
• persistent eye irritation caused by foreign objects (for example, wearing contact lenses).

Clinical picture

Individual symptoms in acute conjunctivitis may vary depending on the type of disease. But as you can see in the photo, there are common signs:

• redness and swelling of the mucosa;
• photophobia;
• the appearance of discharge from the eyes.

infectious type

If the primary cause of the development of inflammation is an infection, then the initial symptoms appear some time after infection. The duration of the incubation period can range from several hours to several days.

The initial symptom of the disease is the appearance of a sensation of the presence of a foreign body in the eye, as the patients say, "as if sand had been poured into the eye." Then other characteristic symptoms appear:

• redness;
• edema;
• burning.

The nature and amount of discharge depends on the type of infection. So, with bacterial inflammation, the characteristic symptoms of the disease are abundant discharge, which has a purulent or mucopurulent character. If the disease is provoked by viruses, then the discharge is usually small.

By studying the symptoms, one can also get the first idea of ​​​​the depth of the spread of the process. If the inflammation has affected only the superficial layers of the mucosa, then the most intense hyperemia will be observed on the periphery of the eye.

If the deeper layers are affected, then, on the contrary, the most intense redness will be observed in the center, decreasing towards the edges. In children, and sometimes in adults, with the acute development of the inflammatory process, general symptoms may also be observed:

• malaise;
• temperature increase;
• headache.

The duration of the acute period of the disease is usually 7-15 days, after which the symptoms begin to subside. In most cases, the disease proceeds without complications, but exceptions are possible. Sometimes inflammation passes to the cornea, which can lead to scarring and visual impairment.

Advice! Especially often complications arise if the inflammatory process was provoked by gonococci, Pseudomonas aeruginosa or bacteria that cause the development of diphtheria.

allergic conjunctivitis

In this type of disease, both eyes are most often affected at the same time. Acute atopic conjunctivitis begins either almost immediately after contact with the allergen, or after 1-2 days. Main symptoms:

• severe itching;
• burning;
• lacrimation;
• photophobia;
• swelling and redness.

Itching in this type of disease is so severe that the patient is often forced to rub his eyes with his hands, which often leads to the addition of secondary infections.

Features of the course of the disease in children

In children, the course of acute conjunctivitis is often accompanied by the formation of films on the eyes. These films are easily removed when the child cries or when rubbing the eye with a swab. In adults, the formation of films in acute conjunctivitis occurs mainly when the eyes are affected by corynebacterium diphtheria.

Diagnosis of acute conjunctivitis

To effectively treat conjunctivitis, it is necessary to find out the causes that provoked inflammation. To do this, conduct a study of the discharge and conduct a number of other tests.

This allows you to determine the presence of the pathogen and its sensitivity to drugs. After receiving these tests, the doctor will prescribe the necessary treatment.

Treatment Methods

It is necessary to prescribe treatment for acute conjunctivitis individually, taking into account the type of disease, the intensity of the process and other characteristics of the patient. As a rule, treatment includes the following steps:

• washing the conjunctival sac with antiseptic solutions;
• the use of drugs to destroy the infection (if the disease is provoked by bacteria or viruses);
• the use of drugs that have anti-inflammatory and restorative effects.

With the bacterial nature of inflammation, treatment is carried out with the help of antibiotics, produced in the form of eye drops and ointments. During the day it is necessary to use drops, instilling them every 2-3 hours, it is recommended to lay the ointment at night.

With a viral disease, the use of antibiotics is useless, treatment with the use of antiviral drugs is necessary. In addition, drugs containing interferons are prescribed to boost immunity.

If conjunctivitis is caused by an infection, it is important to take steps to avoid infecting others. So that later you do not have to treat all family members, the patient needs to allocate separate linen (towels, bedding) and hygiene products.

Effective treatment of allergic conjunctivitis is impossible without eliminating contact with the allergen. Therefore, before prescribing ophthalmic treatment, the patient is referred for a consultation with an allergist.

A fairly common disease is acute conjunctivitis. As you can see in the photo, the disease manifests itself with redness and swelling of the eyes, the appearance of discharge. A doctor should prescribe treatment, since this disease can have a different nature, therefore, it requires a different approach to therapy.

In children and adults, acute conjunctivitis is common, which is diagnosed in 30% of cases. This is an inflammatory process on the mucous membrane of the eyes. The cause is various factors, but more often it is an infection and an allergy. The first symptoms appear immediately, signaling inflammation: swelling, redness, pus. The growth leads to visual impairment. Diagnosis and treatment is carried out by an ophthalmologist. Medications are prescribed in accordance with the etiology of the process.

