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Conjunctivitis

Conjunctivitis is a broad diagnosis that deals with the Sclera or Conjunctiva (white part) of the eye. It is commonly caused by infection – mostly viral – but occasionally bacterial.

An Allergic Reaction may also be a cause. Pink Eye is a Viral Conjunctivitis

Learn more about Eye anatomy by clicking here.

Diagnosis

–  Initially is based on symptoms
–  Discharge present is evaluated based on color or amount
–  Evaluation of the eye itself
–  Schirmer test

Symptoms

–  Redness in the eye  (Hyperaemia)
–  Watering of the eye  (Epiphora)
–  Swelling of the Conjunctiva  (Chemosis)
–  Itching of the eye
–  Burning of the eye
–  Discharge from the eye
–  Closed eyelids in the morning
–  Light sensitivity

Classification of Different Types

1.)  Viral Conjunctivitis
2.)  Bacterial Conjunctivitis
3.)  Allergic Conjunctivitis
4.)  Chemical Conjunctivitis
5.)  Neonatal Conjunctivitis
6.)  Keratoconjunctivitis

1.) Viral Conjunctivitis

–  Often associated with Upper Respiratory Infections  (URI)
–  Can also be seen with sore throats and colds
–  Also called Pink Eye
–  Symptoms usually begin in one eye – it can move to the other eye.
–  Soft pinkness is seen in the sclera
–  Crusting around the eye can be seen
–  If discharge is seen — it is often clear

Treatment for Viral Conjunctivitis

–  Minimal evidence for povidone-iodine eyewashes
–  Most studies are from animal models
–  Eye drops
–  Avoid touching eyes
–  Wash hands
–  Usually will go away on its own

2.) Bacterial Conjunctivitis

–  Very rapid onset of symptoms
–  Typically symptoms start in one eye.
–  The infection can move to the second eye.
–  The swelling of eyelid and discharge can be seen.
–  If discharge becomes pus-like it is called Pyogenic
–  This can cause the lids to stick together after sleep.
–  Crusting around the eye can be seen
–  Discharge is not essential for diagnosis

Bacteria involved

1.)  Staphylococci
2.)  Streptococci
3.)  Chlamydia trachomatis
4.)  Moraxella
5.)  Neisseria gonorrhoeae
6.)  Corynebacterium diphtheriae

Treatment for Bacterial Conjunctivitis

–  Sometimes symptoms will resolve on own
–  Eye drops – Antibiotics
–  Some cases – oral antibiotics can be given
–  If from an STD – a one-time injection could be given.

3.) Allergic Conjunctivitis

–  Symptoms often begin after the introduction of an allergic trigger
–  Could be pet dander, cats, dogs or other animals
–  Can be dust – resulting in an allergic response
–  Pollen is a very likely source
–  Eyes become very itchy, followed by redness, and drainage.
–  Crusting can be seen

Treatment for Allergic

–  Artificial tears
–  Non-steroidal anti-inflammatory
–  Antihistamines
–  Steroid eye drops

4.) Chemical Conjunctivitis

–  Symptoms begin following an eye injury
–  Often substances that are acidic or alkali have gotten into the eye
–  Other foreign substances like dust, sand, metal, or other irritants can cause a change in symptoms
–  Alkalis are typically worse than Acidic burns
–  Mild burns can cause some irritation
–  Serious burns can lead to a change in cornea color and scarring

Treatment

–  Wash the eye thoroughly
–  Use Ringer’s Lactate or Saline solution
–  Often this is a medical emergency and should be seen by a medical provider
–  The eye doctor may be contacted

5.) Neonatal Conjunctivitis

–  This eye infection is given to the newborn as they pass through the vaginal canal
–  Can be caused by bacteria Chlamydia trachomatis
–  Often can be self-healing.
–  Pyogenic drainage can be seen
–  Often some redness can be seen in one or both eyes.

Treatment for Neonatal Conjunctivitis

–  Usually will go away on its own
–  Eye drops can be given

6.) Keratoconjunctivitis

–  This is inflammation that affects the cornea and conjunctiva
–  When only the Cornea is involved – called Keratitis
–  When only the Conjunctiva is involved – called Conjunctivitis
–  When both are involved – called Keratoconjunctivitis
–  Causes could be viral, dryness, trauma, ultraviolet, allergies, and others.

Treatment of Keratoconjunctivitis

–  Largely depends on the cause
–  Eye drops are often used
–  Sometimes, routine visit with Eye Doctor is recommended.

Prevention of Conjunctivitis

1.)  Good Hygiene

2.)  Avoid rubbing eyes

3.)  If contaminated – avoid contacting door nobs, glasses, utensils, and other objects.

4.)  Wash hand regularly

5.)  Vaccinations can help

6.)  Wear glasses or eye protectors when working in areas known for irritants

7.)  Remove contact lenses if you become infected.

8.)  Wash your bed linens, pillowcases, towels and such routinely.

9.)  Avoid sharing make-up

10.)  Avoid sharing contacts

11.)  Do not use someone else’s eye drops