Conjunctivitis
Encyclopedia
Conjunctivitis refers to inflammation
of the conjunctiva
(the outermost layer of the eye
and the inner surface of the eyelid
s). It is most commonly due to an infection
(usually viral
, but sometimes bacterial) or an allergic reaction.
(inflammation of the eyelid
s).
Keratoconjunctivitis
is the combination of conjunctivitis and keratitis
(cornea
l inflammation).
Episcleritis is an inflammatory
condition that produces a similar appearance to conjunctivitis, but without discharge or tearing.
Red eye
(hyperaemia
), irritation (chemosis
) and watering (epiphora
) of the eyes are symptoms common to all forms of conjunctivitis. However, the pupils should be normally reactive and the visual acuity
normal.
, a common cold
, and/or a sore throat
. Its symptoms include watery discharge and variable itch. The infection usually begins with one eye, but may spread easily to the other.
Viral conjunctivitis, commonly known as "pink eye", shows a fine, diffuse pinkness of the conjunctiva, which is easily mistaken for the ciliary injection of iritis
, but there are usually corroborative signs on microscopy
, particularly numerous lymphoid follicles on the tarsal conjunctiva, and sometimes a punctate keratitis.
that may cause the lids to stick together, especially after sleep. Another symptom that could be caused by bacterial conjunctivitis is severe crusting of the infected eye and the surrounding skin. However, contrary to popular belief, discharge is not essential to the diagnosis. Bacteria such as Chlamydia trachomatis
or Moraxella
can cause a non-exudative but persistent conjunctivitis without much redness. The gritty and/or scratchy feeling is sometimes localized enough for patients to insist they must have a foreign body in the eye. The more acute pyogenic infections can be painful. Like viral conjunctivitis, it usually affects only one eye but may spread easily to the other eye. Corynebacterium diphtheriae
causes membrane formation in conjunctiva of non immunized children.
substance getting in the eye. Alkalis are typically worse than acidic burns. Mild burns will produce conjunctivitis while more severe burns may cause the cornea
to turn white. Litmus paper is an easy way to rule out the diagnosis by verifying that the pH
is within the normal range of 7.0—7.2. Large volumes of irrigation is the treatment of choice and should continue until the pH is 6—8. Local anaesthetic eye drops can be used to decrease the pain.
Irritant or toxic conjunctivitis show primarily marked redness. If due to splash injury, it is often present only in the lower conjunctival sac. With some chemicals, above all with caustic alkalis such as sodium hydroxide, there may be necrosis of the conjunctiva with a deceptively white eye due to vascular closure, followed by sloughing of the dead epithelium. This is likely to be associated with slit-lamp evidence of anterior uveitis
.
, and may lead to acute, purulent conjunctivitis. However, it is usually self-healing.
Conjunctivitis is identified by irritation and redness of the conjunctiva. Except in obvious pyogenic or toxic/chemical conjunctivitis, a slit lamp
(biomicroscope) is needed to have any confidence in the diagnosis. Examination of the tarsal conjunctiva is usually more diagnostic than the bulbar conjunctiva.
for its occurrence. Both bacterial and viral infections are contagious. Commonly, conjunctival infections are passed from person-to-person, but can also spread through contaminated objects
or water
.
The most common cause of viral conjunctivitis is adenoviruses . Herpetic keratoconjunctivitis (caused by herpes simplex
viruses) can be serious and requires treatment with acyclovir. Acute hemorrhagic conjunctivitis is a highly contagious disease caused by one of two enterovirus
es, Enterovirus 70 and Coxsackievirus
A24. These were first identified in an outbreak in Ghana
in 1969, and have spread worldwide since then, causing several epidemics.
Swabs for bacterial culture are necessary if the history and signs suggest bacterial conjunctivitis, but there is no response to topical antibiotic
s. Research studies indicate many bacteria implicated in low-grade conjunctivitis are not detected by the usual culture methods of medical microbiology labs, so false negative results are common. Viral culture may be appropriate in epidemic case clusters. Conjunctival scrapes for cytology
can be useful in detecting chlamydial and fungal infections, allergy
and dysplasia
, but are rarely done because of the cost and the general lack of laboratory staff experienced in handling ocular specimens. Conjunctival incisional biopsy
is occasionally done when granulomatous diseases (e.g., sarcoidosis
) or dysplasia
are suspected.