Conjunctivitis usually affects one eye, but then progresses to the other. With adequate treatment, the process can be stopped.

Etiology

Conjunctivitis of the eyes develops as a result of exposure to the mucous membrane of the organ of pathogenic factors. The local microflora contains some microorganisms, but under the influence of certain conditions, the number of harmful elements increases and the inflammatory process develops. Bacteria, viruses and fungi can develop an acute form. A common way of transmission of infection is contact-household. The provoking factors are:

• temperature effects on the body (hypothermia or overheating);
• getting into the cavity of the visual organ of a foreign body;
• mechanical damage to the conjunctiva;
• exposure to the mucous membrane of chemicals;
• inflammatory pathologies of the nasopharynx;
• helminthic invasions;
• chronic ophthalmic processes.

There is a special type of disease - acute allergic conjunctivitis. Inflammation develops under the influence of an allergen. Cosmetics and detergents, poplar fluff, and drugs can provoke a reaction. The disease is manifested by a number of symptoms and is difficult to treat. First of all, you need to exclude contact, and then deal with signs of inflammation on the mucosa.

Possible symptoms

Conjunctivitis in adults and children has the same manifestations, but in young patients it occurs 3 times more often. It is worth denouncing the symptoms of the acute and chronic forms of the disease - in the first case, there is a rapid development and a more extensive symptomatic complex. The complete clinical picture of acute conjunctivitis includes the following features:

• feeling of "sand" in the eyes;
• pain and discomfort;
• purulent discharge, which leads to sticking of the eyelids, especially at night;
• uncontrolled tearing;
• redness of the conjunctiva and the edges of the eyelids;
• increase in body temperature;
• headache and malaise.

Features in children

Children's mucous membrane is very sensitive, so the disease in childhood is considered more dangerous. Most often, the disease develops at this age against the background of an allergy or viral infection. If a child has been diagnosed with conjunctivitis, it is urgent to start treatment. In this case, before consulting a doctor, you should not do anything on your own.

Conjunctivitis in children has a number of distinctive symptoms. Firstly, there is a strong hyperemia on the eyelids and swelling, which greatly complicates the review. Secondly, in children, multiple petechial hemorrhages are possible, so the eyes look red. At the same time, in small patients, the body temperature almost always rises to high rates.

Treatment of acute conjunctivitis in children also has a number of differences. A protracted illness is often diagnosed, so therapy should be carried out throughout the entire period. But for children it is not recommended to use aggressive drugs. It is worth regularly wiping your eyes with a special antibacterial wipe. Among the many drops, the drug "Albucid" is considered completely safe for children. The child needs to be prepared for the fact that the drops burn a little when they get into the eyes.

Another difference between childhood conjunctivitis is the formation of a film in front of the eyes. It prevents the child from looking, so it must be carefully removed with a swab.

Diagnostic measures

Treatment in adults and children necessarily begins with an examination by an ophthalmologist and an accurate diagnosis. The doctor examines the fundus with a slit lamp. This method may suffice. In addition, the ophthalmologist needs to study the full history and features of the development of inflammation. To confirm conjunctivitis and determine its etiology, a number of special studies are prescribed: In the treatment of such a pathology, the drug Vizin Allergy can be used.

• Antihistamine drops in the diagnosis of allergies - "Opatanol", "Histimet" (from 12 years old), "Allergodil", "Vizin Alerzhdi". Or from these - "Lekrolin", "Kromoheksal", "Allergodil".
• Preparations based on interferon in case of viral damage - "Poludan", "Okoferon", "Ophthalmoferon", "Aktipol", "Acyclovir" (5% ointment).
• Antibacterial drops for infection - "Floxal", "Neomycin", "Lincomycin", as well as 1% ointments - tetracycline or erythromycin.
• Vitamins to increase the overall level of immunity.
• Washing solutions - "Furacilin", "Rivanol", boric acid, chamomile decoction.
• Medicines for angular conjunctivitis - 0.5-1% zinc sulfate solution, 1-5% zinc oxide ointment.

Steroid drugs are not recommended, they can be addictive. In case of frequent relapses, an individual treatment regimen is developed and strong antibiotics are prescribed. Symptomatic treatment is not required, traces of inflammation disappear on their own, after the elimination of bacteria. Do not forget that conjunctivitis is a contagious disease, so in the process of treatment it is better to limit contact with healthy people.

