Search Suggest

CONJUNCTIVITIS - Disease Management

Conjunctivitis describes the inflammatory process that involves the conjunctiva; most causes of conjunctivitis are benign. Cellular infiltration and exudation characterize conjunctivitis on a cellular level. Classification is based on the underlying cause, as visual conjunctivitis, bacterial, fungal.

CAUSES

Bacterial

  • Staphylococcus aureus
  • Streptococcus pneumonia
  • Haemophilus influenzae
  • N. gonorrhoeae
  • Neisseria meningitidis
  • .Rarely Streptococcus sp., Pseudomonas, Branhamella catarrhalis, Coliforms, Klebsiella, Proteus, Corynebacterium diphtheriae, Mycobacterium tuberculosis, Treponema pallidum.

Viral

  • Adenoviruses types 3, 4, 7, 8, 11 and 19
  • Herpes simplex, Herpes zoster
  • Enterovirus type 70
  • Coxsackievirus type A24 and A28
  • Molluscum contagiosum
  • Varicella
  • Measles virus

Chlamydial

  • Chlamydia trachomatis (trachoma)
  • Chlamydia oculogenitalis (inclusion conjunctivitis)
  • Chlamydia lymphogranulomatis (lymphogranu-loma venereum)

Allergic

  • Rhinoconjunetivitie (hay fever) humoral
  • Vemal conjunctivitis
  • Giant papillary conjunctivitis
  • Autoimmune

Chemicals or irritants

  • Topical medication
  • Home/industrial chemicals
  • Wind, smoke, ultraviolet light

Other

  • Rickettsial, fungal, parasitic, tuberculosis, syphilis, Kawasaki disease
  • Thyroid disease, gout, carcinoid, sarcoidosis, psoriasis, Stevens-Johnsons syndrome, Ligneous conjunctivitis, Reiter's syndrome.

Signs and Symptoms

  • Bacterial conjunctivitis-acute onset, minimal pain, occasional pruritus, and sometimes, exposure history
  • Ocular surface diseases predispose the patient to bacterial conjunctivitis.
  • Viral conjunctivitis- acute or subacute onset, minimal pain level, and often, exposure history
  • Severe photophobia and foreign-body sensation
  • Chlamydial conjunctivitis chronic onset, minimal pain level, occasional pruritus, and STD history
  • Allergic conjunctivitis -acute or subacute onset, no pain, and no exposure history
  • Pruritus
  • Shield corneal ulcers.
  • Giant papillary conjunctivitis resembles vernal disease; excessive pruritus, mucous production, and increasing intolerance to contact

General

  • Increased tearing
  • Pain, redness and itching of the eyes
  • Gritty feeling in the eyes, blurred vision
  • Sensitivity to light
  • Crusts that form on the eyelid overnight

Risk Factors

  • Trauma
  • Chemicals and foreign body

DIAGNOSIS

Differential Diagnosis

  • Glaucoma, Acute Angle-Closure
  • Herpes Zoster, Herpes Zoster Ophthalmicus
  • Iritis and Uveitis
  • Scleritis

Investigations

  • Gram stain
  • Giemsa staining
  • Immunofluorescent antibody test

TREATMENT

Pharmacological Treatment

Classes of drugs used are:

  • Antibiotics:-Tetracyclines,Cephalosporins,Macrolides
  • Mast cell stabilizers
  • Decongestants
  • Nonsteroidal anti-inflammatory agents (NSAIDs)

PATIENT EDUCATION

Good hygiene can help prevent the spread of conjunctivitis:

  • Keep your hands away from the eye.
  • Wash hands frequently.
  • Change pillowcases frequently.
  • Replace eye cosmetics regularly.
  • Do not share eye cosmetics, towels or handkerchiefs.
  • Proper use and care of contact lenses.

Complications

  • Pneumonia
  • Conjunctival scarring
  • Penetration of the cornea can occur within 2 days in
  • patients with untreated N gonorrhea
  • Meningitis.

Prognosis

  • The prognosis is good. Conjunctivitis typically is self-
  • I limited and without long-term complications.

Post a Comment

if you have any doudts.please let me know