A purulent discharge (a whitish-yellow, yellow or yellow-brown substance, more commonly known as pus) suggests a bacterial infection. It can also be caused by bacteria from feces, pet hair, or by smoke or other fumes. Infection with Neisseria gonorrhoeae
should be suspected if the discharge is particularly thick and copious.
Itching (rubbing eyes) is the hallmark symptom of allergic conjunctivitis. Other symptoms include history of eczema, or asthma.
A diffuse, less "injected" conjunctivitis (looking pink rather than red) suggests a viral cause, especially if numerous follicles are present on the lower tarsal conjunctiva on biomicroscopy.
Scarring of the tarsal conjunctiva suggests trachoma
, especially if seen in endemic areas, if the scarring is linear (von Arlt's line
), or if there is also corneal vascularisation.
Clinical tests for lagophthalmos
, dry eye (Schirmer test) and unstable tear film may help distinguish the various types of conjunctivitis.
Other symptoms, including pain, blurring of vision and photophobia
, should not be prominent in conjunctivitis. Fluctuating blurring is common, due to tearing and mucoid discharge. Mild photophobia is common. However, if any of these symptoms are prominent, it is important to exclude other diseases such as glaucoma
, uveitis
, keratitis
and even meningitis
or caroticocavernous fistula.
Many people with conjunctivitis have trouble opening their eyes in the morning because of the dried mucus on their eyelids. There is often excess mucus over the eye after sleeping for an extended period.
, haemophilus influenzae
, and neisseria meningiditis
is also effective.
s may be prescribed. Persistent allergic conjunctivitis may also require topical steroid drops.
. Chemical injuries (particularly alkali burns) are medical emergencies, as they can lead to severe scarring, and intraocular damage. People with chemically-induced conjunctivitis should not touch their eyes, regardless of whether or not their hands are clean, as they run the risk of spreading the condition to another eye.
Inflammation
Inflammation is part of the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Inflammation is a protective attempt by the organism to remove the injurious stimuli and to initiate the healing process...
of the conjunctiva
Conjunctiva
The conjunctiva covers the sclera and lines the inside of the eyelids. It is composed of rare stratified columnar epithelium.-Function:...
(the outermost layer of the eye
Human eye
The human eye is an organ which reacts to light for several purposes. As a conscious sense organ, the eye allows vision. Rod and cone cells in the retina allow conscious light perception and vision including color differentiation and the perception of depth...
and the inner surface of the eyelid
Eyelid
An eyelid is a thin fold of skin that covers and protects an eye. With the exception of the prepuce and the labia minora, it has the thinnest skin of the whole body. The levator palpebrae superioris muscle retracts the eyelid to "open" the eye. This can be either voluntarily or involuntarily...
s). It is most commonly due to an infection
Infection
An infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...
(usually viral
Virus
A virus is a small infectious agent that can replicate only inside the living cells of organisms. Viruses infect all types of organisms, from animals and plants to bacteria and archaea...
, but sometimes bacterial) or an allergic reaction.
By cause
- Allergic conjunctivitisAllergic conjunctivitisAllergic conjunctivitis is inflammation of the conjunctiva due to allergy. Although allergens differ between patients, the most common cause is hay fever. Symptoms consist of redness , oedema of the conjunctiva, itching and increased lacrimation...
- Bacterial conjunctivitis
- Viral conjunctivitis
- Chemical conjunctivitis
- Neonatal conjunctivitis is often defined separately due to different organisms
By extent of involvement
Blepharoconjunctivitis is the dual combination of conjunctivitis with blepharitisBlepharitis
Blepharitis is an ocular condition characterized by chronic inflammation of the eyelid, the severity and time course of which can vary. Onset can be acute, resolving without treatment within 2–4 weeks , but more generally is a long standing inflammation varying in severity...