Redness, tearing, photophobia, sour eyes - these and other symptoms of acute conjunctivitis can occur in anyone. Every day a person comes into contact with infection, allergens, dust, which can cause inflammation of the conjunctiva. At the first signs of the disease, not every patient rushes to the doctor, tries to get rid of the symptoms on their own. This often leads to a delay in the inflammatory process, the development of complications. To prevent this from happening, you need to understand the danger of conjunctivitis, know the causes of their occurrence, symptoms and preventive measures.

What is acute conjunctivitis?

Acute conjunctivitis is a disease characterized by inflammation of the conjunctiva (the lining of the eye). Its function is the production of tear fluid, moisturizing and protecting the eye.

Interestingly, the eye is the only part of the body whose living cells are in contact with the environment. A cell cannot live without water, otherwise it dries up and dies. Therefore, a person blinks - this is a protective mechanism that prevents the mucous membrane of the eye from drying out.

In an adult, more often than in babies, there are bacterial conjunctivitis caused by a sexual infection (chlamydia, gonococcus and other pathogens). In addition, harmful working conditions (dust, allergens, visual stress) increase the incidence of this disease. Chronic diseases of other internal organs can greatly increase the likelihood of an illness.

A newborn baby should normally be born with a sterile conjunctiva. If an infection has got into the conjunctival sac, then the baby’s eyes “turn sour” after sleep, the eyelids swell. In children older than a year, viral and allergic conjunctivitis are more common than in adults. The onset of the disease is very often accompanied by symptoms of general malaise (weakness, fever, loss of appetite, sore throat, cough). In addition, inflammation of the conjunctiva in children often leads to visual impairment. The kid complains that objects become fuzzy, because of this there is an unsteady gait, the child falls “out of the blue”.

Conjunctivitis in children - video by Dr. Komarovsky

Disease classification

Conjunctivitis due to the occurrence is divided into infectious and non-infectious.

1. Infectious conjunctivitis, in turn, are divided into the following types:
   • Bacterial caused by staphylococcus, streptococcus, pneumococcus, diphtheria bacillus, gonococcus.
   • Viral, caused by influenza viruses, measles, adenovirus, herpes virus. Epidemic keratoconjunctivitis, provoked by some strains of adenovirus infection, can be distinguished into a separate group.
   • Fungal. The most common fungal infections that cause conjunctivitis are sporotrichia, candida, actinomycots, rhinosporidium, coccidia, aspergillus.
2. Noninfectious conjunctivitis:
   • Allergic - pollinous conjunctivitis when plant pollen gets into the eyes, spring or atopic conjunctivitis as an allergic reaction to ultraviolet rays, tuberculosis-allergic conjunctivitis, which develops when the decay products of tubercle bacillus get in.
   • Medicinal - with frequent use of eye drops, ointments. May occur when using antibiotics, sulfonamides, antiseptics.
   • Autoimmune - when the conjunctiva is damaged by cells of its own immunity.

Interestingly, adenoviral conjunctivitis in adults occurs six times more often than in children!

Types of conjunctivitis in the photo

One of the manifestations of adenoviral conjunctivitis is a lesion of the cornea with the formation of a film Allergic conjunctivitis is manifested by swollen eyelids, redness and itching of the eyes. The appearance of yellow-brown discharge from the eye is a characteristic sign of bacterial conjunctivitis
With viral conjunctivitis, redness, tearing, burning in the eyes appear

Causes

The causes of acute conjunctivitis can be very different, but the most common are:

• infections - getting into the eyes of viruses, bacteria or fungi causes an inflammatory process that leads to irritation of the mucous membrane (redness), exudation (formation of an inflammatory fluid). You need to understand that getting an infection in the eye does not necessarily lead to a disease, this happens with reduced immunity;
• allergens;
• hypo- or vitamin A - the lack of this vitamin makes the conjunctiva loose and susceptible to the effects of infection, allergens.

