Conjunctivitis Of The Eye In Adults - Treatment, Symptoms

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-11 07:35

Conjunctivitis of the eye in adults

Conjunctivitis is an inflammatory process that occurs on the mucous membrane of the eye. The term "conjunctivitis" cannot be considered a full-fledged name for a pathology without mentioning the cause or nature of the infectious lesion, for example, "chronic conjunctivitis" or "allergic conjunctivitis". This is the full name used in the medical history.

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

Types of conjunctivitis, depending on the cause that caused it:

• Bacterial - pathogenic and opportunistic bacteria (streptococci, staphylococci, pneumococci, gonococci, diphtheria and Pseudomonas aeruginosa) are a provoking factor;
• Chlamydial - occurs due to the ingress of chlamydia on the mucous membrane;
• Viral - provoke herpes viruses, adenoviruses, etc.;
• Fungal - occurs as a manifestation of systemic infections (aspergillosis, candidiasis, actinomycosis, spirothrychillosis), or is provoked by pathogenic fungi;
• Allergic - occurs after the introduction into the body of an allergen or irritant to the mucous membrane of the eyes (dust, wool, lint, varnish, paint, acetone, etc.);
• Dystrophic - develops as a result of the damaging action of occupational hazards (chemicals, paint, varnish, gasoline vapors and other substances, gases).

Chlamydial conjunctivitis, as well as angular (angular), can be varieties of the bacterial form of the disease.

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

• Acute form;
• Chronic form.

Epidemic conjunctivitis (caused by Koch-Weeks bacillus) is a special case of an acute form of the disease.

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

• Purulent - purulent discharge is formed;
• Catarrhal - profuse mucus is formed, pus is absent;
• Papillary (appears as a manifestation of allergies) - seals in the form of small grains form on the mucous membrane of the upper eyelid;
• Follicular (develops according to type 1 of an allergic reaction) - follicles form on the mucous membrane of the eye;
• Hemorrhagic - hemorrhages form on the mucous membrane of the eye;
• Filmy - develops against the background of ARVI.

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

Content:

• Causes of conjunctivitis
• Symptoms of different types of conjunctivitis
• Conjunctivitis temperature
• General principles for the treatment of all types of conjunctivitis
• Treating conjunctivitis at home
• Drugs used for conjunctivitis
• Treatment of conjunctivitis with folk remedies
• What is the rehabilitation treatment for conjunctivitis?

Causes of conjunctivitis

Groups 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 named herpes virus;
   • Chlamydia;
   • Pathogenic fungi (aspergillus, candida, actinomycetes, spirotrihella);
   • Exposure to allergens (medicinal, atopic, seasonal forms of conjunctivitis, use of contact lenses);

2. Other factors (occupational hazards, chemicals, gases). The contact of provoking factors on the mucous membrane of the eye occurs by airborne droplets (viruses, allergens), ascending from the nasopharynx, middle ear, throat, and also by simply transferring them from dirty hands.

Symptoms of different types of conjunctivitis

Nonspecific symptoms inherent in all types of conjunctivitis:

• Redness of the eyelids and conjunctiva;
• Swelling of the eyelids and mucous membrane of the eye;
• Photophobia;
• Lachrymation;
• Feeling of a foreign body in the eye;
• Purulent, mucous or mucopurulent discharge.

If catarrh of the upper respiratory tract joins the conjunctivitis proceeding against the background of ARVI, symptoms such as hyperemia, headache, signs of intoxication (aching muscles and joints, weakness and fatigue) are possible.

Specific symptoms are inherent in various types of conjunctivitis and depend on the factors causing them. Knowing the main manifestations, you can make an approximate diagnosis without laboratory research.

Acute (epidemic) conjunctivitis

The full name of this form of mucosal inflammation is acute epidemic Koch-Weeks conjunctivitis. The cause of its occurrence is the Koch-Weeks wand. This fact gives reason to attribute it to the bacterial types of conjunctivitis. However, the rapid spread in the human population and the defeat of a large number of people at the same time allows it to be distinguished into a special form.

The area of distribution of acute conjunctivitis is the Caucasus, Asian countries. It practically does not occur in the northern regions; it manifests itself seasonally, more often in autumn and summer, in the form of epidemic outbreaks. Infection with the Koch-Weeks stick occurs by airborne droplets - through household contacts, dishes, household items, water, food.

