Acute bacterial conjunctivitis. Acute and subacute conjunctivitis: symptoms and how to treat

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Classification

Currently, there are a number of classifications of conjunctivitis, each of which reflects some significant factor regarding the cause or nature of inflammation of the mucous membrane of the eye.

Depending on the cause that provoked inflammation of the mucous membrane of the eye, conjunctivitis is divided into the following types:

• Bacterial conjunctivitis is provoked by various pathogenic or opportunistic bacteria, such as streptococci, pneumococci, staphylococci, gonococci, diphtheria bacillus, Pseudomonas aeruginosa, etc.;


• Chlamydial conjunctivitis (trachoma) is provoked by the ingress of chlamydia into the eyes;


• Angular conjunctivitis (angular) is provoked by Morax-Axenfeld diplobacillus and is characterized by a chronic course;


• Viral conjunctivitis provoked by various viruses, such as adenoviruses, herpes viruses, etc.;


• Fungal conjunctivitis is provoked by various pathogenic fungi and is a particular manifestation of systemic infections, such as actinomycosis, aspergillosis, candidomycosis, spirotrichelosis;


• Allergic conjunctivitis develops under the influence of any allergen or factor that irritates the mucous membrane of the eye (for example, dust, wool, varnishes, paints, etc.);


• Dystrophic conjunctivitis develops under the influence of various substances that cause damage to the mucous membrane of the eye (for example, reagents, paints, industrial fumes and gases, etc.).

Chlamydial and angular (angular) conjunctivitis are special cases of bacterial conjunctivitis, however, based on certain features of the clinical course and signs, they are distinguished into separate varieties.

Depending on the type of inflammatory process on the mucous membrane of the eye, conjunctivitis is divided into:

• Acute conjunctivitis;


• Chronic conjunctivitis.

A special case of acute conjunctivitis is epidemic, provoked by the Koch-Wicks wand.

Depending on the nature of inflammation and morphological changes in the mucous membrane of the eye, conjunctivitis is divided into the following types:

• Purulent conjunctivitis, proceeding with the formation of pus;


• Catarrhal conjunctivitis, occurring without the formation of pus, but with profuse mucous discharge;


• Papillary conjunctivitis develops against the background of an allergic reaction to ophthalmic drugs and is the formation of small grains and seals on the mucous membrane of the eye in the upper eyelid;


• Follicular conjunctivitis develops according to the first type of allergic reaction and is the formation of follicles on the mucous membrane of the eye;


• Hemorrhagic conjunctivitis is characterized by numerous hemorrhages in the mucous membrane of the eye;


• Filmy conjunctivitis develops in children against the background of acute viral respiratory diseases.

The reasons

1. infectious causes:
   
   
   • Pathogenic and conditionally pathogenic bacteria (staphylococci, streptococci, gonococci, meningococci, Pseudomonas aeruginosa, etc.);
   
   
   
   • Viruses (adenoviruses and herpes viruses);
   
   
   • Pathogenic fungi (actinomycetes, aspergillus, candida, spirotrichella);


2. Allergic causes (wearing contact lenses, atopic, medicinal or seasonal conjunctivitis);


3. Other causes (occupational hazards, dust, gases, etc.).

Symptoms of different types of conjunctivitis

• swelling of the eyelids;


• swelling of the mucous membrane of the eye;


• Redness of the conjunctiva and eyelids;


• Photophobia;


• lacrimation;



• Sensation of a foreign body in the eye;


• Discharge of mucous, purulent or mucopurulent nature.

However, in addition to non-specific symptoms, various types of conjunctivitis are characterized by the appearance of specific signs, which are due to the properties of the factor that causes the inflammatory process. It is the specific symptoms that make it possible to differentiate different types of conjunctivitis based on the clinical picture without special laboratory tests. Let us consider in detail what non-specific and specific symptoms manifest various types of conjunctivitis.

Acute (epidemic) conjunctivitis

Acute conjunctivitis is bacterial, as it is provoked by a pathogenic bacterium - the Koch-Wicks bacillus. However, since acute epidemic conjunctivitis has flow characteristics associated primarily with the defeat of a large number of people and rapid spread in the population, this type of bacterial inflammation of the mucous membrane of the eye is isolated into a separate form.

Acute Koch-Wicks conjunctivitis is common in Asia and the Caucasus, in more northern latitudes it practically does not occur. The infection occurs in the form of seasonal, epidemic outbreaks mainly in the autumn and summer periods of the year. Infection with Koch-Wicks conjunctivitis occurs by contact and airborne droplets. This means that the causative agent of conjunctivitis is transmitted from a sick person to a healthy person through close household contacts, as well as through common household items, dirty hands, dishes, fruits, vegetables, water, etc. Epidemic conjunctivitis is a contagious disease.

Koch-Wicks conjunctivitis begins acutely and suddenly, after a short incubation period of 1 to 2 days. As a rule, both eyes are affected at the same time. Conjunctivitis begins with redness of the mucous membrane of the eyelids, which quickly captures the surface of the eyeball and transitional folds. The most severe redness and swelling develops in the area of ​​the lower eyelid, which takes the form of a roller. Within 1-2 days, a mucopurulent or purulent discharge appears on the eyes, and brownish thin films are also formed, which are easily rejected and removed without damaging the mucous membrane of the eye. In addition, numerous hemorrhages in the form of dots are visible in the mucous membrane of the eye. A person is concerned about photophobia, a feeling of pain or a foreign body in the eyes, lacrimation, swelling of the eyelids and redness of the entire surface of the eyeball.