Risk factors for developing the disease

Risk factors are those conditions or conditions of the body that contribute to the onset of a disease. In the case of acute conjunctivitis, risk factors may be:

• non-compliance with personal hygiene (incorrect or insufficient processing of contact lenses, the use of eye drops by several patients, swimming in polluted waters);
• hypothermia, overheating of the body and, as a result, a decrease in immunity;
• getting into the eyes of foreign objects, dust, the so-called eye piercing (implantation of "decorative" objects into the eyeball);
• eye injury (there is a violation of the integrity of the conjunctiva);
• the presence of chronic infections (sinusitis, otitis media, tonsillitis, caries, etc.). They serve as a source of infection that can lead to conjunctivitis;
• the use of low-quality cosmetics (eye cream, shadows, mascara, eyeliners, etc.). This leads to the development of allergic conjunctivitis;
• sexually transmitted diseases - a source of infection for the development of conjunctivitis in a carrier or child. When the fetus passes through the birth canal, it can become infected with a sexually transmitted infection, and this will lead to conjunctivitis of the newborn;
• violations of metabolic processes in the body (for example, diabetes mellitus).

It must be understood that risk factors do not lead directly to conjunctivitis, but increase the likelihood of its occurrence several times.

Photo gallery: risk factors for the development of conjunctivitis

In case of an eye injury, the integrity of the conjunctiva is violated, it ceases to perform its protective functions.
A foreign body entering the eye damages the conjunctiva and can bring infection with it. Seemingly harmless eye piercing causes microtrauma to the conjunctiva, violating its integrity An allergic reaction to mascara can start with swelling of the eyelid and end with conjunctivitis.

Symptoms and signs

The disease and its manifestations depend on the type of conjunctivitis, but there are common symptoms. These include:

• redness of the conjunctiva (hyperemia);
• the presence of discharge from the eyes (tears, inflammatory fluid, pus);
• swelling of the eyelids.

Different types of the disease have the following symptoms:

1. Bacterial conjunctivitis is characterized by an acute onset, severe reddening of the conjunctiva and swelling of the eyelids. A yellow-green liquid (pus) separates from the eyes, in the morning it can lead to sticking of the eyelids. Separately, it is necessary to highlight pneumococcal conjunctivitis. It is manifested by small hemorrhages in the form of dots on the conjunctiva and the appearance of a whitish-gray film on the eyes, which is easily removed with a cotton swab or napkin. Under the films, a loose, bumpy conjunctiva is visible, which does not bleed after their removal.
2. Viral conjunctivitis is characterized by bilateral eye damage. The disease begins acutely - with the appearance of general symptoms of viral intoxication (weakness, lethargy, fever, swollen lymph nodes). The conjunctiva of the eyes becomes red, the edema is insignificant, the release of a clear (serous) fluid from the eyes is pronounced. Adenovirus conjunctivitis is manifested by the formation of tubercles (follicles) on the conjunctiva and the formation of a thin, easily removable film on the eyes.
3. Allergic conjunctivitis - symptoms are swollen, red eye with severe itching, tearing, photophobia. Often the patient has sneezing, nasal congestion.

It is important to know about a special type of bacterial conjunctivitis of the newborn caused by gonococcus (gonoblennorrhea). Infection occurs when passing through the birth canal. The eyelids of the child swell, close, become bluish-red. A purulent discharge appears from the eyes, sometimes the color of "meat slops". The disease is dangerous blindness, as ulcers can form on the cornea.

Diagnostic methods

To confirm the diagnosis, it is enough for the doctor to examine the eye and interview the patient. It is important to know the history of the disease - how the disease began (acutely or the beginning was erased for the patient), under what conditions complaints arose (after contact with an allergen, sunlight or a sick person). On examination, the doctor pays attention to the swelling of the eyelids (the most intense swelling will be with allergic conjunctivitis), to the presence of discharge from the eyes (lacrimation speaks in favor of a viral or allergic type of disease, yellow discharge in favor of a bacterial one). Sometimes, for differential diagnosis, the doctor prescribes additional examinations.

Laboratory and instrumental diagnosis of conjunctivitis:

• General blood analysis. With infectious conjunctivitis, corresponding changes appear in the blood. With bacterial - an increase in the number of leukocytes, an increase in the rate of erythrocyte sedimentation. With viral damage - an increase in the number of lymphocytes. With an allergic process - an increase in the number of eosinophils.
• Seeding discharge from the eye. A smear is sent to the laboratory - it is very important to take the material from the discharge, and not from the surface of the skin, otherwise the result of the analysis will be unreliable. Sowing will show the presence or absence of pathogenic microflora (bacterial) and the sensitivity of these microbes to antibiotics, which is very important when prescribing treatment. If a fungal infection of the conjunctiva is suspected, sowing on mushrooms is prescribed.
• Fluorography. It is prescribed for suspected tuberculosis-allergic conjunctivitis.
• Ultrasound of internal organs. It is prescribed for suspected secondary conjunctivitis caused by metabolic or endocrine disorders (diabetes mellitus, autoimmune pathologies).