(inflammation of the eyelid
Eyelid
An eyelid is a thin fold of skin that covers and protects an eye. With the exception of the prepuce and the labia minora, it has the thinnest skin of the whole body. The levator palpebrae superioris muscle retracts the eyelid to "open" the eye. This can be either voluntarily or involuntarily...
s).
Keratoconjunctivitis
Keratoconjunctivitis
Keratoconjunctivitis is inflammation of the cornea and conjunctiva.When only the cornea is inflamed, it is called keratitis; when only the conjunctiva is inflamed, it is called conjunctivitis....
is the combination of conjunctivitis and keratitis
Keratitis
Keratitis is a condition in which the eye's cornea, the front part of the eye, becomes inflamed. The condition is often marked by moderate to intense pain and usually involves impaired eyesight.-Types:...
(cornea
Cornea
The cornea is the transparent front part of the eye that covers the iris, pupil, and anterior chamber. Together with the lens, the cornea refracts light, with the cornea accounting for approximately two-thirds of the eye's total optical power. In humans, the refractive power of the cornea is...
l inflammation).
Episcleritis is an inflammatory
Inflammation
Inflammation is part of the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Inflammation is a protective attempt by the organism to remove the injurious stimuli and to initiate the healing process...
condition that produces a similar appearance to conjunctivitis, but without discharge or tearing.
Signs and symptoms
Red eye (medicine)
In medicine, red eye is a non-specific term to describe an eye that appears red due to illness, injury, or some other condition. Conjunctivitis and subconjunctival hemorrhage are two forms of a red eye....
(hyperaemia
Hyperaemia
Hyperaemia or hyperemia describes the increase of blood flow to different tissues in the body. It can have medical implications, but is also a regulatory response, allowing change in blood supply to different tissues through vasodilation. Clinically, hyperaemia in tissues manifest as erythema,...
), irritation (chemosis
Chemosis
Chemosis is the swelling of the conjunctiva. In general, chemosis is a nonspecific sign of eye irritation. The outer surface covering appears to have fluid in it. Often, the eye area swells so much that the eyes become difficult or impossible to close fully. It is usually caused by allergies or...
) and watering (epiphora
Epiphora (medical)
Epiphora is overflow of tears onto the face. A clinical sign or condition that constitutes insufficient tear film drainage from the eyes in that tears will drain down the face rather than through the nasolacrimal system.-Etiology:...
) of the eyes are symptoms common to all forms of conjunctivitis. However, the pupils should be normally reactive and the visual acuity
Visual acuity
Visual acuity is acuteness or clearness of vision, which is dependent on the sharpness of the retinal focus within the eye and the sensitivity of the interpretative faculty of the brain....
normal.
Viral
Viral conjunctivitis is often associated with an infection of the upper respiratory tractRespiratory tract
In humans the respiratory tract is the part of the anatomy involved with the process of respiration.The respiratory tract is divided into 3 segments:*Upper respiratory tract: nose and nasal passages, paranasal sinuses, and throat or pharynx...
, a common cold
Common cold
The common cold is a viral infectious disease of the upper respiratory system, caused primarily by rhinoviruses and coronaviruses. Common symptoms include a cough, sore throat, runny nose, and fever...
, and/or a sore throat
Sore throat
A sore throat or throat pain is a common physical symptom usually caused by acute pharyngitis, or throat inflammation, though it also occurs in a number of other situations, such as post trauma and in diphtheria. It can cause mild to extreme pain....
. Its symptoms include watery discharge and variable itch. The infection usually begins with one eye, but may spread easily to the other.
Viral conjunctivitis, commonly known as "pink eye", shows a fine, diffuse pinkness of the conjunctiva, which is easily mistaken for the ciliary injection of iritis
Iritis
Iritis is a form of anterior uveitis and refers to the inflammation of the iris of the eye.-Types:There are two main types of iritis: acute and chronic. They differ in numerous ways....
, but there are usually corroborative signs on microscopy
Microscopy
Microscopy is the technical field of using microscopes to view samples and objects that cannot be seen with the unaided eye...
, particularly numerous lymphoid follicles on the tarsal conjunctiva, and sometimes a punctate keratitis.
