Adenovirus conjunctivitis how long is it treated. Manifestation and treatment of adenoviral conjunctivitis in children

Adenovirus conjunctivitis is an inflammation of the mucous membranes of the eye. It is provoked by adenovirus 3,4,7, 10 or 11 types. It develops in conjunction with respiratory diseases. Adenovirus conjunctivitis is more common in children than in adults.

Among the classic symptoms of the disease, experts distinguish poor health, nasopharyngitis, fever, lacrimation and itching in the eyes. Conjunctivitis is diagnosed by an ophthalmologist. The classic form of the disease is treated with antibacterial and antiviral drugs.

Adenovirus conjunctivitis has several forms of manifestation.

1. Catarrhal conjunctivitis. Differs in ease of flow. It is characterized by local inflammation. This species is characterized by slight reddening of the mucous membrane of the eye, lacrimation, partial closure of the palpebral fissure. Rarely, the illness lasts more than 7 days. Does not require serious treatment, is not accompanied by complications.
2. follicular form. The main difference lies in the formation of bubble inflammations on the loosened mucous membrane of the eye. They are characterized by plurality and arbitrary sizes. The formations resemble capsules with transparent contents. The maximum number of follicles is localized in the transitional fold and in the corners of the eyelid. The mucous membrane of the eye is hyperemic. This form of conjunctivitis is easily confused with trachoma at an early stage. A distinctive feature is nasopharyngitis, chills and other signs of a respiratory viral infection.
3. Filmy form. Diagnosed in a quarter of cases of adenoviral conjunctivitis. A distinctive feature is the formation of thin films on the surface of the eye of white or gray color. The plates can be easily removed with a cotton swab. In difficult cases, they are plates tightly connected to the inflamed conjunctiva. When they are removed, damage to the mucosa occurs, bleeding is possible. In the membranous form, there is an increased body temperature, general malaise, weakness, chills. The disease lasts about 10 days.

Symptoms of the disease

Adenovirus conjunctivitis in children has a latent period of 1 week. At this time, the child is a carrier of the infection, but he does not get sick. The disease begins to actively develop with hypothermia or a decrease in immunity.

Symptoms of conjunctivitis vary depending on its form. Traditionally, the inflammatory process begins in one eye, infecting the other within 2-3 days.

There are a number of common symptoms:

• chills, fever;
• enlarged lymph nodes in the neck;
• weakness, malaise;
• diseases of ENT organs;
• swelling of the eyes and redness of the mucosa and eyelids;
• lacrimation;
• discomfort in the eye area, burning sensation, itching;
• moderate blepharospasm.

Gradually, the edema captures the entire conjunctiva completely. The semilunar and lower folds of the eye swim.

There are individual signs for different forms of the disease.

1. In the case of catarrhal conjunctivitis, the child reacts painfully to bright light. There is profuse lacrimation. There is a burning sensation and pain in the affected eye. The eye is swollen and partially closed.
2. The follicular type is characterized by multiple fluid-filled vesicles. Purulent formations appear.
3. The film type is determined only by the presence of films of arbitrary sizes.

Treatment for conjunctivitis caused by adenoviruses is based on the symptoms present.

There are different types of adenoviral conjunctivitis in children. Only a qualified specialist can make a correct diagnosis.

Features of treatment

Conjunctivitis develops against the background of diseases of the ENT organs. For this reason, treatment should be comprehensive and aimed at solving all problems.

1. Antihistamines. Designed to relieve swelling from mucous tissues. In childhood, Fenistil, Zirtek, Zodak are prescribed. As a last resort, the use of Suprastin is allowed.
2. Antiviral and immunomodulating agents. Designed to strengthen the immune system and combat pathogens of the underlying disease.
3. Antibacterial eye drops. In childhood, Albucid eye drops are a universal medicine. In addition to him, the child is prescribed antiviral eye drops Oftalmoferon, Poludan, Aktipol, Tobrex. The multiplicity of application in the first days of the disease is from 6 to 8 times. The frequency of use decreases as the conjunctivitis is treated. The duration of the course is at least 8-10 days.
4. Antiviral ointments. Ointments are prescribed in case of severe damage to the eye. They are laid after treatment of the mucosa with infusion of chamomile, furacilin or tea. The ointment is placed behind the lower eyelid or along its edges. The most famous drugs are Florenal, Tebrofen ointment, Bonafton. It is allowed to use funds with a local antibiotic: Erythromycin or Tetracycline ointment. The course of treatment is from 10 to 20 days. The duration is determined by the attending physician.
5. Nasal drops. To completely exclude the recurrence of the disease, it is necessary to treat the respiratory organs. For this, children are prescribed vasoconstrictor drugs to facilitate breathing. From birth, Nazol-Baby is used. After that, you need to rinse your nose and drip antibacterial drops. It can be Albucid, Dioxidin, Isofra or Polydex. The drug is prescribed by an ENT doctor depending on the age of the child.