In addition to epidemic Koch-Wicks conjunctivitis, the term "acute conjunctivitis" is often used by doctors to refer to any acute inflammation of the mucous membrane of the eye, regardless of what pathogen or cause provoked it. Acute conjunctivitis always occurs suddenly and usually occurs in both eyes in succession.
Any acute conjunctivitis with proper treatment ends with recovery within 5 to 20 days.

Bacterial

Staphylococcal conjunctivitis is characterized by severe redness and swelling of the eyelids, as well as profuse mucopurulent discharge, which makes it difficult to open the eyes after sleep. Edema of the eyelids is combined with their intense itching and burning. There is photophobia and a sensation of a foreign body under the eyelid. Usually both eyes are involved alternately in the inflammatory process. With timely treatment with local antibiotics (ointments, drops, etc.), conjunctivitis resolves within 3 to 5 days.

Gonococcal conjunctivitis (gonoblennorrhea) usually develops in newborns due to infection when passing through the birth canal of a mother infected with gonorrhea (gonorrhea). With gonococcal conjunctivitis, a rapid and very dense swelling of the eyelids and the mucous membrane of the eye develops. Appears abundant mucopurulent discharge, which has a characteristic appearance of "meat slops". When opening closed eyelids, the discharge literally splashes out in a jet. As the recovery progresses, the amount of discharge decreases, it becomes thick, and films form on the surface of the mucous membrane of the eye, which are easily removed without damaging the underlying tissues. After 2-3 weeks, the discharge again acquires a liquid consistency and a greenish color, completely disappearing by the end of the 2nd month of the disease. Together with the disappearance of the discharge, both swelling and redness of the conjunctiva disappear. Gonoblenorrhea requires treatment with topical antibiotics until complete recovery.

Pneumococcal conjunctivitis occurs in children. Inflammation begins acutely, with one eye first affected, and then the second is involved. First, there is an abundant purulent discharge, combined with swelling of the eyelids, petechial hemorrhages in the mucous membrane of the eye and photophobia. Films are formed on the conjunctiva, which are easily removed and do not damage the underlying tissues.

Pseudomonas aeruginosa is characterized by profuse purulent discharge, pronounced redness of the mucous membrane of the eye, swelling of the eyelids, pain, photophobia and lacrimation.
Diphtheritic conjunctivitis develops against the background of diphtheria. First, the eyelids swell, redden and thicken. The skin is so thick that it is impossible to open the eyes. Then a cloudy discharge appears, which is replaced by a bloody one. Dirty-gray films are formed on the mucous membrane of the eyelids, which are not removed. When the films are forcibly removed, bleeding surfaces are formed.

Approximately on the 2nd week of the disease, the films are rejected, the edema disappears, and the amount of discharge increases. After 2 weeks, diphtheritic conjunctivitis ends or becomes chronic. After inflammation, complications may develop, such as scars on the conjunctiva, torsion of the eyelid, etc.

Chlamydial

Often, chlamydial conjunctivitis appears in the form of epidemic outbreaks during mass visits to swimming pools. Therefore, chlamydial conjunctivitis is also called pool or bath.

Viral

Herpetic conjunctivitis is characterized by a sharp redness, infiltration, and the formation of follicles on the mucous membrane of the eye. Quite often, thin films are also formed, which are easily removed without damaging the underlying tissues. Inflammation of the conjunctiva is accompanied by photophobia, blepharospasm and lacrimation.

Adenovirus conjunctivitis can occur in three forms:

1. The catarrhal form is characterized by mild inflammation. The redness of the eye is not strong, and the discharge is very poor;


2. The membranous form is characterized by the formation of thin films on the surface of the mucous membrane of the eye. The films are easily removed with a cotton swab, but sometimes they are firmly attached to the underlying surface. In the thickness of the conjunctiva, hemorrhages and seals can form, which completely disappear after recovery;


3. The follicular form is characterized by the formation of small bubbles on the conjunctiva.

Allergic

• Pollinous conjunctivitis provoked by an allergy to pollen, flowering plants, etc.;


• Spring keratoconjunctivitis;


• Drug allergy to eye preparations, manifested in the form of conjunctivitis;


• Chronic allergic conjunctivitis;


• Allergic conjunctivitis associated with wearing contact lenses.

The symptomatology of any form of allergic conjunctivitis is unbearable itching and burning on the mucous membrane and on the skin of the eyelids, as well as photophobia, lacrimation, severe swelling and redness of the eye.

Chronic

Chronic conjunctivitis is triggered by physical or chemical factors that irritate the mucous membrane of the eye, such as dust, gases, smoke, etc. Most often, chronic conjunctivitis affects people working in flour, chemical, textile, cement, brick and sawmills and factories. In addition, chronic conjunctivitis can develop in people against the background of diseases of the digestive system, nasopharynx and sinuses, as well as anemia, beriberi, helminthic invasions, etc. Treatment of chronic conjunctivitis is to eliminate the causative factor and restore the normal functioning of the eye.

Angular

Purulent

catarrhal

Papillary

Follicular

Follicular conjunctivitis, depending on the type of pathogen, can be viral (adenoviral) or bacterial (for example, staphylococcal). Follicular conjunctivitis actively proceeds for 2-3 weeks, after which the inflammation gradually decreases, completely disappearing also within 1-3 weeks. The total duration of follicular conjunctivitis is 2-3 months.

Temperature with conjunctivitis

Conjunctivitis - photo

What tests can a doctor prescribe for conjunctivitis?