How to diagnose and treat conjunctivitis - video

Methods of treatment

If the first signs of conjunctivitis occur, you should immediately contact an ophthalmologist or therapist (pediatrician). You should not try to treat acute conjunctivitis on your own, because the technique is different for different types of disease. Only a doctor can correctly diagnose and prescribe the necessary treatment regimen.

Groups of drugs used to treat conjunctivitis:

1. Antiseptics. Used to wash the eyes before using drops or ointment. Also used to prevent infectious complications in allergic and atopic conjunctivitis. The most popular remedies are Chlorhexidine, Furacilin, potassium permanganate solution.
2. Antibacterial agents. They are prescribed in the form of drops or eye ointments for the treatment of bacterial types of conjunctivitis. Broad-spectrum preparations are used until the bacterial class is established by culture from the discharge of the eyes. Treatment of gonoblenorrhea requires the use of antibiotics and systemically (by mouth) - until the gonococci completely disappear from the body. In the treatment of bacterial conjunctivitis, the frequency and duration of taking medications is important. It is not advisable to stop therapy immediately after improvement.
3. Antiviral drugs. This group of drugs is used to treat conjunctivitis of viral origin. There are eye drops based on interferon, which stimulates local immunity to fight viruses.
4. Fungicidal preparations. Used to treat fungal conjunctivitis. In foreign practice, eye drops based on antifungal agents are widespread, in Russia these drugs are available only for systemic use. Some types of eye drops are prepared in pharmacies on demand.
5. Antiallergic (antihistamine). Preparations in the form of eye drops are used to treat allergic conjunctivitis. They remove itching, swelling, tearing. With spring conjunctivitis, it is advisable to prescribe systemic antihistamines.
6. Hormonal agents. They can be in the form of ointments, drops, and also be part of complex preparations. This group of drugs has anti-inflammatory, anti-edematous action.

Drugs used to treat eye damage - table

Medications in the photo

Opatanol - immunomodulating eye drops, used to treat viral conjunctivitis Fungal conjunctivitis is treated with the antifungal drug Nystatin. Lekrolin - drops for the treatment of allergic conjunctivitis Tobrex is a drug of tobramycin, a broad-spectrum antibiotic. Used to treat bacterial conjunctivitis Hydrocortisone in the form of eye ointment effectively removes swelling, itching and redness of the eyelids Ciprolet - ciprofloxacin drops for the treatment of bacterial conjunctivitis Oftalmoferon enhances the formation of interferons, is used to treat viral conjunctivitis Dexamethasone - a remedy for the treatment of allergic, atopic or medicinal conjunctivitis

Consequences and possible complications

It must be understood that all the consequences and complications occur with incorrect or untimely treatment. Therefore, it is very important to consult a doctor at the first signs of the disease, to follow all recommendations for treatment.

The most common consequence of acute conjunctivitis is its transformation into a chronic form. This happens when the process is delayed, when the infection goes into the so-called "sleeping" state. There are no acute manifestations of conjunctivitis, and the causative agent of the disease continues to be on the conjunctiva. With a decrease in immunity, hypothermia, the appearance of concomitant pathology, it is activated and leads to an exacerbation.

Complications of infectious conjunctivitis:

It should be noted that acute conjunctivitis is not a harmless disease. Many patients believe that it is not necessary to see a doctor with a "red eye". But this is not so at all. Conjunctivitis can be a manifestation of a more serious pathology or cause a severe complication, up to blindness. Timely access to a doctor and the implementation of all recommendations for treatment can save vision and prevent complications. And following preventive measures will help to avoid the disease altogether.

- an infectious lesion of the mucous membrane of the eye, caused by gram-positive or gram-negative bacteria. In acute conjunctivitis, marked photophobia and lacrimation, swelling and hyperemia of the eye mucosa, pinpoint hemorrhages, and mucopurulent discharge from the conjunctival cavity are noted. Diagnosis of acute conjunctivitis of bacterial etiology includes biomicroscopy of the anterior segment of the eye, staining of the cornea with fluorescein, bacteriological culture of discharge from the conjunctiva. In acute bacterial conjunctivitis, local antimicrobial treatment (eye drops and ointments) is carried out, taking into account the sensitivity of the pathogen to drugs.