Bacterial
Bacterial conjunctivitis due to common pyogenic (pus-producing) bacteria causes marked grittiness/irritation and a stringy, opaque, greyish or yellowish mucopurulent dischargeMucopurulent discharge
Mucopurulent discharge is the emission or secretion of fluid containing mucus and pus from the eye, nose, cervix, vagina or other part of the body due to infection and inflammation....
that may cause the lids to stick together, especially after sleep. Another symptom that could be caused by bacterial conjunctivitis is severe crusting of the infected eye and the surrounding skin. However, contrary to popular belief, discharge is not essential to the diagnosis. Bacteria such as Chlamydia trachomatis
Chlamydia trachomatis
Chlamydia trachomatis, an obligate intracellular human pathogen, is one of three bacterial species in the genus Chlamydia. C. trachomatis is a Gram-negative bacteria, therefore its cell wall components retain the counter-stain safranin and appear pink under a light microscope.The inclusion bodies...
or Moraxella
Moraxella
Moraxella is a genus of Gram-negative bacteria in the Moraxellaceae family. It is named after the Swiss ophthalmologist Victor Morax. The organisms are short rods, coccobacilli or, as in the case of Moraxella catarrhalis, diplococci in morphology, with asaccharolytic, oxidase-positive and...
can cause a non-exudative but persistent conjunctivitis without much redness. The gritty and/or scratchy feeling is sometimes localized enough for patients to insist they must have a foreign body in the eye. The more acute pyogenic infections can be painful. Like viral conjunctivitis, it usually affects only one eye but may spread easily to the other eye. Corynebacterium diphtheriae
Corynebacterium diphtheriae
Corynebacterium diphtheriae is a pathogenic bacterium that causes diphtheria. It is also known as the Klebs-Löffler bacillus, because it was discovered in 1884 by German bacteriologists Edwin Klebs and Friedrich Löffler .-Classification:Four subspecies are recognized: C. diphtheriae mitis, C....
causes membrane formation in conjunctiva of non immunized children.
Chemical
Chemical eye injury is due to either an acidic or alkaliAlkali
In chemistry, an alkali is a basic, ionic salt of an alkali metal or alkaline earth metal element. Some authors also define an alkali as a base that dissolves in water. A solution of a soluble base has a pH greater than 7. The adjective alkaline is commonly used in English as a synonym for base,...
substance getting in the eye. Alkalis are typically worse than acidic burns. Mild burns will produce conjunctivitis while more severe burns may cause the cornea
Cornea
The cornea is the transparent front part of the eye that covers the iris, pupil, and anterior chamber. Together with the lens, the cornea refracts light, with the cornea accounting for approximately two-thirds of the eye's total optical power. In humans, the refractive power of the cornea is...
to turn white. Litmus paper is an easy way to rule out the diagnosis by verifying that the pH
PH
In chemistry, pH is a measure of the acidity or basicity of an aqueous solution. Pure water is said to be neutral, with a pH close to 7.0 at . Solutions with a pH less than 7 are said to be acidic and solutions with a pH greater than 7 are basic or alkaline...
is within the normal range of 7.0—7.2. Large volumes of irrigation is the treatment of choice and should continue until the pH is 6—8. Local anaesthetic eye drops can be used to decrease the pain.
Irritant or toxic conjunctivitis show primarily marked redness. If due to splash injury, it is often present only in the lower conjunctival sac. With some chemicals, above all with caustic alkalis such as sodium hydroxide, there may be necrosis of the conjunctiva with a deceptively white eye due to vascular closure, followed by sloughing of the dead epithelium. This is likely to be associated with slit-lamp evidence of anterior uveitis
Iritis
Iritis is a form of anterior uveitis and refers to the inflammation of the iris of the eye.-Types:There are two main types of iritis: acute and chronic. They differ in numerous ways....
.
Other
Inclusion conjunctivitis of the newborn (ICN) is a conjunctivitis that may be caused by the bacteria Chlamydia trachomatisChlamydia trachomatis
Chlamydia trachomatis, an obligate intracellular human pathogen, is one of three bacterial species in the genus Chlamydia. C. trachomatis is a Gram-negative bacteria, therefore its cell wall components retain the counter-stain safranin and appear pink under a light microscope.The inclusion bodies...