However, in some cases, when it is not possible to accurately determine the type of conjunctivitis on the basis of an examination and a survey, or it occurs in an erased form, an ophthalmologist may prescribe the following studies:

• Sowing discharge from the eye for aerobic microflora and determining the sensitivity of microorganisms to antibiotics;
• Sowing discharge from the eye for anaerobic microflora and determining sensitivity to antibiotics;
• Sowing discharge from the eye for gonococcus (N. gonorrhoeae) and determining sensitivity to antibiotics;
• Determination of the presence of IgA antibodies to adenovirus in the blood;
• Determination of the presence of IgE antibodies in the blood.

An analysis for the determination of antibodies to adenovirus in the blood is used in cases of suspected viral conjunctivitis.

An IgE blood test is used to confirm suspected allergic conjunctivitis.

Which doctor should I contact with conjunctivitis?

General principles for the treatment of all types of conjunctivitis

Symptomatic treatment aimed at eliminating the manifestations of an inflammatory disease consists in the use of topical drugs that are injected directly into the eye.

With the development of the first signs of conjunctivitis, it is necessary first of all to stop pain by introducing drops containing local anesthetics into the eye sac, such as, for example, Pyromecaine, Trimecaine or Lidocaine. After pain relief, it is necessary to toilet the ciliary edge of the eyelids and the mucous membrane of the eye, washing its surface with antiseptic solutions, such as potassium permanganate, brilliant green, Furacilin (dilution 1: 1000), Dimexide, Oxycyanate.

After pain relief and sanitation of the conjunctiva, drugs containing antibiotics, sulfonamides, antiviral or antihistamine substances are injected into the eye. In this case, the choice of drug depends on the causative factor of inflammation. If there is bacterial inflammation, then antibiotics are used. sulfonamides (for example, tetracycline ointment, Albucid, etc.).

For viral conjunctivitis, local agents with antiviral components are used (for example, Kerecid, Florenal, etc.).

With allergic conjunctivitis, it is necessary to use antihistamines, for example, drops with Diphenhydramine, Dibazol, etc.

Treatment of conjunctivitis should be carried out until the complete disappearance of clinical symptoms. In the process of treating conjunctivitis, it is strictly forbidden to put any bandages on the eyes, as this will create favorable conditions for the reproduction of various microorganisms, which will lead to complications or aggravation of the course of the process.

Principles of treatment at home

Viral

Herpes virus
In order to destroy the virus, interferon solutions are also used, which are prepared from a lyophilized powder immediately before injection into the eye. The first 2-3 days, interferon solutions are administered 6-8 times a day, then 4-5 times a day until the symptoms disappear completely. To reduce inflammation, relieve pain, itching and burning, Diclofenac is injected into the eye. To prevent bacterial complications in herpetic conjunctivitis, Picloxidine or silver nitrate solution is injected into the eyes 3-4 times a day.

Bacterial

Chlamydial

At the same time, local preparations with antibiotics, such as Erythromycin ointment or Lomefloxacin drops, should be injected into the affected eye 4 to 5 times a day. Ointment and drops must be applied continuously from 3 weeks to 3 months, until the clinical symptoms completely disappear. To reduce the inflammatory reaction, Diclofenac is injected into the eye 2 times a day, also for 1 to 3 months. If Diclofenac does not help to stop the inflammation, then it is replaced with Dexamethasone, which is also administered 2 times a day. For the prevention of dry eye syndrome, it is necessary to use artificial tears daily, such as Oksial, Oftagel, etc.

Purulent

Allergic

Chronic

Preparations (medicine) for the treatment of conjunctivitis

Folk remedies

• Pass the dill greens through a meat grinder, collect the resulting slurry in cheesecloth and squeeze thoroughly to get pure juice. Moisten a clean soft cotton cloth in dill juice and put it on the eyes for 15-20 minutes when the initial signs of conjunctivitis appear;


• Dilute honey with boiled water in a ratio of 1: 2 and instill the eye with the resulting solution as needed;


• Grind two teaspoons of rose hips and pour them with a glass of boiling water. Boil the berries and insist for half an hour. Strain the finished infusion, moisten a clean cloth in it and apply lotions on the eyes when pus is released;


• Pound 10 g of plantain seeds in a mortar and pour them with a glass of boiling water, then leave for half an hour and strain. In the finished infusion, moisten a clean cloth and apply lotions to the eyes. You can also rinse your eyes with infusion as needed;


• Collect fresh Datura leaves and grind them. Then pour 30 g of crushed leaves with a glass of boiling water, leave for half an hour, then strain. Ready infusion to use for the manufacture of lotions.

What is the recovery treatment after conjunctivitis

Among the most effective and commonly used reparants is Solcoseryl eye gel, made from the blood of dairy calves.

This drug activates the metabolism at the cellular level, as a result of which tissue restoration occurs in a short time. In addition, there is a complete restoration of the damaged structure, which, accordingly, creates conditions for the normalization of the functions of the damaged organ, in this case the eye. Solcoseryl ensures the formation of a normal and uniform mucous membrane of the eye, which will perfectly perform its functions and will not create any subjective discomfort. Thus, restorative treatment after conjunctivitis consists in the use of Solcoseryl eye gel for 1 to 3 weeks.

The mucous membrane of the eye becomes inflamed under the influence of infections, allergens, negative environmental factors. There are acute, subacute and chronic course of the disease. If conjunctivitis is not treated in time, the inflammatory process may spread to other tissues of the eye.

The disease occurs due to the irritating effects of infections, dust, smoke, allergens, chemicals, contact lenses. The following factors contribute to the development of the disease:

• refractive errors;
• metabolic diseases;
• hypothermia;
• decreased immunity;
• avitaminosis;
• overwork;
• frequent stress;
• non-observance of hygiene rules;
• improper use of contact lenses.