The incubation period takes 1-2 days, followed by a rapid and acute manifestation of symptoms in both eyes at once. There is a strong swelling and redness of the mucous membrane of both eyelids, the eyeball, transitional folds. The lower eyelid is most severely affected, acquiring the shape of a roller. In a couple of days, punctate hemorrhages appear on the mucous membrane, pus and mucus begin to separate. The mucous membrane is not damaged, but thin brown films are formed on it, which are easily separated from the mucous membrane. The patient feels pain, a feeling of a foreign body in the eye, there is photophobia, lacrimation. The entire surface of the eyeball turns red.

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

Bacterial conjunctivitis

The reason for the appearance is the introduction of pathogenic bacteria into the mucous membrane of the eye. This form of conjunctivitis is always symptomatic. Regardless of the bacterium that triggered the inflammatory process, the primary symptoms are approximately the same - a cloudy, gray-yellow discharge suddenly appears on the mucous membrane, sticking together the eyelids in the morning. Additional symptoms are pain and pain, dryness of the mucous membrane and skin of the eyelids. Almost always one eye is affected, but if hygiene rules are not followed, the disease passes to the other.

The most common forms of bacterial conjunctivitis are:

• Staphylococcal conjunctivitis - severe swelling and redness of the eyelids, profuse purulent discharge that sticks together the eyelids after sleep, severe itching and burning. Additionally, there is a photophobia, a feeling of a foreign body under the eyelids. Both eyes are affected alternately. With antibiotic treatment, symptoms disappear within 3-5 days.
• Gonococcal conjunctivitis (gonoblenorrhea) - occurs in newborns during the passage through the birth canal of a mother with gonorrhea. Symptoms are rapidly developing dense swelling of the eyelids and mucous membranes. From under the eyelids, a stream of abundant purulent discharge of the color of "meat slops" is released. After a little time, its amount decreases, the discharge becomes liquid, acquires a greenish tint. All symptoms disappear after 2 months from the onset of infection. Treatment of gonoblenorrhea - therapy with local antibiotics, is used until the final recovery.
• Pneumococcal conjunctivitis is diagnosed in children. It starts abruptly in one eye, then moves on to the other. Symptoms are the discharge of a large amount of pus, photophobia, severe swelling of the eyelids, punctate hemorrhages. The films formed on the conjunctiva are easily removed and do not damage the mucous membrane of the eye.
• Pseudomonas aeruginosa - all symptoms are pronounced (a large amount of pus, pain, redness, edema, lacrimation, photophobia).
• Diphtheria conjunctivitis is a complication of diphtheria, manifested by the strongest compaction and swelling of the eyelids, due to which it is impossible to open the eyes. Detachable cloudy, bloody. There are dirty gray films on the mucous membrane that cannot be removed. After forcible removal, bleeding defects of the mucous membrane remain in their place. In the second week of the disease, the films easily go away on their own, the puffiness disappears, the amount of discharge increases. After 2 weeks, the disease ends with recovery, although it can become chronic. Possible complications are eyelid curvature, defects and scars of the conjunctiva.

Chlamydial conjunctivitis

The onset of the disease is acute, its main symptoms are severe photophobia, accompanied by rapid redness and swelling of the mucous membrane. During the night, the eyelids are glued together with a small amount of mucopurulent discharge. The lower eyelid is most affected. The disease begins in only one eye, but with poor hygiene it spreads to both eyes.

It occurs as a flash in swimming pools and saunas.

Viral conjunctivitis

The cause of infection is smallpox, measles, herpes viruses, adenovirus, atypical trachoma virus. Conjunctivitis provoked by adenoviruses and herpes viruses are very contagious, patients with such forms need isolation from others.

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

Forms of adenoviral conjunctiva:

• Catarrhal - inflammation and redness are insignificant, discharge is minimal.
• Filmy - thin films are formed on the surface of the mucous membrane, they can be easily removed, and can be tightly attached to the surface of the eyeball. In the thickness of the conjunctiva, seals and hemorrhages are formed, regenerating after recovery.
• Follicular - small bubbles form on the conjunctiva.

Additionally, the patient experiences a sore throat, hyperthermia is noted, which gives rise to the term "adenopharyngoconjunctival fever".

Learn More: Viral Conjunctivitis

Allergic conjunctivitis

Clinical forms of allergic conjunctivitis:

• Spring keratoconjunctivitis;
• Pollinosis conjunctivitis (allergy to pollen from flowering plants);
• Chronic conjunctivitis;
• Drug-induced conjunctivitis, as an allergy to drugs for the treatment of eye diseases;
• Allergic conjunctivitis caused by wearing contact lenses.