General information

Symptoms

Acute conjunctivitis develops rapidly and rapidly - from the moment the pathogen is introduced to the appearance of detailed clinical symptoms, it takes from several hours to several days.

The course of various forms of bacterial conjunctivitis is characterized by hyperemia, infiltration and swelling of all parts of the conjunctiva, burning sensation, "sand" and itching, pain in the eye, profuse mucopurulent discharge from the conjunctival sac. In acute conjunctivitis, conjunctival injection is pronounced, hemorrhages, the formation of papillae and follicles on the mucous membrane of the eye are noted. With significant edema, chemosis of the conjunctiva can develop - its infringement in the palpebral fissure when the eyelids close. Eye damage in infectious conjunctivitis is initially unilateral; the other eye is involved in inflammation somewhat later.

Acute conjunctivitis occurs with a copious discharge of purulent secretion from the conjunctival cavity, which sticks together the eyelashes, dries up at the edges of the eyelids, forming crusts. Acute conjunctivitis is dangerous in terms of the development of infectious lesions of the cornea - bacterial keratitis, a purulent corneal ulcer with a threat of perforation. Deep keratitis and ulcerative lesions of the cornea occur mainly against the background of a weakening of the body - with anemia, dystrophy, hypovitaminosis, bronchoadenitis, etc.

Sometimes with acute conjunctivitis, there is a general malaise - subfebrile condition, headache, insomnia, respiratory tract lesions. The duration of the disease is 10-14 days.

Diagnostics

The diagnosis of acute conjunctivitis is established by an ophthalmologist on the basis of epidemiological data and clinical manifestations. In order to clarify the etiology of infectious conjunctivitis, a microscopic and bacteriological examination of a smear from the conjunctiva with an antibiogram is performed.

Examination of the anterior segment of the eye with a slit lamp (eye biomicroscopy) reveals hyperemia and friability of the conjunctiva, vascular injection, papillary and follicular growths, and corneal defects. To exclude ulcerative lesions of the cornea, an instillation test with fluorescein is performed.

Treatment

In acute infectious conjunctivitis, local treatment is prescribed, taking into account the type of pathogen isolated and its antibiotic sensitivity. A thorough toilet of the eyes is carried out: rubbing the eyelids, jet washing of the conjunctival sac with antiseptic solutions (furacilin, boric acid). In this case, separate cotton balls, pipettes, eye sticks, syringes are used for each eye.

After a thorough mechanical cleansing of the eyelids and the conjunctival cavity, antibacterial eye drops (solutions of tetracycline, chloramphenicol, neomycin, lincomycin, ofloxacin, etc.) are instilled every 2-3 hours. Antibacterial ointment is recommended to be applied over the eyelids at night. With severe edema and inflammatory changes in the conjunctiva, anti-allergic and anti-inflammatory drops are added to the treatment.

In acute bacterial conjunctivitis, it is strictly forbidden to apply a bandage on the eyes, since this makes it difficult to evacuate the contents from the conjunctival cavity and increases the likelihood of infection of the cornea. Treatment of acute conjunctivitis is carried out for 10-12 days until the symptoms completely and permanently disappear, after which it is desirable to conduct a repeated bacteriological control of the contents of the conjunctival cavity.

Forecast and prevention

Etiologically substantiated and timely therapy of acute conjunctivitis allows to achieve a stable cure for inflammation. With an unfavorable outcome, the course of acute infectious conjunctivitis can be complicated by bacterial keratitis, corneal clouding, decreased vision, development of a corneal ulcer, and orbital cellulitis. The transition of the acute form to chronic conjunctivitis is possible.

Prevention of acute bacterial conjunctivitis consists in observing hygiene standards, preventing eye injuries, proper care of contact lenses, and timely sanitation of foci of infection of the skin and nasopharynx. In children's groups where acute conjunctivitis is recorded, it is necessary to prescribe preventive treatment to all contact persons (instillations of antiseptic eye drops).

Most acute conjunctivitis is extremely contagious, and some of them even occur in the form of epidemics. In 73% of cases, inflammation of the conjunctiva has a bacterial etiology, 25% of patients have allergic conjunctivitis. and other lesions are rarely detected by doctors - in only 2% of cases.

Classification

All conjunctivitis are divided into infectious and non-infectious. The causative agents of the former are bacteria, viruses, fungi and other pathogenic microorganisms. The latter develop under the influence of irritating external factors. Along with inflammation of the mucous membrane of the eyes, damage to the eyelids or cornea can be observed. In this case, we are talking about blepharo- and keratoconjunctivitis.