In addition to strict adherence to the treatment regimen for adenoviral conjunctivitis, it is necessary to create special conditions for the patient and the people around him.

1. Separate room. A sick child should be in a separate room. This is due to the high degree of contagiousness of the disease. The room should be regularly ventilated. In case of a painful reaction to sunlight, it is recommended to shade the windows with curtains.
2. Individual toilet items and bedding. The patient should be provided with his own towel, soap, bed linen and dishes.
3. Hands should be washed thoroughly before and after contact with the patient and carrying out medical manipulations. This will avoid infection of other family members and exclude the introduction of additional infection.
4. During eye treatment, change cotton swabs regularly. One swab can not wipe the eye twice. Handkerchiefs are subject to boiling.

Prognosis of development and prevention of the disease

Adenovirus conjunctivitis is not a disease leading to severe consequences. With timely diagnosis and the use of antibacterial drugs, improvement occurs in 4-7 days. In the case of an uncomplicated form, a cure is possible without the use of medicines, subject to the rules of personal hygiene. In a complicated case, it is possible to extend the treatment for up to 1 month. Relapses are quite rare.

To prevent the disease, it is important to strengthen the immune system, take vitamin complexes. During the cold and flu season, the use of immunomodulatory drugs is allowed. Particular attention should be paid to personal hygiene and the environment. It is important to regularly ventilate the room. Hands should be washed after each visit to the street and contact with animals. During the period of exacerbation of respiratory viral infections, special attention should be paid to the treatment of ENT diseases.

May 11, 2017 Anastasia Graudina

Adenovirus conjunctivitis occurs due to the ingestion of an adult adenovirus of different types. Despite the fact that, at first glance, this disease seems completely harmless, but in fact it is not.

The cause of the development of pathology are adenoviruses of the following serotypes: 3, 4, 7, 10 and 11. As a rule, inflammation of the conjunctiva precedes any damage to the upper respiratory tract.

If conjunctivitis is not treated for a long time, then clouding of the lens occurs due to the inflammatory process. Over time, a thorn can form, which will lead to complete blindness.

How does infection occur?

Infection with adenoviral conjunctivitis occurs by airborne droplets when coughing and sneezing, less often by direct contact with the pathogen on the mucous membrane of the eyes.

The disease begins with severe nasopharyngitis and fever. On the second wave of temperature increase, they appear first on one eye, and after 1-3 days on the other. A scanty clear mucous discharge appears. The conjunctiva of the eyelids and transitional folds is hyperemic, edematous, with a greater or lesser follicular reaction and with the formation of easily removable films on the conjunctiva of the eyelids (usually in children). Regional lymph nodes are enlarged. The sensitivity of the cornea is reduced.

How long does adenoviral conjunctivitis last? The phenomena of keratitis usually completely disappear with recovery, which occurs within 2-4 weeks.

Classification

Depending on what symptoms are present, the following forms of adenoviral conjunctivitis are distinguished:

1. Filmy - characterized by the formation of grayish-white films in the area of ​​\u200b\u200bthe shell of the eye, they are easily removed with cotton swabs. If the film is too tight to the conjunctiva, bleeding may occur when it is removed. At the site of mucosal deformation, scars or small seals are visible, but they quickly resolve after complete recovery. A severe form of the disease is accompanied by fever, high fever.
2. Follicular - this type of inflammation of the conjunctiva is recognized by the presence of numerous bubble rashes on the loosened mucous membrane of the eye. In size, they can be different: both large and very small. Visually, these are translucent gelatinous capsules. Especially many follicles cover the transitional fold. The follicular form is very similar to trachoma in the initial stage of development. But errors in diagnosis are very rare, since it is not characterized by manifestations of nasopharyngitis and febrile conditions. In addition, trachoma rashes are located on the conjunctiva of the upper eyelid of the eye.
3. Catarrhal - inflammation and redness are of a minor nature, the discharge is scarce. The disease proceeds easily, takes about 7 days, there are no complications.