The most common cause of inflammation is a bacterial infection (pneumococcus, gonococcus, streptococcus, staphylococcus, and others). They account for about ¾ of the cases. Approximately a quarter of conjunctivitis is of allergic origin. Viral inflammation of the conjunctiva accounts for less than 2% of cases.

Classification

Conjunctivitis of the eyes can occur in an acute form (symptoms are pronounced), subacute (signs of the disease are less noticeable) and chronic (the disease is sluggish, requires long-term treatment). Non-infectious conjunctivitis is also distinguished by the type of irritant. Due to the occurrence, the following types of disease occur:

1. Bacterial - develops as a result of pathogenic bacteria entering the eye. Often, the subacute form of the disease is provoked by Morax-Axenfeld's diplobacillus. The most dangerous and requiring hospitalization is inflammation caused by diphtheria bacillus. Epidemic acute conjunctivitis occurs when exposed to the Koch-Wicks bacteria. More information about this form is written in.
2. - proceeds in a chronic or subacute form. You can get infected through dirty hands or contact lenses. The presence of a fungal infection in the body, dusty and humid air in the house, and prolonged local use of antibiotics are conducive to the development of the disease.
3. - has a high degree of contagiousness. The most common types of infectious lesions of the conjunctiva are: enteroviral - causes significant; herpetic - provokes follicular, catarrhal or vesicular-ulcerative inflammation; adenovirus - inflammation of the throat and conjunctiva at the same time.
4. Conjunctivitis of chemical or mechanical origin. Often occurs as a result of exposure to smoke, dust, household chemicals, toxic fumes. Contact lens wearers may develop giant papillary conjunctivitis as a reaction to protein deposits on the surface of the lens.
5. Allergic - appears due to the increased sensitivity of the body to certain substances (allergens). Often the acute form of this disease is accompanied by rhinitis, asthma, atopic dermatitis. There are such types of illness: medicinal - some antibiotics and anesthetics give a negative reaction; atopic - has an unexplained nature, manifests itself seasonally; pollinous - occurs on the pollen of plants during the flowering period. For more information on allergic conjunctivitis, see.

If symptoms of conjunctivitis appear in an acute or subacute form in an adult or a child, you need to contact an ophthalmologist to identify the cause of the disease and prescribe treatment.

Symptoms of conjunctivitis

Acute conjunctivitis is recognized by the following signs:

• irritation of the conjunctiva - severe itching and redness;
• feeling of clogging of the eyes;
• eyelids visibly swollen;
• discharge oozes from the eyes;
• bubbles or growths sometimes form on the inner surface of the lower eyelid;
• hypersensitivity to light and wind develops.

By the nature of the discharge, you can determine the cause of inflammation. The presence of pus indicates bacteria in the conjunctiva; with viral and allergic conjunctivitis, the mucus is transparent. Fungi provoke the formation of films and infiltrates on the surface of the eyeball.

In the infectious form, respiratory symptoms are often observed. It also often happens, headache, swollen lymph nodes. Such manifestations are especially pronounced in children.

Diagnostics

Before treating acute conjunctivitis in adults and children, it is necessary to accurately establish the diagnosis and find out the cause of the disease. To do this, the ophthalmologist prescribes the following examinations:

1. Examination of the eyes with a slit lamp.
2. Clinical blood test - establishes the presence of an inflammatory process in the body and its etiology.
3. Examination of a smear from the conjunctiva to determine the pathogen. With a bacterial infection, it is possible to establish its sensitivity to antibiotics at the same time.

Depending on the cause of the disease, it may be necessary to consult other specialists: a phthisiatrician, a therapist, a urologist, an allergist.

Treatment methods for the disease

Treatment of acute and subacute conjunctivitis in adults is carried out in a complex manner. Prescribe drugs that act directly on the causative agent of the disease. Depending on the type of infection, the following groups of drugs are used:

1. In case of bacterial infection, it is necessary in the form of eye drops and ointments: Neomycin, Tetracycline ointment, Floksal. Sometimes you have to use pills and injections.
2. Treatment of fungal inflammation takes up to 1.5 months. In complex therapy, fungistatic and fungicidal agents are used.
3. With allergic conjunctivitis, they are prescribed with antiallergic effects: Allergodil, Kromoheksal.
4. Viral diseases of the mucous membrane of the eye are treated with antiviral drugs, interferons: Acyclovir, Oftolmoferon, Poludan.

The patient definitely needs regular eyes with decoctions of chamomile and calendula, Furacilin solution, boric acid. To reduce inflammation and itching, non-steroidal anti-inflammatory drugs are used: Nevanak, Indocollir.

Features of the course of the disease and treatment in children

Children are most susceptible to measles, adenovirus and conjunctivitis. There are gonococcal and chlamydia types of the disease. The child can become infected with these infections, passing through the birth canal of a sick mother. In this case, the disease is difficult to treat and can lead to loss of vision - complete or partial.

In an uncomplicated form, the treatment of acute conjunctivitis in children takes from 1 to 2 weeks and passes without a trace. But sometimes the disease is complicated, the inflammation spreads to, which threatens to deteriorate vision.

With inflammation of the conjunctiva in a child, parents can, as a first aid, rinse their eyes with chamomile and drip Albucid. Then you need to see a doctor.

An ophthalmologist should deal with conjunctivitis in children - only a specialist is able to accurately determine the cause of the disease and prescribe effective medications.

Preventive measures

To protect yourself from the occurrence of acute or subacute inflammation of the conjunctiva, it is recommended to follow the following rules:

• avoid contact with people suffering from infectious conjunctivitis;
• observe hygiene, do not touch your eyes with unwashed hands;
• use clean pillowcases and towels;
• use contact lenses correctly: do not wear longer than the indicated expiration date, rinse them every day, replace the case regularly.