Symptoms are severe itching and burning of the eyelids and mucous membranes of the eyes, severe swelling and redness, lacrimation and photophobia. The diagnosis is made as a result of diagnosis and study of the history, this is important for the effectiveness of treatment.

Find out more: Allergic conjunctivitis: symptoms and treatment

Chronic conjunctivitis

It runs for a long time, is characterized by numerous complaints of a subjective nature. Symptoms - a feeling of "sand" in the eyes, itching, heaviness of the eyelids, soreness and fatigue when reading. Visually, during examination, slight redness of the conjunctiva, enlarged papillae, and scanty discharge are recorded.

The appearance of chronic conjunctivitis occurs when the mucous membrane of the eye is irritated with dust, smoke, gases. Most often, workers in chemical, textile, cement, brick, sawmills suffer from it. Another category of the risk group is patients with a history of gastrointestinal diseases, nasopharynx, anemia, vitamin deficiency. Treatment - elimination of the cause of eye inflammation, restoration of its functions.

Angular conjunctivitis

This form of conjunctivitis is called "corner", often becomes chronic. Its appearance is provoked by the Morax-Axenfeld bacterium. Symptoms are pain and itching in the corners of the eyes, which is most felt in the evening. The skin in the corners of the eyes turns red, becomes covered with cracks. A small amount of stringy mucus appears on the reddish mucous membrane of the eye. It accumulates in the corners of the eyes overnight, taking on the appearance of a dense lump. Timely diagnosis and treatment will quickly relieve the symptoms of the disease, otherwise it will turn into a chronic process.

Purulent conjunctivitis

Belongs to the bacterial types of conjunctivitis, the main symptom is a large amount of purulent discharge. The causative agents are gonococcus, pneumococcus, staphylococcus, Pseudomonas aeruginosa. Treatment always includes topical antibiotics.

Catarrhal conjunctivitis

It is observed in viral, allergic and chronic forms of the disease. Symptoms are moderate redness and swelling of the mucous membrane of the eyelids and the eyeball, mucopurulent discharge, slight photophobia. Hemorrhage, the appearance of follicles and films, and enlarged papillae are not diagnosed. The course of treatment is no more than 10 days, no complications arise.

Papillary conjunctivitis

The clinical form of allergic conjunctivitis has a long course. Symptoms - the mucous membrane of the eye becomes uneven and rough due to the increase in papillae on its surface, itching and burning, pain, scanty mucous discharge appear. A common reason for the appearance of this form is the wearing of contact lenses, eye prostheses, and the ingress of a foreign body into the eye.

Follicular conjunctivitis

Infiltrates appear on the mucous membrane of the eye in the form of papillae and follicles of gray-pink color. It is manifested by severe redness, slight swelling of the eyelids and conjunctiva. A characteristic symptom is blepharospasm (closing of the eyelids) and severe lacrimation.

A possible cause of the appearance is a viral or bacterial infection. The disease lasts in an active form for 2-3 weeks, in a subsiding form - another 1-3 weeks, in total from 2 to 3 months.

Conjunctivitis temperature

An increase in body temperature is not characteristic of conjunctivitis; this symptom practically does not occur among the symptoms of the disease. Hyperthermia can join the manifestations of this disease if the inflammation of the mucous membrane of the eye occurs against the background of acute respiratory viral infections, bronchitis, acute respiratory infections, laryngitis, sinusitis, pharyngitis.

General principles for the treatment of all types of conjunctivitis

The main thing in the treatment of all forms of the disease is to eliminate the cause of the appearance of negative symptoms of the inflammatory process. For this purpose, drug therapy is used.

Symptomatic treatment that eliminates the manifestations of conjunctivitis consists in the use of topical drugs. They are injected into the mucous membrane of the eyes.

Painful sensations that appear with the first signs of conjunctivitis are stopped by the administration of drops with local anesthetics (Lidocaine, Trimecaine, Pyromecaine). Hygienic treatment of the ciliary edge of the eyelids and the mucous membrane of the eye is carried out with antiseptic solutions (Furacillin, Dimexidum, Oxycyanate, potassium permanganate, brilliant green).

After removing pain and hygienic treatment of the eye, they begin to treat the cause of the disease, inject antibiotics, antihistamines, antiviral agents, sulfonamides into the eye. They are used depending on the factors that caused the disease. In the treatment of bacterial conjunctivitis, antibiotics are used, for viral conjunctivitis - antiviral agents (Florenal, Kerecid), for allergic ones - antihistamines (Diphenhydramine, Dibazol).