When the first signs of pathology appear, it is important to immediately consult a doctor for diagnosis, confirmation or refutation of the diagnosis.

Symptoms of adenovirus conjunctivitis

In the case of adenoviral conjunctivitis, the symptoms may vary depending on the subspecies of conjunctivitis and its associated diseases (see photo). Sometimes the signs that a person has caught a similar virus do not appear, sometimes a person simply begins to be a carrier of the virus.

The onset of adenoviral conjunctivitis is acute. As a rule, at first the lesion is applied to one eye, and after 1-3 days the disease passes to another eye organ.

In this case, the following external signs are observed:

• edema and hyperemia of the conjunctiva;
• the patient feels a burning sensation in the eyes;
• mucous exudate oozes from the eyes;
• the appearance of specific films on the mucosa. This symptom is more common in children;
• follicles of various sizes are formed on the mucosa;
• Strong headache;
• The patient complains of a foreign body sensation in the eye.

Symptoms of the disease may vary depending on the form of the disease:

1. Viral conjunctivitis is characterized by a runny nose, sore throat, and a slight increase in temperature up to 37.5 degrees. The above symptoms of redness and inflammation of the eyes also appear.
2. Adenovirus keratoconjunctivitis has more severe symptoms. All of the above signs are accompanied by the formation of a film on the conjunctiva, blurred vision, enlargement and soreness of the lymph nodes near the ears.

Very often, the disease considered is called pharyngoconjunctival fever. In this case, in addition to eye damage, pharyngitis occurs, accompanied by a rise in temperature. Later, swelling and redness of the eyelids appear. Transparent mucus begins to stand out from the eyes.

What does adenoviral conjunctivitis look like: photo

The photo below shows how the disease manifests itself in adults on the eye.

Diagnostics

The diagnosis is established by an ophthalmologist in the presence of typical symptoms. It is important to carry out differential diagnosis with other types of conjunctivitis (allergic and bacterial), since each case has its own treatment characteristics.

• From laboratory methods, scraping from the conjunctiva, followed by PCR, can confirm the adenoviral nature of the disease. However, this assay is complex and expensive, and therefore does not have a wide clinical application.
• A blood test for the content of antibodies to adenovirus, taken in dynamics, will show an increase in this indicator by more than 4 times.

With persistent conjunctivitis with purulent discharge, a swab is shown for flora and sensitivity to antibiotics, which allows for a correction of the prescribed therapy.

Treatment of adenoviral conjunctivitis in adults

If adenoviral conjunctivitis is detected, outpatient treatment is carried out using antiviral agents. Locally prescribed instillations of interferon and deoxyribonuclease in drops 6-8 times a day in the first week of the disease and 2-3 times a day - during the second week. For adults, as an antiviral therapy, they also use the application of ointments for the eyelids (tebrofen, florenal, bonafton, rhyodoxol, adimal).

To prevent the attachment of a secondary infection, it is advisable to use antibacterial eye drops and ointments. Until complete clinical recovery in adenoviral conjunctivitis, antihistamines are indicated. In order to prevent the development of xerophthalmia, artificial tear substitutes (for example, carbomer) are used.

Medical therapy

Most often, the treatment of adenoviral conjunctivitis is carried out using the following drugs:

• Tebrofen. Antiviral drug. Available in the form of drops or eye ointment.
• Phloxal. The basis of the drug is the antimicrobial agent ofloxacin.
• Albucid. Broad spectrum antimicrobial eye drops.
• Interferon. Immunomodulatory antiviral agent.
• Tobrex. Antimicrobial drops. Can be used from the first days of a child's life.
• Poludan. A drug that stimulates the production of interferon.
• Florenal. Designed to neutralize the virus. Especially effective against Herpessimplex.
• Vitabact. A drug with aseptic properties. Can be used on breasts.

Treatment is carried out under the strict supervision of a doctor. The wrong remedy can only worsen the situation.