, and may lead to acute, purulent conjunctivitis. However, it is usually self-healing.
Conjunctivitis is identified by irritation and redness of the conjunctiva. Except in obvious pyogenic or toxic/chemical conjunctivitis, a slit lamp
Slit lamp
The slit lamp is an instrument consisting of a high-intensity light source that can be focused to shine a thin sheet of light into the eye. It is used in conjunction with a biomicroscope...
(biomicroscope) is needed to have any confidence in the diagnosis. Examination of the tarsal conjunctiva is usually more diagnostic than the bulbar conjunctiva.
Causes
Conjunctivitis is most commonly caused by viral infection, but bacterial infections, allergies, other irritants and dryness are also common etiologiesEtiology
Etiology is the study of causation, or origination. The word is derived from the Greek , aitiologia, "giving a reason for" ....
for its occurrence. Both bacterial and viral infections are contagious. Commonly, conjunctival infections are passed from person-to-person, but can also spread through contaminated objects
Fomite
A fomite is any inanimate object or substance capable of carrying infectious organisms and hence transferring them from one individual to another. A fomite can be anything...
or water
Waterborne diseases
Waterborne diseases are caused by pathogenic microorganisms which are directly transmitted when contaminated fresh water is consumed. Contaminated fresh water, used in the preparation of food, can be the source of foodborne disease through consumption of the same microorganisms...
.
The most common cause of viral conjunctivitis is adenoviruses . Herpetic keratoconjunctivitis (caused by herpes simplex
Herpes simplex
Herpes simplex is a viral disease caused by both Herpes simplex virus type 1 and type 2 . Infection with the herpes virus is categorized into one of several distinct disorders based on the site of infection. Oral herpes, the visible symptoms of which are colloquially called cold sores or fever...
viruses) can be serious and requires treatment with acyclovir. Acute hemorrhagic conjunctivitis is a highly contagious disease caused by one of two enterovirus
Enterovirus
Enteroviruses are a genus of ssRNA viruses associated with several human and mammalian diseases. Serologic studies have distinguished 66 human enterovirus serotypes on the basis of antibody neutralization tests. Additional antigenic variants have been defined within several of the serotypes on the...
es, Enterovirus 70 and Coxsackievirus
Coxsackievirus
Coxsackievirus is a virus that belongs to a family of non enveloped linear positive-sense ssRNA viruses, Picornaviridae and the genus Enterovirus, which also includes poliovirus and echovirus. Enteroviruses are among the most common and important human pathogens and ordinarily its members are...
A24. These were first identified in an outbreak in Ghana
Ghana
Ghana , officially the Republic of Ghana, is a country located in West Africa. It is bordered by Côte d'Ivoire to the west, Burkina Faso to the north, Togo to the east, and the Gulf of Guinea to the south...
in 1969, and have spread worldwide since then, causing several epidemics.
Diagnosis
Cultures are done infrequently because most cases of conjunctivitis are treated empirically and (eventually) successfully, but often only after running the gamut of the common possibilities.Swabs for bacterial culture are necessary if the history and signs suggest bacterial conjunctivitis, but there is no response to topical antibiotic
Antibiotic
An antibacterial is a compound or substance that kills or slows down the growth of bacteria.The term is often used synonymously with the term antibiotic; today, however, with increased knowledge of the causative agents of various infectious diseases, antibiotic has come to denote a broader range of...
s. Research studies indicate many bacteria implicated in low-grade conjunctivitis are not detected by the usual culture methods of medical microbiology labs, so false negative results are common. Viral culture may be appropriate in epidemic case clusters. Conjunctival scrapes for cytology
Cytology
Cytology means "the study of cells".Cytology is that branch of life science, which deals with the study of cells in terms of structure, function and chemistry.Based on usage it can refer to:...
can be useful in detecting chlamydial and fungal infections, allergy
Allergy
An Allergy is a hypersensitivity disorder of the immune system. Allergic reactions occur when a person's immune system reacts to normally harmless substances in the environment. A substance that causes a reaction is called an allergen. These reactions are acquired, predictable, and rapid...
and dysplasia
Dysplasia
Dysplasia , is a term used in pathology to refer to an abnormality of development. This generally consists of an expansion of immature cells, with a corresponding decrease in the number and location of mature cells. Dysplasia is often indicative of an early neoplastic process...