This algorithm is followed until all clinical symptoms of conjunctivitis disappear. All this time, it is prohibited to apply any bandages to the eyes, so as not to create favorable conditions for bacteria and other pathogenic microorganisms, not to cause relapses and complications.

Treating conjunctivitis at home

Viral conjunctivitis. For the treatment of adenoviral conjunctivitis, interferon preparations are used that have an antiviral effect (Laferon, Interferon). They are used in the form of instillations of a solution of the drug on the mucous membrane.

• The first 2-3 days - interferons, 6-8 rubles / day;
• Until the symptoms disappear completely - interferons at 4-5 rubles / day;
• Ointments with antiviral effect (bonafton, tebrofen, florenal) - 2-4 rubles / day;
• With severe inflammation of the mucous membrane - diclofenac 3-4 r. / Day;
• For the prevention of dry eye syndrome - tear substitutes Vidisik, Oftagel, Sistane.

Herpes is viral. The herpes virus is destroyed with interferon solutions prepared from the lyophilisate immediately before instillation into the eye. The first 2-3 days they are administered 6-8 times a day, then 4-5 times. Treatment continues until the disappearance of clinical symptoms. With severe inflammation, itching and burning, Diclofenac is administered. For the prevention of relapses or complications, a solution of silver nitrate or Pikloxidin is used 3-4 times a day.

Bacterial. For quick relief of inflammation, Diclofenac is instilled 2-4 times a day. Hygienic treatment of the eye is carried out with antiseptic solutions (Furacillin 1: 1000, 2% boric acid). The destruction of pathogenic bacteria is carried out with sulfonamides and antibiotics in the form of ointments and drops (Erythromycin, Tetracycline, Gentamicin ointment, Albucid drops, Ciprofloxacin, Ofloxacin). Initially, they are buried or laid 4-6 times a day, after 2-3 days - 2-3 times a day until the symptoms of the disease disappear. For the prevention of relapses, Piloxidine drops are used simultaneously 3 times a day.

Chlamydial. Treatment of conjunctivitis, provoked by protozoa microorganisms, is carried out with systemic drugs. Most often, it is Levofloxacin (1 tablet daily for 7 days).

At the same time, drugs with local antibiotics are used 4-5 times a day (drops of Lomefloxacin or Erythromycin ointment). They are used from 3 weeks to 3 months until the symptoms of conjunctivitis are completely relieved. Treatment of inflammation is carried out with Diclofenac 2 times a day for a long time. If it is ineffective, Dexamethasone is used with the same frequency. Prevention of dry eye syndrome is carried out with artificial tears (Oksial, Oftagel).

Purulent. With 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 inflammation, apply Gentamicin, Erythromycin or Tetracycline ointment, drops of Lomefloxacin 2-3 times a day until complete cure. Puffiness is stopped with Diclofenac.

Allergic. Treatment is carried out with topical antihistamines (Allergophthal, Spersallerg), as well as drugs that reduce mast cell degranulation. (Alomid 1%, Lekrolin 2%, Kuzikrom 4%). They have been used for a long time, injected 2 times a day. If these funds are ineffective, Maxidex, Diclofenac, Dexalox are additionally used. In the treatment of severe allergic conjunctivitis, eye drops with corticosteroids and antibiotics are used (Tobradex. Maxitrol).

Chronic. Treatment of this form of conjunctivitis will be successful if the cause of the disease is identified in a timely manner. Apply drops of 0.25-0.5% solution of zinc sulfate and 1% solution of resorcinol. Alternative drugs - administration of Protargol or Collargol solution 2-3 r. / Day, putting yellow mercury ointment into the eyes before going to bed.

Drugs used for conjunctivitis

The main dosage forms of drugs for the treatment of conjunctivitis are ointments and eye drops

Ointments for the treatment of conjunctivitis

Name	Brief instruction
	Contraindications: jaundice, liver failure, hypersensitivity to antibiotics from the macrolide group Side effects: itching, redness, allergies, candidiasis, tachycardia, tinnitus, gastrointestinal disturbances Dosage: 0.2-0.3 g 4-5 r / day
Tetracycline ointment	Contraindications: pregnancy, lactation, liver failure, mycoses, leukopenia, children under 8 years of age Side effects: gastrointestinal disturbances, itching, redness, Quincke's edema Dose: 0.2-0.4 g 3-5 times a day
Gentamicin ointment	Contraindications: viral and fungal eye lesions, increased intraocular pressure, corneal epitheliopathy, hypersensitivity Side effects: local allergic reaction, burning eyes Dosage: put a 1 cm strip in the eyelid cavity 2-3 times a day
Yellow mercury ointment	Contraindications: eczema, allergies Side effects: kidney damage, disorders of the central nervous system, skin irritation, gastrointestinal disturbances Dosage: once at night