Prevention

In order to prevent the development of the problem and its initial appearance, it is necessary to resort to preventive measures that are similar to those for influenza, SARS and similar negative diseases. It is necessary to observe the cleanliness of hands, carry out wet cleaning of the premises and ventilate them regularly.

Also, in order to prevent problems, you should not resort to self-treatment, especially if the disease has entered a fairly serious and noticeable stage. Consult a doctor who will help you correctly prescribe a comprehensive treatment that allows you to get rid of the problem as soon as possible.

Complications and prognosis

Late or incorrect treatment of adenoviral conjunctivitis can lead to the development of rather serious complications, namely:

• development of chronic recurrent conjunctivitis;
• keratoconjunctivitis (spread of inflammation to the cornea);
• accession of a secondary (bacterial) infection;
• development ;
• iridocyclitis (lesion of the iris and ciliary body of the eye).

The prognosis is favorable: the disease usually ends with a complete clinical recovery in 2-4 weeks. With the development of dry eye syndrome, long-term use of tear substitutes is required.

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Adenovirus conjunctivitis is an acute eye disease of an infectious nature. In this case, it is the mucous membrane that is affected. This pathology has a rather bright symptomatology.

And if you do not seek medical help in time, the treatment is long and various complications may occur. Diagnosis and treatment should be carried out by an ophthalmologist.

In the article, you will learn everything about the symptoms and treatment of adenovirus eye conjunctivitis in adults and children.

The reasons

This pathology of the eyes occurs when adenoviruses enter the mucous membrane. It should be noted that not all of their strains can cause inflammation. In this case, adenoviruses 3, 4, 6, 7, 10 and 11 types are aggressive. You can get infected both from a sick person and from a virus carrier(the person has no pathological symptoms, and the virus is present in the body).

Ways of penetration of infection into the human body:

• Contact household. This path is especially common in children, as they do not always follow the rules of personal hygiene. Viruses are introduced into the mucous membrane with contaminated hands;
• Airborne. If there is a sick person nearby, the infection can be transmitted by sneezing and coughing. Microscopic droplets of saliva can get into the eyes.

Etiological factors (what contributes to the onset of the disease) are:

• Acute respiratory viral infections, as well as pathologies of ENT organs. In this situation, conjunctivitis is a complication of the underlying disease;
• Hypothermia of the body;
• Neglect of personal hygiene rules;
• Injury to the organs of vision;
• Operations on the eyes;
• Improper use and care.

Symptoms of adenovirus conjunctivitis

After the penetration of adenoviruses into the body, pathological symptoms do not appear for a week - this is the prodromal period of an infectious disease. After that, signs of damage to the nasopharynx come to the fore: cough and runny nose. At this time, a person may be disturbed by hyperthermia (fever), headache and weakness, there is an increase in the submandibular lymph nodes.

After a couple of days, 1 eye is affected, and after 3 days the infection passes to the second organ of vision. At this time, the following pathological symptoms are noted:

In adults, adenoviral conjunctivitis can occur in a catarrhal or follicular form. With catarrhal conjunctivitis, signs of inflammation are not pronounced. The disease proceeds quite easily and lasts no more than 7 days.

The follicular form of adenoviral conjunctivitis is characterized by the presence of a specific rash. They can be of various sizes, single or multiple. The follicles are located on the inflamed mucosa and in the folds of the eyelids.

Diagnosis of the disease

When a patient is contacted, first of all, an examination and questioning is carried out. It is necessary to identify predisposing factors for the development of a viral infection, as well as possible contact with a sick person or a virus carrier.

On examination, the ophthalmologist records all subjective (complaints) and objective pathological symptoms.

To confirm the diagnosis of adenoviral conjunctivitis, laboratory tests are carried out:

• Immunofluorescence method. A smear of the detachable conjunctiva of the eyes is being examined, specific antigens are detected;
• PCR (polymer chain reaction). In this case, adenovirus DNA is detected in a scraping from the mucosa;
• Bacteriological examination of a smear from the mucous membrane of the eyes. In this case, viruses are grown on a special nutrient medium;
• ELISA (enzyme-linked immunosorbent assay) - antibodies to adenoviruses are detected in the blood. Of great importance is a sharp increase in antibody titer.

Treatment of conjunctivitis in adults

If a person has adenoviral conjunctivitis, then you should immediately seek help from an ophthalmologist. He will prescribe effective treatment.