There are also acute (lasts 1-3 weeks and has pronounced symptoms) and subacute conjunctivitis (less aggressive). Epidemic outbreaks most often occur in children's groups and become the cause of quarantines.

Bacterial

It develops due to the entry of pathogenic bacteria into the conjunctival cavity. Harmful microorganisms can be introduced with dust, dirty water or unwashed hands. The severity and duration of the disease depends on the type of pathogen, its virulence and the timeliness of medical care.

pathogens acute purulent conjunctivitis:

• strepto- and staphylococci;
• pneumococci;
• gonococci;
• bacterium Koch-Wicks;
• corynebacterium diphtheria;
• Diplobacillus Morax-Axenfeld.

The most dangerous among bacterial conjunctivitis is diphtheria. Patients with this pathology must be immediately hospitalized in the infectious diseases department. Epidemic Koch-Wicks conjunctivitis usually occurs in the form of epidemics. Whole families or children's groups can get sick.

Viral

All acute viral conjunctivitis is extremely contagious. People can easily become infected from family members, colleagues, medical personnel. The infection is introduced into the eyes with untreated ophthalmic instruments, infected drops or unwashed hands of medical staff.

Most often, patients are diagnosed with:

• Herpesvirus conjunctivitis. Caused by the herpes simplex virus. It is most common in children and affects predominantly one eye. It has an acute or subacute course, often combined with keratitis - a lesion of the cornea. It can occur in the form of catarrhal, follicular or vesicular-ulcerative inflammation.
• Acute adenovirus conjunctivitis. The causative agents are adenoviruses 3, 5 and 7 types. Infection occurs by airborne droplets or contact. After infection, the patient develops pharyngoconjunctival fever or epidemic keratoconjunctivitis. The latter often occurs in the form of outbreaks in children's and adult groups.
• Epidemic hemorrhagic conjunctivitis. The causative agents are enteroviruses. Massive hemorrhages form throughout the conjunctiva, which makes the eye look completely swollen with blood.

Allergic

It can develop against the background of hypersensitivity to drugs, plant pollen or other substances. Often accompanied by the appearance of cough, runny nose, skin rash.

Types of allergic conjunctivitis:

• medicinal - occurs when using certain anesthetics, antibiotics, sulfonamides;
• hay fever - develops as a result of irritation of the conjunctiva by the pollen of flowering plants;
• acute atopic conjunctivitis - occurs in spring or summer, the etiology of the disease has not yet been fully elucidated.

Caused by the action of a mechanical or chemical stimulus

Inflammation of the conjunctiva can occur after sand, dust, smoke or chemicals used in everyday life (soap, powder, bleach) enter the conjunctival cavity. It often develops after a walk in windy weather. Individuals who regularly wear contact lenses may develop giant papillary conjunctivitis.

Causes

Acute and subacute conjunctivitis can develop as a result of infection or prolonged exposure to various irritants on the eye. The latter can be corrosive gases, smoke, plant pollen, chemicals, ultraviolet radiation, including that reflected from snow.

The development of infectious inflammation is facilitated by disorders of the immune system, beriberi, and metabolic disorders. A certain etiological role is played by hypothermia, stress, overwork, uncorrected refractive errors (,). The disease can develop if personal hygiene is not followed and contact lenses are not used correctly.

Symptoms of acute conjunctivitis

The disease begins acutely with sharp pain, redness and swelling of the conjunctiva. All this may be preceded by contact with a sick person. Almost every conjunctivitis has its own specific symptoms.

Typical symptoms of bacterial, allergic, viral and other conjunctivitis:

• redness of the eyes (conjunctival vascular injection is typical);
• lacrimation, and with concomitant damage to the cornea - photophobia;
• feeling of sand or a foreign body in the conjunctival cavity;
• the formation of a pathological discharge, which often causes gluing of eyelashes in the morning.

Acute purulent conjunctivitis is characterized by the appearance of purulent discharge. For viral and allergic inflammation, serous discharge is more characteristic. In some cases, follicles can form on the mucous membrane - rounded formations resembling bubbles.

Often, along with eye manifestations, general symptoms also appear. A person may suffer from catarrhal phenomena (inflammation of the upper respiratory tract), headache, high fever and chills. Often there is an increase in the anterior and / or submandibular lymph nodes. Systemic manifestations are especially pronounced in children.