Find out more: Conjunctivitis ointment

Drops for the treatment of conjunctivitis

Name	Brief instruction
	Contraindications: lactation, pregnancy, hypersensitivity Side effects: burning sensation, hyperemia of the mucous membrane Dosage: 2-6 times a day, 1 drop for 10 days
Albucid 20%	Contraindications: hypersensitivity to sulfonamides Side effects: burning sensation, hyperemia, mucosal edema, itching Dosage: 2-3 drops up to 6 times a day
Levomycetin drops	Contraindications: pregnancy, individual intolerance, neonatal period, psoriasis, eczema, mycoses, inhibition of hematopoiesis Side effects: allergies Dosage: 1 drop 3-4 r / day
Diclofenac	Contraindications: sensitivity to NSAIDs, 3rd trimester of pregnancy, children under 2 years of age, keratitis, bronchial asthma Side effects: burning, redness, swelling of the face, fever, erythema, nausea, vomiting, skin rash Dosage: 1 drop 3-4 times a day
Dexamethasone	Contraindications: trachoma, glaucoma, damage to the corneal epithelium, tuberculous, viral, fungal eye lesions Side effects: increased intraocular pressure, loss of visual fields, perforation of the cornea Dosage: 1-2 drops every 2-4 hours
Olopatadin	Contraindications: special sensitivity to drug components Side effects: burning, pain, conjunctival hyperemia, keratitis, iritis, swelling of the eyelids, headache, rhinitis, change in taste Dosage: 1 drop 2 times a day
Suprastin	Contraindications: lactation, pregnancy, children under 6 years of age, lactose intolerance, individual sensitivity Side effects: allergies, drowsiness, headache, migraine, asthenia Dosage: inside, 1 tablet 3-4 times a day, there are no eye drops with this name
Fenistil	Contraindications: lactation, 1 trimester of pregnancy, children under 1 month of age, prostatic hyperplasia, bronchial asthma, angle-closure glaucoma Side effects: anxiety, fatigue, drowsiness, gastrointestinal disorders Dosage: adults 3-6 mg / day in 3 divided doses, children - from 3-10 to 15-20 drops
Oxial	Contraindications: allergy to the components of the product Side effects: extremely rare allergic manifestations Dosage: as needed or 1-2 drops 4-5 times a day
Tobradex	Contraindications: mycoses, fungal eye diseases, conditions after removal of a foreign body, viral diseases of the cornea, hypersensitivity Side effects: itching and swelling of the eyelids, increased eye pressure, corneal ulcers Dosage: 1-2 drops every 4-6 hours

Find out more: Conjunctivitis drops

Treatment of conjunctivitis with folk remedies

Traditional medicine recipes can be used in the complex treatment of the disease. On the basis of folk remedies, solutions are prepared for washing and treating the eyes.

Effective folk recipes:

• Squeeze gruel from dill greens, passed through a meat grinder, with gauze. In the resulting juice, moisten a soft cotton cloth, apply on the eye for 15-20 minutes. Apply when the first signs of illness appear.
• A solution of honey and boiled water (in a ratio of 1: 2) is instilled into the eye several times a day;
• Broth from 2 tsp. rosehip berries and 200 ml of water, infused for 30 minutes, drain. Moisten a clean cloth or cotton pad, make applications on the eye for purulent conjunctivitis.
• Pour 200 ml of boiling water with 10 g of plantain seeds, crushed in a mortar, leave for 30 minutes, strain. Moisten a clean napkin in a solution, make lotions. Flush eyes as needed.
• Make lotions from 30 g of crushed dope leaves, infused in 200 ml of boiling water for 30 minutes.

What is the rehabilitation treatment for conjunctivitis?

The consequence of conjunctivitis can be visual impairment, provoked by damage to the mucous membrane. Timely treatment will help completely eliminate discomfort. To restore the structures of the eye and regenerate the mucous membrane in ophthalmology, reparants are used. The most effective of these is Solcoseryl gel, made from bovine plasma.

Solcoseryl acts at the cellular level, quickly restoring eye tissue, activating metabolism. After accelerated regeneration, visual functions are quickly restored, the mucous membrane of the eye returns to normal. The full course of rehabilitation treatment with Solcoseryl takes from one to three weeks.

Before using the drug, you should consult an ophthalmologist.

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The author of the article: Degtyareva Marina Vitalievna, ophthalmologist, ophthalmologist