It should be noted that the treatment of a viral infection is rather difficult. This is due to the fact that in medicine there are no drugs that can destroy viruses. Only human immunity can kill them. In this case, it is necessary to maintain the body's defenses so that they can overcome adenoviruses.

Therapy for adenoviral conjunctivitis should be comprehensive, that is, include the following types of treatment:

• Antiviral;
• Antibacterial;
• Anti-inflammatory;
• Antihistamine;
• Immunomodulating and immunostimulating;
• Fortifying.

Consider how to treat adenovirus conjunctivitis.

Antiviral treatment

In the treatment of adenoviral conjunctivitis, antiviral drops and ointments are used. Drops such as Tebrofen, Interferon, Laferon and others are instilled 6-8 times a day in the first few days of the disease. When inflammation subsides, drops are used 3 times a day.

If the inflammation is severe, then the use of anti-inflammatory ointments is indicated: Florenal, Bonafton, Riodoxol ointment, and so on. The ointment is placed behind the lower eyelid into the crease. Before this, it is necessary to rinse the eyes, chamomile.

Antibacterial treatment

To prevent the attachment of a secondary bacterial infection, the use of antibacterial agents in the form of eye drops (,) and ointments (and) is indicated.

Antibacterial nose drops (Albucid, Polydex) are also prescribed. This is necessary to prevent the re-development of adenoviral conjunctivitis.

The course of treatment lasts from 1 week to 10 days. it all depends on the form of the disease, the condition of the patient's body and the severity of pathological symptoms. In the first days of treatment, the drops must be used 6 times, then the frequency of use decreases. This issue is decided by the attending physician.

Anti-inflammatory treatment

In order to remove the signs of inflammation and the associated inconvenience in treatment as soon as possible, non-steroidal anti-inflammatory drugs in the form of tablets are used. These drugs include: Ibuprofen, Nurofen, Diclofenac and others.

They also relieve pain, which is especially important in the early days of illness.

Antihistamine treatment

To get rid of swelling and itching in adenoviral conjunctivitis, it is necessary to use antihistamines (tablets and drops for oral administration). Sometimes patients, especially children, experience very severe itching. If you start rubbing and scratching your eyes, the swelling and soreness will only increase. It is also possible to attach a secondary infection. That is why the ophthalmologist without fail prescribe antiallergic drugs: Zodak, Fenistil, Zirtek.

Restorative and immunomodulatory treatment

To support immunity, it is necessary to take a special group of drugs: immunostimulants and immunomodulators. They boost the immune system and help it fight adenoviruses.

However, it is possible to strengthen the body's defenses with the help of general strengthening therapy, which includes:

• Taking vitamins;
• Balanced diet rich in vitamins and minerals;
• Compliance with the drinking regime (this is very important in the development of inflammation and an increase in body temperature);
• Compliance with bed rest.

Also in the later stages of the disease, the use of eye drops is indicated, which in composition resemble a tear (for example, Artificial tear). This is necessary to prevent dry eyes.

Features of symptoms and treatment in children

It should be noted that any viral disease in children is more severe than in adults. The child's general condition suffers significantly:

• He becomes lethargic;
• Naughty, babies cry a lot, may refuse to breastfeed;
• Body aches;
• Increase in body temperature.

In infants and children, the film form of adenoviral conjunctivitis is most often noted. This is the most difficult form of the disease. Symptoms of adenoviral conjunctivitis in children:

Treatment of adenoviral conjunctivitis in children

Treatment is carried out on an outpatient basis under the supervision of an ophthalmologist. The following drugs are prescribed:

• Non-steroidal antiviral drug - Nurofen in the form of syrup. It can be used from 3 months of a child's life. It will reduce pain and help lower the temperature;
• Antiviral eye drops:,;
• Antibacterial eye drops. The drug of choice in children of different ages is Albucid. The drug must be dripped into both eyes, even if pathological signs are observed only in one;
• Drops for the treatment of rhinitis (runny nose). Children from birth can be instilled with Nazol Baby and Albucid.

The child needs to drink water, fruit drinks, herbal tea. This will help to avoid dehydration during hyperthermia.