, but are rarely done because of the cost and the general lack of laboratory staff experienced in handling ocular specimens. Conjunctival incisional biopsy
Biopsy
A biopsy is a medical test involving sampling of cells or tissues for examination. It is the medical removal of tissue from a living subject to determine the presence or extent of a disease. The tissue is generally examined under a microscope by a pathologist, and can also be analyzed chemically...
is occasionally done when granulomatous diseases (e.g., sarcoidosis
Sarcoidosis
Sarcoidosis , also called sarcoid, Besnier-Boeck disease or Besnier-Boeck-Schaumann disease, is a disease in which abnormal collections of chronic inflammatory cells form as nodules in multiple organs. The cause of sarcoidosis is unknown...
) or dysplasia
Dysplasia
Dysplasia , is a term used in pathology to refer to an abnormality of development. This generally consists of an expansion of immature cells, with a corresponding decrease in the number and location of mature cells. Dysplasia is often indicative of an early neoplastic process...
are suspected.
Differential diagnosis
Conjunctivitis is a relatively nonspecific symptom. Even after biomicroscopy, laboratory tests are often necessary if proof of etiology is needed.A purulent discharge (a whitish-yellow, yellow or yellow-brown substance, more commonly known as pus) suggests a bacterial infection. It can also be caused by bacteria from feces, pet hair, or by smoke or other fumes. Infection with Neisseria gonorrhoeae
Neisseria gonorrhoeae
Neisseria gonorrhoeae, also known as gonococci , or gonococcus , is a species of Gram-negative coffee bean-shaped diplococci bacteria responsible for the sexually transmitted infection gonorrhea.N...
should be suspected if the discharge is particularly thick and copious.
Itching (rubbing eyes) is the hallmark symptom of allergic conjunctivitis. Other symptoms include history of eczema, or asthma.
A diffuse, less "injected" conjunctivitis (looking pink rather than red) suggests a viral cause, especially if numerous follicles are present on the lower tarsal conjunctiva on biomicroscopy.
Scarring of the tarsal conjunctiva suggests trachoma
Trachoma
Trachoma is an infectious disease causing a characteristic roughening of the inner surface of the eyelids. Also called granular conjunctivitis and Egyptian ophthalmia, it is the leading cause of infectious blindness in the world...
, especially if seen in endemic areas, if the scarring is linear (von Arlt's line
Carl Ferdinand von Arlt
Carl Ferdinand Ritter von Arlt was an Austrian ophthalmologist who was born in Ober-Graupen, a village near Teplitz in Bohemia. He earned his doctorate in Prague in 1839, and later became a professor of ophthalmology in Prague and Vienna...
), or if there is also corneal vascularisation.
Clinical tests for lagophthalmos
Lagophthalmos
Lagophthalmos is defined as the inability to close the eyelids completely.Blinking covers the eye with a thin layer of tear fluid, thereby promoting a moist environment necessary for the cells of the exterior part of the eye. The tears also flush out foreign bodies and wash them away. This is...
, dry eye (Schirmer test) and unstable tear film may help distinguish the various types of conjunctivitis.
Other symptoms, including pain, blurring of vision and photophobia
Photophobia
Photophobia is a symptom of abnormal intolerance to visual perception of light. As a medical symptom photophobia is not a morbid fear or phobia, but an experience of discomfort or pain to the eyes due to light exposure or by presence of actual physical photosensitivity of the eyes, though the term...
, should not be prominent in conjunctivitis. Fluctuating blurring is common, due to tearing and mucoid discharge. Mild photophobia is common. However, if any of these symptoms are prominent, it is important to exclude other diseases such as glaucoma
Glaucoma
Glaucoma is an eye disorder in which the optic nerve suffers damage, permanently damaging vision in the affected eye and progressing to complete blindness if untreated. It is often, but not always, associated with increased pressure of the fluid in the eye...