Conjunctivitis in acute and subacute form of infectious origin is treated from one to three weeks. Therapy of an allergic type may take several days, but more often the disease becomes chronic. With it, the frequency of relapses depends on the frequency of contact with the allergen and the state of the patient's immunity.

The most dangerous disease is caused by diphtheria bacillus, chlamydia (), gonococci. These infections require long-term treatment. The risk of spreading the inflammatory process to the cornea and deterioration of visual acuity is higher.

Do you use contact lenses longer than the recommended wearing period?

It is forbidden to apply a bandage over the eye, as this prevents the blinking movements of the eyes, due to which the conjunctiva is cleared of pus.

The main treatment for acute bacterial conjunctivitis is topical antibiotics. Drops are usually applied at intervals of 1 - 4 hours, ointments - 4 times a day. Treatment should continue until the complete disappearance of clinical symptoms, usually 10 - 14 days. Currently, fluoroquinolones have replaced the aminoglycosides that have been used for many years for the topical treatment of bacterial conjunctivitis (except streptococcal and pneumococcal). However, an increase in resistance to fluoroquinolones was noted, and therefore their use in ophthalmic practice should be limited only to severe destructive bacterial lesions. Currently, the most justified is the use of a combination of polymyxin-B with trimethoprim in the form of drops and a combination of polymyxin-B with bacitracin in the form of an eye ointment. Systemic antimicrobial therapy is rarely used for acute uncomplicated bacterial conjunctivitis, except for hemophilic conjunctivitis in children and for infection in all age groups. Haemophilus influenzae biogroups aegiptius, which is often accompanied by the development of severe complications.

First aid for pneumococcal conjunctivitis consists primarily in acidifying the environment of the conjunctival sac, since pneumococcus develops well in an alkaline environment, and dies in an acidic environment. For this purpose, every 1.5-2 hours, the conjunctival sac is washed with a 2% solution of boric acid. In addition, antibiotic solutions are instilled, to which this flora is sensitive.

Morax-Axenfeld diplobacillus is specifically affected by zinc sulfate, which is used as an instillation of 0.25-0.5% and less often 1% solution 4-6 times a day.

Clinical picture of viral conjunctivitis

Viral conjunctivitis caused by adenoviruses types 3 and 7a, less often adenoviruses types 6 and 10, 11, 17, 21, 22, is the most common form of conjunctivitis. It is transmitted by contact and airborne droplets.

The incubation period lasts 4 - 8 days. Often the development of conjunctivitis is preceded by the phenomena of inflammatory diseases of the upper respiratory tract, fever. The process is usually unilateral, although the second eye may be affected. Are celebrated severe hyperemia and edema conjunctiva (catarrhal form), folliculosis lower transitional fold (follicular form); secreted mucous. Possible damage to the cornea (coin-shaped infiltrates), leading to a temporary decrease in visual acuity.

Enteroviral or epidemic hemorrhagic conjunctivitis is caused by a virus from the picornavirus family (enterovirus-70, coxsackie A-24).

The virus of epidemic hemorrhagic conjunctivitis is transmitted mainly by contact through infected solutions of eye drugs, devices and tools, as well as common items. The disease is highly contagious and acute.

It spreads rapidly and has a very short incubation period (8-48 hours). Epidemics proceed "by explosive type", causing outbreaks in organized groups, they can quickly cover entire continents, taking on the character of a pandemic.

There are severe pain in the eyes, conjunctival hyperemia, lacrimation, photophobia, feeling of a foreign body in the eye. Swelling and hyperemia of the eyelids rapidly increase, which leads to a sharp narrowing of the palpebral fissure. Discharge (usually mucopurulent) is insignificant. Acute pronounced conjunctivitis is accompanied by subconjunctival hemorrhages from barely noticeable pinpoint to extensive, capturing the entire eyeball. The sensitivity of the cornea is reduced, there are multiple punctate subepithelial infiltrates. At the same time, general symptoms of the disease can be observed: headache, fever, tracheobronchitis. The pronounced phenomena of conjunctivitis usually last for a week, then gradually decrease and disappear after 2-3 weeks. However, subepithelial infiltrates of the cornea, despite ongoing treatment, very slowly regress (within a few months).

Chlamydial conjunctivitis (paratrachoma, conjunctivitis of adults with inclusions, bath conjunctivitis, pool conjunctivitis) develops when the mucous membrane of the eye infected with chlamydia is released from the affected eyes or the genitourinary system. Epidemic outbreaks of diseases are also observed when swimming in polluted reservoirs. The incubation period is 5-14 days. Usually one eye is affected, which is a characteristic difference from trachoma.

Acute paratrachoma is characterized by a sharp hyperemia of the conjunctiva of the eyelids and transitional folds, its edema and infiltration. Typically, the appearance of large loose follicles arranged in rows in the lower fornix; in the future, the follicles can merge, forming horizontally located rollers. Complete resorption of conjunctival follicles without scarring is characteristic.

At the beginning of the disease, there is a slight mucopurulent discharge, later, with the development of the process, the discharge becomes abundant, often purulent. Hypertrophy of the papillae of the conjunctiva, mainly of the upper eyelid, is also observed; pseudomembranes are rarely formed on the conjunctiva. In the acute phase of the disease, pronounced edema of the eyelids and narrowing of the palpebral fissure, unilateral pseudoptosis due to subtarsal edema of the conjunctiva of the eyelids and folliculosis can be observed.