Rules for caring for a child with adenovirus conjunctivitis:

• Allocate separate bed linen and towels for the child;
• Frequently ventilate the room where the patient is located;
• Frequent sienna underwear and bed linen;
• Wash hands thoroughly before handling eyes to avoid re-infection;
• There should not be a bright source of light in the room, as the baby may experience pain;
• Eyes should be treated with sterile gauze swabs. 1 tampon is used per wipe. Reuse is prohibited!
• Wash hands after handling a child's eyes. This will help prevent further spread of the infection.

You can read about the treatment of conjunctivitis in children.

Consequences and complications

The prognosis for adenoviral conjunctivitis is favorable . If the treatment is started in a timely manner and carried out correctly, then the cure occurs on the 8th - 10th day. In the event that treatment is started late, the disease lasts about 1 month. In this case, the likelihood of frequent relapses (recurrence of infection) is high.

If the treatment of adenoviral conjunctivitis was incorrect, then the following complications develop:

• Chronic recurrent conjunctivitis. In this case, pathological symptoms appear when immunity is weakened (poor nutrition, stress, SARS, diseases of internal organs, hypothermia);
• Accession of a secondary infection of a bacteriological nature;
• Attachment of inflammation of the cornea;
• Iris damage;
• Decreased visual acuity;
• . The production and release of tears in the eye is sharply reduced, which is why there is constant dryness, a feeling of "sand in the eyes";
• Otitis - inflammation of the middle ear;
• Tonsillitis is an inflammation of the palatine tonsils.

Adenovirus conjunctivitis- a disease caused by adenoviruses, occurring with damage to the conjunctiva of both eyes. At the same time, there are symptoms of nasopharyngitis, an increase in body temperature.

Acute adenoviral conjunctivitis is always characterized by the manifestation of such local symptoms as hyperemia of the mucous membrane, pain, burning, a feeling of sand in the eyes, constant profuse lacrimation, and the formation of a pathological discharge.

Adenovirus conjunctivitis is much more common among pediatric patients, as often children are unable to adequately maintain hand and eye hygiene. Often, with untimely started therapy, the risk of developing various undesirable complications, as well as consequences, increases significantly. Treatment of the pathology of adenoviral conjunctivitis should often be complex and include antiviral drugs and local antibacterial drugs.

Causes of adenovirus conjunctivitis

Acute adenoviral conjunctivitis belongs to the group of highly contagious diseases, and often can even cause epidemic outbreaks. Most often, such cases are recorded in children's groups and with the onset of spring, as well as in the autumn period.

Adenovirus conjunctivitis in adults, as, in principle, in children develops as a result of the introduction into the body of an infectious agent belonging to the Adenovirus family. A feature of this pathogen is that it contains a molecule of deoxyribonucleic acid or DNA. This fact significantly distinguishes it from other representatives of various diseases belonging to the group of respiratory infections. In diameter, adenovirus does not exceed 90 nanometers, has a spherical shape. Of its physical properties, it should be noted the good resistance of the virus in the external environment, heating to 50 ° C and exposure to drugs such as phenol and chloramine can be detrimental to it. It should be noted its high ability to replicate in animal and human tissues. Upon penetration into the human body, adenovirus has a damaging effect on cells with the development of their destruction, vacuolization, hypertrophy of cell nucleoli, and chromatin decay. In the course of the research, the existence of over 40 serotypes of this infectious agent was established, but with sporadic episodes of adenoviral conjunctivitis, serotype 4, 6, as well as 7 and 10 most often prevail. In the case of registering epidemic outbreaks, types such as 3, 11 and 7a.

Infection with this pathology occurs through the airborne route of transmission or contact, which is feasible when talking, coughing, sneezing. Adenovirus conjunctivitis in children is most often transmitted by contact through contaminated hands while touching the face and eyes.

There is a group of factors that contribute to the development of this disease, these include direct contact with a patient with adenoviral conjunctivitis, poor hygiene, hypothermia, improper wearing and care of glasses and contact lenses, eyeball trauma, and all kinds of surgical interventions on the organs of vision.

There are the following 3 forms of adenoviral conjunctivitis: membranous, catarrhal and follicular. It should be noted that the membranous form is more often registered among the child population, and the other two forms are found in all age groups.

After suffering, according to established data, a person develops a stable immune response against only the serotype of the virus with which he was infected.

Symptoms and signs of adenoviral conjunctivitis

The time from the moment of infection with adenovirus to the manifestation of the very first clinic is on average about 5-7 days, but sometimes the incubation period can be much shorter, up to 3 days.