, uveitis
Uveitis
Uveitis specifically refers to inflammation of the middle layer of the eye, termed the "uvea" but in common usage may refer to any inflammatory process involving the interior of the eye....
, keratitis
Keratitis
Keratitis is a condition in which the eye's cornea, the front part of the eye, becomes inflamed. The condition is often marked by moderate to intense pain and usually involves impaired eyesight.-Types:...
and even meningitis
Meningitis
Meningitis is inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges. The inflammation may be caused by infection with viruses, bacteria, or other microorganisms, and less commonly by certain drugs...
or caroticocavernous fistula.
Many people with conjunctivitis have trouble opening their eyes in the morning because of the dried mucus on their eyelids. There is often excess mucus over the eye after sleeping for an extended period.
Prevention
The best effective prevention is hygiene and not rubbing the eyes by infected hands. Vaccination against adenovirusAdenovirus vaccine
An adenovirus vaccine is a vaccine against Adenovirus.It was used by the United States military from 1971 to 1999, but was discontinued when the only manufacturer stopped production. This vaccine elicited immunity to serotypes 4 and 7. On March 16, 2011, the U.S. Food and Drug Administration...
, haemophilus influenzae
Hib vaccine
Haemophilus influenzae type B vaccine is a conjugate vaccine developed for the prevention of invasive disease caused by Haemophilus influenzae type b bacteria. The Centers for Disease Control and Prevention has recommended the use of the Hib vaccine. Due to routine use of the Hib vaccine in...
, and neisseria meningiditis
Meningococcal vaccine
Meningococcal vaccine is a vaccine used against Meningococcus, a bacterium that causes meningitis, meningococcemia, septicemia, and rarely carditis, septic arthritis, or pneumonia.-Types:...
is also effective.
Management
Conjunctivitis resolves in 65% of cases without treatment, within two to five days. The prescribing of antibiotics to most cases is not necessary.Allergic
For the allergic type, cool water poured over the face with the head inclined downward constricts capillaries, and artificial tears sometimes relieve discomfort in mild cases. In more severe cases, nonsteroidal anti-inflammatory medications and antihistamineAntihistamine
An H1 antagonist is a histamine antagonist of the H1 receptor that serves to reduce or eliminate effects mediated by histamine, an endogenous chemical mediator released during allergic reactions...
s may be prescribed. Persistent allergic conjunctivitis may also require topical steroid drops.
Bacterial
Bacterial conjunctivitis usually resolves without treatment. Antibiotics, eye drops, or ointment are thus only needed if no improvement is observed after three days. In patients receiving no antibiotics, recovery was in 4.8 days, with immediate antibiotics it was 3.3 days, and with delayed antibiotics 3.9 days. No serious effects were noted either with or without treatment.Viral
Although there is no specific treatment for viral conjunctivitis, symptomatic relief may be achieved with cold compresses and artificial tears. People are often advised to avoid touching their eyes or sharing towels and washcloths.Chemical
Conjunctivitis due to chemicals is treated via irrigation with Ringer's lactate or saline solutionSaline (medicine)
In medicine, saline is a general term referring to a sterile solution of sodium chloride in water but is only sterile when it is to be placed intravenously, otherwise, a saline solution is a salt water solution...
. Chemical injuries (particularly alkali burns) are medical emergencies, as they can lead to severe scarring, and intraocular damage. People with chemically-induced conjunctivitis should not touch their eyes, regardless of whether or not their hands are clean, as they run the risk of spreading the condition to another eye.
External links
- Facts About the Cornea and Corneal Disease The National Eye Institute (NEI).
- Conjunctivitis Mayo Clinic website.
- Comparison of symptoms of Conjunctivitis versus Orbital Cellulitis Medical notes and photographs of a real patient experience.
- Differentiating Viral and Bacterial conjunctivitis Medscape Article.
- Bacterial conjunctivitis: A review for internists AHMAD B. TARABISHY and BENNIE H. JENG. Cleveland Clinic Journal of Medicine July 2008 vol. 75 7 507-512.