With the help of a slit lamp during biomicroscopy, it is often possible to detect involvement in the process of the upper limb in the form of the appearance of a micropannus, as well as multiple small, punctate epithelial infiltrates in the cornea, similar to infiltrates in adenovirus infection.

Characteristic for paratrachoma is the occurrence from the 3-5th day of the disease regional anterior adenopathy on the side of the diseased eye which is not the case with trachoma. An enlarged lymph gland is usually painless on palpation, serving as one of the criteria for a differential diagnosis with adenoviral conjunctivitis.

The diagnosis of paratrachoma is made on the basis of an anamnesis and a characteristic clinical picture, as well as laboratory data. One of the main signs, characteristic and typical only for chlamydial infections, is the detection of intracellular inclusions in the scraping of the epithelium of the conjunctiva - Provachek-Halberstedter bodies (cytological method).

More informative are methods such as the study of fluorescent antibodies, immunofluorescent analysis, as well as methods of serological diagnostics.

The human eye has a very complex and multifaceted structure. Wise nature has created a truly unique optical apparatus, which consists of many different biological elements. Each detail of this complex mechanism is aimed at solving certain problems, and a failure in the work of even the most insignificant element at first glance can cause the development of serious ophthalmic pathologies. It is also necessary to take into account the fact that the eye is the only human organ whose mucous membrane is in direct contact with the external environment. This factor, combined with a complex optical structure, makes the visual apparatus the most vulnerable part of the human body.

The organ of vision is especially susceptible to external irritants and infections, which most often affect the mucous membrane of the eyeball. And one such eye disease is acute conjunctivitis, which usually affects both eyes and occurs with equal probability in both adults and children.

The conjunctiva and its importance in the work of the visual apparatus

The conjunctiva is the most important part of the accessory apparatus of the eye. It has the appearance of the thinnest mucous tissue, which, as if with a transparent film, gently envelops the inner surface of the eyelids, forms the vaults of the eye folds, forms the lacrimal sac and covers the outer part of the eyeball. This film is only 0.1 mm thick and performs two very important functions. First, it produces tear fluid components that moisturize and disinfect the surface of the eyeball. And secondly, the conjunctiva protects the eye from dust, dirt, pathogenic infection and other pathogens.

Forms of conjunctivitis

Conjunctivitis is a generalized name for all inflammatory diseases that affect the mucous membrane of the eye. According to statistics, almost a third of all ophthalmic pathologies occur precisely in conjunctivitis, and what is most interesting about 15% of the entire population of the planet suffers from this disease.

Conjunctivitis, like any disease, which is accompanied by both chronic and acute inflammatory process. As a rule, this form of this disease is nothing more than a consequence of transferred and not always treated acute conjunctivitis. The course of this form of inflammation is very protracted and stable, and short-term improvements are quickly replaced by sharp exacerbations. Therefore, in order not to bring the disease to a chronic form, it is necessary at the first unpleasant symptoms indicating conjunctivitis to immediately seek help from a doctor who will confirm the diagnosis and prescribe effective therapy.

Important to remember , that only timely and correct treatment will help eliminate discomfort in the eyes, prevent the development of relapses and, as a result, prevent the disease from becoming chronic.

Factors provoking the development of acute conjunctivitis

The composition of the microflora of the mucous membrane of the eye, the posterior walls of the eyelids and the vaults of the eye folds always includes various bacteria and microbes, and they can be found even in completely healthy people. If the accessory apparatus of the organ of vision does not have pathological changes, then its lacrimal glands function normally. And this means that they constantly secrete a secret that, during the blinking movements of the eyelids, moisturizes the conjunctiva of the eye and removes all pathogens from its surface. But with a confluence of unfavorable both external and internal factors, certain conditions are created that lead to a malfunction in the adnexal apparatus of the eye, as a result of which, acute conjunctivitis develops in a person.

External factors that influence the development of the disease can be divided into infectious and non-infectious types. Infectious pathogens include:

• viruses - influenza, herpes, measles, a strain of adenovirus infection;
• bacteria - staphylococcus, streptococcus, pneumococcus, gonococcus, as well as sticks: Pseudomonas aeruginosa, intestinal, hemophilic, diphtheria and Koch-Wicks;
• fungi: candida, actinomycota, aspergillus, rhinosporidium and sporotrichia.

It is important to remember that everyone is contagious, which means they can be transmitted from a sick person to a healthy person. Therefore, it is necessary to always observe the rules of personal hygiene and, if possible, limit contact with a person suffering from this infectious disease.

But the development of non-infectious inflammation of the mucous membrane of the organ of vision is provoked by the following factors:

• allergic - plant pollen, ultraviolet rays, exposure to dust, smoke, contact lenses, toxic and chemical irritants;
• medication - or antiseptics in the form of ointments and drops;
• autoimmune - morphological changes in the conjunctiva occur under the influence of cells of one's own immunity.

It is important to consider that in rare, but very severe cases, acute conjunctivitis can be provoked by several types of infections at once, for example, a fungus and a virus, or a bacterium, a virus and a fungus.

The situation is even worse when a bacterial or viral infection is superimposed. A disease of this combinatorial type is treated very difficult and long.

Risk factors contributing to the development of conjunctivitis. If an infection, an allergen or another causative agent of conjunctivitis has entered the body or eyes, this does not mean at all that a person will definitely get sick. For this, there must also be risk factors that will create favorable conditions for the development of the inflammatory process. The main ones include:

• weakened immunity;
• long-term chronic and inflammatory general diseases;
• hypothermia or overheating of the whole organism;
• vitamin A deficiency;
• skin diseases;
• injuries and mechanical damage to the conjunctiva of the eye;
• frequent bronchitis, otitis, tonsillitis and sinusitis;
• pathology of the endocrine system;
• blepharitis and disruption of the lacrimal glands;
• problems with refractive vision;
• violation of the rules of personal hygiene.