Adenovirus conjunctivitis in adults usually proceeds much easier than in a child, however, the symptoms of the disease are identical.

The disease begins as usual and is accompanied by an increase in body temperature with the development of symptoms of pharyngitis, nasal congestion or rhinitis. The accompanying complaints of the patient include such as: headaches, loose stool disorders. When palpation of the submandibular region, an increase in all groups of lymph nodes located there is revealed. A day or 2-3 days later, a characteristic sign of the disease with adenoviral conjunctivitis is revealed, which is manifested by manifestations of damage initially to one eye, but after a while the other eye is also affected. Usually, the period between the involvement of both eyes in the process is 2-3 days. A close examination reveals swelling in the eyelids, the development of redness, the presence of a transparent mucous discharge, however, it can often acquire the character of a purulent discharge. Patients usually complain of lacrimation, as well as pain in the eyes in bright light, a feeling of a foreign body in the eye, itching, burning, and icterus of the sclera in the region of both eyes is also clearly visible.

It is customary to distinguish the following forms of adenoviral conjunctivitis:

- The membranous form of conjunctivitis of adenoviral etiology is mainly recorded among pediatric patients and is characterized by the formation of typical thin films that cover the mucous membrane of the eye. They can be painlessly and easily removed with a cotton swab. When viewed, they are white with a grayish tinge, however, in rare cases, they can acquire the character of fibrinous films, of a dense consistency, which are able to solder with the conjunctiva of the eye and, accordingly, they are difficult to remove without damaging the mucous membrane. As a rule, scars after suffering this form of adenoviral conjunctivitis can form, but this is rare. Basically, the formation of small hemorrhages is observed, which gradually disappear. It should be noted that this form of the disease always proceeds quite long and hard, with a rise in high temperature and developed symptoms of intoxication.

- The catarrhal form is characterized by a slight reddening of the mucous membrane of the eye with the release of a small amount of secretion. With this type of adenoviral conjunctivitis, the disease is rarely accompanied by the development of complications and, as a rule, lasts no more than 7-8 days.

- With the follicular form, a large number of vesicles or follicles are detected in the mucous membrane of the eyes, translucent, with possible localization also on the eyelids, on the transitional fold. The mucous membrane of the eye in this form is loose, icteric.

Among the most frequently reported complications, such as the attachment of secondary microflora in the form of bacterial agents, the development of dry eye syndrome, eye damage with the formation of keratitis, as well as involvement in the pathological infectious process of a closely located organ of hearing with the occurrence of otitis media, damage to the oropharynx with diagnosing tonsillitis.

Complications of adenoviral conjunctivitis are diagnosed relatively infrequently and are associated primarily with delayed treatment.

On average, adenoviral conjunctivitis in children, as in adults, is characterized by a duration of 14 days, that is, 2 weeks with its timely diagnosis and appropriate etiopathogenetic treatment.

Diagnosis of adenoviral conjunctivitis

Acute adenoviral conjunctivitis can be diagnosed when examined by the attending physician, preferably an ophthalmologist, as a preliminary diagnosis, if the following symptoms of the lesion are present: an immediate clinical picture of conjunctivitis with mucosal hyperemia, swelling of the eyelids, the presence of discharge from the eyes of a different nature; diagnosis of pharyngitis with the development of rhinitis, as well as the detection of enlarged lymph nodes in the neck and adjacent areas. The assumption of infection with adenovirus arises because the signs of eye damage in this pathology are very similar in similar lesions, but only of allergic and bacterial etiology.

There are the following types of laboratory tests that can be performed to confirm the diagnosis of adenoviral conjunctivitis, namely:

- Immunofluorescent diagnostic method, which belongs to the methods of early detection of the presence of viral antigens in smears taken from the mucous membrane of the conjunctiva;

- Among the common serological reactions, RSK or the Complement Fixation Reaction and ELISA or Enzyme Immunoassay are used, which make it possible to detect the titer of antibodies in the blood to adenoviruses. As a rule, in most infections and in adenoviral conjunctivitis, in particular, this indicator is informative when an increase of 4 times or more is achieved. However, this technique does not apply to urgent, as well as quickly feasible, and the sampling of biological material must be carried out twice, that is, at the beginning of the development of the disease and after recovery;

- When using the PCR method or the Polymerase Chain Reaction, it is possible to identify a DNA molecule belonging to adenovirus, if it is present in a conjunctival scraping. This technique can be carried out only in special laboratories and refers to expensive research;

- It is also possible to conduct a bacteriological study, which does not apply to rapid diagnostic methods, but allows you to get the growth of adenovirus on a special nutrient medium, to identify it. Usually a smear is taken from the conjunctiva of the affected eye. In addition, with this pathology, it is possible to determine the possible growth of concomitant pathological microflora, with subsequent adjustment of treatment.