Diagnostics

It is possible to suspect inflammation of the conjunctiva according to the patient's complaints and the appearance of typical symptoms. Often, the ophthalmologist can recognize the disease already during the examination in the slit lamp. Before treating acute conjunctivitis, it is necessary to confirm the diagnosis and establish the etiology of the disease.

General blood analysis

Allows you to find out the etiology (cause) of the disease. For example, with bacterial inflammation in the general blood test, neutrophilic leukocytosis and an increase in ESR can be observed, with viral inflammation - lymphocytosis. Acute atopic and other allergic conjunctivitis is characterized by an increase in the level of eosinophils in the blood. Unfortunately, this study is not always informative enough.

Culture of discharge from the eye

If an infectious inflammation is suspected, a swab is taken from the patient from the conjunctival cavity or a scraping is done. With bacterial conjunctivitis, bacterioscopic and bacteriological research methods are quite informative. In the first case, the smear is stained and viewed under a microscope, in the second case, the biomaterial is sown on nutrient media.

Sowing allows not only to identify the pathogen, but also to determine its sensitivity to antibiotics. However, the study is not informative for viral lesions of the conjunctiva. In this case, virological methods are indicated.

Fluorography

The study is necessary for phlyctenular keratoconjunctivitis. The disease can be caused by staphylococci, chlamydia and mycobacterium tuberculosis. Fluorography in this case is carried out in order to exclude pulmonary tuberculosis. Additionally, tuberculin tests and a consultation with a phthisiatrician are shown.

Ultrasound of internal organs

Required for suspected serious diseases of the internal organs. It is performed with chlamydial, gonorrheal and some other types of conjunctivitis. Ultrasound of the pelvic organs is of great importance in the diagnosis of obstruction of the fallopian tubes in women.

Treatment

Treatment of the disease should be carried out by a qualified ophthalmologist and include etiological and symptomatic therapy. First of all, the patient is prescribed drugs that destroy pathogens.

Treatment for acute conjunctivitis may include drugs such as:

• Solution of Furacilin, Rivanol, boric acid, chamomile decoction. Used to wash the conjunctival cavity with inflammation.
• Antibacterial ointments and drops - Floksal, Neomycin, Lincomycin, 1% tetracycline or erythromycin ointment. Indicated for purulent inflammation of the conjunctiva.
• Antiviral agents, interferons and their inducers - drops Poludan, Okoferon, Oftalmoferon, Aktipol, 5% eye ointment Acyclovir. Their appointment requires acute viral conjunctivitis.
• 0.5-1% solution of zinc sulfate or 1-5% ointment containing zinc oxide. Used for diplobacillary (angular) conjunctivitis.
• Antiallergic eye drops - Lekrolin, Kromoheksal, Allergodil. Indicated for allergic conjunctivitis.
• Non-steroidal anti-inflammatory drugs - Indocollir, Nevanak. They are prescribed for severe inflammation and severe pain. Great for helping relieve symptoms.

Forecast

Uncomplicated bacterial conjunctivitis usually resolves in 5-7 days without any negative consequences. In case of high aggressiveness of the pathogen, the disease can drag on for a couple of weeks. Viral inflammation lasts longer - an average of 2-3 weeks. Allergic conjunctivitis can go away in a few days or last for months or even years.

The most severe and dangerous are chlamydial, gonococcal and diphtheria conjunctivitis. As a rule, they are treated for several months and lead to severe complications. With damage to the cornea, the prognosis for vision is extremely unfavorable.

Prevention

To avoid the disease will help compliance with the rules of personal hygiene and the correct use of contact lenses. It is very important for children to wash their hands regularly, especially after playing in the yard. If possible, contact with persons with signs of inflammation of the conjunctiva should be avoided. When the first symptoms of the disease appear, you should immediately consult a doctor - this will help to avoid undesirable consequences.

Acute conjunctivitis in children

Children most often develop acute adenovirus, bacterial, measles and allergic conjunctivitis. In newborns, eye damage by chlamydia and gonococci is possible. These two diseases are extremely difficult and often lead to complete or partial loss of vision.

Most acute conjunctivitis is bacterial in nature and, with adequate treatment, resolves within a week. However, in some cases, inflammation of the conjunctiva can have serious consequences and even lead to blindness. Therefore, only an ophthalmologist should treat the disease.

Some conjunctivitis (especially viral conjunctivitis and those caused by the Koch-Wicks bacterium) are highly contagious and often occur in the form of epidemics. Outbreaks of diseases most often occur in children's groups.

Useful video about conjunctivitis