As a rule, the risk factor alone does not lead to the development of pathology. But thanks to him and in the presence of external pathogens, the likelihood that acute conjunctivitis will develop increases significantly.

The main symptoms of conjunctivitis

It is the causative agent of the disease that determines the type of inflammatory process, which can be: bacterial, allergic, viral or autoimmune. But regardless of the causes that caused inflammation of the conjunctiva, each type of this pathology has a number of unifying features that determine the general ones. The main ones include:

• severe redness of the white of the eyeball;
• persistent souring of the organ of vision;
• severe hyperemia and swelling of the eyelids;
• profuse lacrimation;
• burning and discomfort in the eyes;
• photophobia.

It is worth noting that each has its own special signs, which indicate the cause of the inflammation. For example, acute epidemic conjunctivitis, which is provoked by the toxic Koch-Wicks bacillus, in addition to severe swelling of the eyelids and numerous hemorrhages under the conjunctiva, is always accompanied by high body temperature, headache, weakness, insomnia and general physical fatigue.

It is important to consider that acute epidemic conjunctivitis has a very short incubation period, up to several hours, and it mainly affects the younger age group of the population, especially children under two years of age are susceptible to it.

But it is characterized by abundant and specific lacrimation from the eyes. This is due to the fact that this type of pathology is caused by bacteria that form pus. Therefore, discharge from the eyes is usually of a dirty yellow color, and its viscous and thick consistency causes strong sticking of the eyelids, especially after sleep.

The leaders in the number of irritated factors are allergic conjunctivitis. They are distinguished by severe itching, unpleasant burning and aching pain in the eyes. This type of inflammation has many subspecies, the most unpleasant of which is acute. Its main danger is that it can develop even without the participation of a provoking allergen. This is the first sign that a person is not all right with the immune system. In addition to the usual, the most acute period of this inflammation is always accompanied by the appearance of yellow vesicles and nodules on the mucous surface of the eye.

Characteristic signs of the development of various conjunctivitis

Conjunctivitis, depending on the causes of occurrence, is divided into certain types, and according to the course of the disease, into different forms. But this anomaly is still classified according to the nature of inflammation and morphological changes to which the conjunctiva is subject. On this basis, both infectious and non-infectious eye diseases are classified.

Thus, by nature, all inflammations of the conjunctiva are identified as:

• , which is always accompanied by copious secretions;
• differs in the formation of vesicles and follicles;
• catarrhal conjunctivitis is characterized by profuse lacrimation, but without pus;
• hemorrhagic conjunctivitis always leads to numerous capillary hemorrhages in the mucosa of the white of the eyes.

Acute conjunctivitis can have not only a different nature of occurrence, but also differ in particular symptoms and affect morphological changes in the conjunctiva in different ways. That is why, before starting to treat inflammation of the conjunctiva, it is necessary to establish an accurate diagnosis that will determine the cause, type and nature of the disease. It is the correct classification of pathology that helps to find the most effective treatment regimen. This makes it possible to prevent the development of relapses in the future.

Diagnosis of conjunctivitis

To diagnose conjunctivitis, it is enough for a doctor to examine the eyes and interview the patient. But in order to correctly identify the type and nature of the inflammatory process on the mucous surface of the eye, a specialist can obtain epidemiological data and find out the clinical picture of the disease.

That is, he must conduct laboratory and hardware diagnostics, which consists of the following procedures:

• general analysis of blood and urine;
• to identify the allergen or virus that caused the inflammation, an appropriate blood test is prescribed;
• fluorography;
• Ultrasound of the internal organs, if the cause of the disease is a disruption of the endocrine system or autoimmune pathologies;
• to establish the bacterial microflora, a tank is made by sowing a smear of the conjunctiva of the eye;
• additional studies to determine the herpes virus and adenovirus;
• eye biomicroscopy.

When examining a patient, the doctor necessarily assesses the patient's condition and finds out if he has a cough, runny nose and other respiratory diseases. Further, swelling of the eyelids, friability of the conjunctiva, damage to the blood vessels of the eyes are detected and the condition of the cornea and the presence of follicular formations on it are checked.

Treatment options for acute conjunctivitis

Only after establishing an accurate diagnosis, determining the causes, type and nature of inflammation, the doctor prescribes a comprehensive treatment for acute conjunctivitis. In no case should you try to get rid of such a serious and dangerous disease on your own. The thing is, each type of conjunctivitis has its own treatment method, which consists in prescribing drugs of different groups:

• antiseptic preparations are intended to prevent infectious and allergic conjunctivitis;
• antibiotics are prescribed to treat bacterial inflammation;
• antiviral agents stimulate the immune system and fight against;
• fungicides are aimed at treating fungal conjunctivitis;
• antihistamines - relieve itching, burning, swelling and tearing in allergic conjunctivitis;
• hormonal drugs are aimed at removing swelling and inflammation.

The doctor, in addition to eye drops and ointments, depending on the factors that caused the inflammation, may prescribe immunostimulants, vitamins, painkillers, as well as remedies for the common cold, otitis or cough.

Attention! If the development of inflammation of the conjunctiva of the eye is not stopped in time, then this can lead to such consequences dangerous for human health as bacterial keratitis, corneal clouding, development of orbital cellulitis, and even cause complete loss of vision.