It is always worth remembering that the clinic of adenoviral conjunctivitis is in many ways similar to bacterial eye damage, and if it is not properly treated, serious and rather severe complications of adenoviral conjunctivitis can develop. Often in such cases, the process is able to move to the cornea of ​​​​the eye with its defeat, which can even cause visual impairment. Therefore, a very important point is not to conduct an independent selection of medicines and treatment, but to contact a specialist for correct diagnosis and prescription. essential medicines drugs.

Differential diagnosis of adenoviral conjunctivitis must necessarily be carried out with such diseases as acute manifestation of glaucoma, keratitis, iritis, episcleritis. It is equally important to establish the presence of adenoviral conjunctivitis in connection with the presence of a similar clinic for eye lesions of a bacterial nature, herpetic, chlamydial etiology, and also fungal.

Treatment of adenovirus conjunctivitis

Adenovirus conjunctivitis in adults, as well as when diagnosing it in children, is treated with the use of drugs, both local and general. Often, with a long and protracted recovery process, as well as if there is a suspicion of the addition of a secondary bacterial flora, along with antiviral agents, topical antibacterial medications should also be prescribed.

Most often in the practice of a doctor in the treatment of this pathology, drops such as Interferon, Tobrex, Poludan, Vitabact and many others are prescribed. On the first day of the disease, a fairly frequent use of these drugs is recommended, up to 8 times a day, but when the condition improves, the number of instillations is reduced to 3-4.

Simultaneously with the use of local antiviral drugs, it is recommended to use antihistamines inside, as well as to prescribe so-called artificial eye moisturizers, for example, Oftagel or Vidisik. When deciding to add topical antibacterial drugs to the main treatment, you can choose between drops or ointments.

Since this infection is of the viral type and during its development there is not only damage to the eye apparatus, but also the manifestation of symptoms of rhinitis and pharyngitis, it is by no means superfluous to prescribe systemic immunomodulatory drugs that have a general strengthening effect, as well as antiviral, and are able to activate protective the body's strength to fight the pathogen.

In addition to the appointment of etiological treatment, a very important point in the treatment of adenoviral conjunctivitis is the fulfillment of the following conditions:

- If possible, a sick child (or adult) should be in a separate room, which must be well ventilated at least 2 times a day, and with the development of an increased reaction to light, ensure darkening with curtains;

- A prerequisite for preventing infection of other family members is to provide a patient with adenoviral conjunctivitis with a separate towel, pillow, soap and dishes;

- It is very important for all those caring for patients with this pathology, always wash their hands well before contact with him and after, in order to prevent the introduction of a bacterial infection, as well as to prevent the possible spread of adenovirus to healthy family members;

- Be sure to provide the patient with his individual pipette for instillation into the eyes, a handkerchief, cotton swabs, cotton pads for processing and washing the eyes. All items that can be boiled must be processed.

If a patient with adenoviral conjunctivitis is detected, especially in the children's team, it is imperative to isolate him, then carry out a wet cleaning of the room and ventilate it thoroughly. An important step in the prevention of the disease is always the observance of personal hygiene measures. All instruments that were used when examining a patient in an ophthalmologist's office must be sterilized and thoroughly disinfected. Since the causative agent of the disease can exist not only in the air, but also in the aquatic environment, it is necessary to carefully monitor the chlorination of water in pools.

Therapy for adenoviral conjunctivitis lasts on average, even with the appointment of competent treatment, about 10-12 days. Relapses of this disease can occur, but very rarely. The prognosis of the pathology of adenoviral conjunctivitis is generally favorable.

Adenovirus conjunctivitis - which doctor will help? At the slightest suspicion of the development of this disease, you should immediately consult a doctor such as an ophthalmologist.