Prognosis and prevention of the disease

Modern drug therapy for acute conjunctivitis provides a stable and complete cure for this disease. But even taking into account the high possibilities of medicine, the main thing is not to fight the disease, but not to allow its development. Therefore, in order not to experience all the unpleasant symptoms of acute conjunctivitis, ophthalmologists recommend not touching your eyes with dirty hands, not using other people's towels, handkerchiefs, cosmetic accessories, not swimming in dirty water, avoiding contact with sick people and not being in places with a high content of allergens, dust, smoke and toxins.

Acute conjunctivitis is an inflammatory eye disease.

It is characterized by a pronounced reddening of the conjunctiva, the appearance of an inflammatory process in the eyeball. Occurs when affected by bacterial or viral microflora, also occurs due to exposure to chemicals or various allergens on the eye.

Symptoms and complaints of acute conjunctivitis

The onset of the disease is acute and rapid. The most basic symptoms are:

• Redness of the eyelids, they become bright red;
• There is a sensation of a foreign body in the eye;
• In the morning, there is sticking of the eyelids from the formed crust;
• Increased tearing, may be replaced by dry eyes;
• Visibly reddens the eye, hemorrhages appear;
• Complaints about rapid eye fatigue after work;
• Eyes react to wind and sun, pain in eyes;
• In the early stages of the disease, there is a release of exudate of a light and transparent color, which are replaced by greenish-purulent.

Causes of the disease

The reasons why the disease occurs can be very diverse. Conjunctivitis can occur from contact with the eyes of bacterial microflora, such as staphylococcus aureus, streptococcus, gonococcus, Pseudomonas aeruginosa. Also due to adenovirus infection. Often the cause is the ingress of various allergens.

It is generally accepted that the onset of the disease is preceded by overheating of the body or its hypothermia, early viral infections, depletion of the body and the immune system, trauma to the eye, as well as certain chronic eye diseases.

In eye practice, all forms of conjunctivitis occupy 1/3 of all eye diseases. More often, young children suffer from this disease, since the infection can get to them through unwashed hands, much less often the infection comes with dust or a foreign body. As a rule, both eyes are involved in the inflammatory process, but not always simultaneously, the period between the disease varies from one to several days.

In young children, acute conjunctivitis can cause more severe consequences, such as swelling of the cheek, near the sore eye, swelling of the parotid lymph nodes, general malaise, fever, drowsiness, children become capricious and restless.

Diagnosis of acute conjunctivitis

According to the international classification of diseases 10 (ICD), conjunctivitis has a code from H10.1 to H10.9, there are also additional codes in accordance with the disease. An important step in the diagnosis is the correct diagnosis of the disease. First of all, it is necessary to make a differential diagnosis between bacterial and viral conjunctivitis. Exclude the presence of an allergic factor.

The eye is examined under a slit lamp, the presence of edema of the mucous membranes and conjunctiva, the presence of discharge are determined. Sometimes the eyes are stained with special dyes, which makes it possible to diagnose and identify the amount of damage to the cornea and conjunctiva.

To exclude the bacterial nature of the origin of the disease, the separated eyes are sown, if the study reveals bacterial microflora, sensitivity to antibiotics is determined, and appropriate treatment is prescribed. A blood test will help identify allergic conjunctivitis or viral. To understand that it is an adenovirus or a herpes virus, additional research is being carried out.

Treatment of conjunctivitis

Treatment of acute conjunctivitis should begin immediately after diagnosis. Acute conjunctivitis is a disease that can be easily passed on to another person. From the photo you can distinguish different types of disease. To avoid the development of such a situation, it is necessary to observe the rules of personal hygiene. Treatment is prescribed by a doctor, after a thorough examination and diagnosis, collection of complaints.

After the diagnosis is made, immediate treatment is prescribed. If conjunctivitis is allergic in nature, it is necessary to identify the allergen and limit its contact with the patient. Treatment is carried out by a group of hormonal drugs and antispasmodics, these are usually drops.

If the disease is caused by microflora and has a bacterial basis, after testing the sensitivity to antibiotics, the most suitable drug from the group of broad-spectrum antibiotics is selected and treatment is started, these can be drugs in the form of drops or ointments, in this case the ointment is applied behind the eyelid.

Important precautions in case of illness are frequent washing of hands with soap, the use of an individual towel, a handkerchief should be replaced with paper napkins, less touching of the face and eyes with hands. On average, the disease lasts about two weeks, but in some cases it can last up to a month.

The most basic drug in the treatment of conjunctivitis are eye drops and ointments, one of the more commonly used drops is Albucid, Lecrolin, Tobrex, which is often used to prevent conjunctivitis in children at birth, Dexamethasone ointment, Hydrocortisone ointment. Drops belong to different groups of drugs and categories. There are also many traditional medicines, washing the eyes with a decoction of calendula or chamomile, and much more. It is important to remember that drug treatment is more effective and the cure will come much faster.

Forecast

The prognosis is favorable with proper treatment. Often, acute conjunctivitis can turn into a chronic form, this is noted when the wrong treatment is prescribed. A complication such as keratitis may also occur, the level of vision may decrease, the cornea may become cloudy, ulcers may form on the eyelids, which are difficult to treat.

Prevention

Prevention consists in maintaining a personal hygiene regimen, frequent washing of hands during illness, the use of personal hygiene products, proper care of contact lenses so that various debris does not accumulate in them, before removing them, it is necessary to clean them, do not delay in the treatment of chronic diseases of the ENT- organs.

In order to prevent the occurrence of conjunctivitis in newborns during the passage of the birth canal, it is necessary to detect the disease in a pregnant woman in time and immediately prescribe treatment. In children's groups, if there is a child with conjunctivitis, it is necessary to limit his communication with children, to carry out prevention individually at home.