Conjunctivitis (popularly known as apollo) is
the inflammation of the conjunctiva (the
outermost layer of the eye and the inner
surface of the eyelids). It is commonly due
to an infection (usually viral, but sometimes
bacterial) or an allergic reaction. It is
caused by allergens (Allergic conjunctivitis)
bacterial or viral invasion (Bacterial
conjunctivitis and viral conjunctivitis
respectively), chemical splash on the eye(s),
and neonatal conjunctivitis.
SIGNS AND SYMPTOMS
Red eye (hyperaemia), swelling of
conjunctiva (chemosis) and watering
(epiphora) of the eyes are symptoms
common to all forms of conjunctivitis.
However, the pupils are should normally
react to light.
Viral conjunctivitis is often associated with
an infection of the upper respiratory tract, a
common cold, and/or a sore throat. Its
symptoms include excessive watering and
itching. The infection usually begins with one
eye, but may spread easily to the other.
Bacterial conjunctivitis causes the rapid
onset of conjunctival redness, swelling of the
eyelid, and discharge of mucous. Typically,
symptoms develop first in one eye, but may
spread to the other eye within 2–5 days.
Bacterial conjunctivitis due to common pus-
producing bacteria causes marked grittiness/
irritation and a stringy, opaque, greyish or
yellowish mucous that may cause the lids to
stick together, especially after sleep. Severe
crusting of the infected eye and the
surrounding skin may also occur, but,
contrary to popular belief, discharge is not
essential to the diagnosis. The gritty and/or
scratchy feeling is sometimes localized
enough for patients to insist they must have
a foreign body in the eye. The more acute
pyogenic infections can be painful. Common
bacteria responsible for non-acute bacterial
conjunctivitis are Staphylococci and
Streptococci.
Chemical eye injury is due to either an
acidic or alkali substance getting in the eye.
Alkalis are typically worse than acidic burns.
Mild burns will produce conjunctivitis while
more severe burns may cause the cornea to
turn white. Litmus paper is an easy way to
rule out the diagnosis by verifying that the
pH is within the normal range of 7.0—7.2.
Large volumes of water is the treatment of
choice and should continue until the pH is 6
—8. Local anaesthetic eye drops can be used
to decrease the pain.
Other
Inclusion conjunctivitis of the newborn (ICN)
is a conjunctivitis that may be caused by the
bacteria Chlamydia trachomatis, and may
lead to acute, purulent conjunctivitis.
However, it is usually self-healing.


PREVENTION


The best effective prevention is hygiene and
not rubbing the eyes by infected hands.
Vaccinations against adenovirus and bacteria
like Haemophilus influenzae, pneumococcus,
and Neisseria meningitidis are also effective.



MANAGEMENT


Conjunctivitis resolves in 65% of cases
without treatment, within two to five days.
The prescription of antibiotics is not
necessary in most cases.
For the allergic type, cool water poured over
the face with the head inclined downward
constricts capillaries, and artificial tears
sometimes relieve discomfort in mild cases.
In more severe cases, non-steroidal anti-
inflammatory medications and
antihistamines may be prescribed. Persistent
allergic conjunctivitis may also require
topical steroid drops.
Bacterial conjunctivitis usually resolves
without treatment. Antibiotics, eye drops, or
ointment may only be needed if no
improvement is observed after three days. In
people receiving no antibiotics, recovery was
in 4.8 days, with immediate antibiotics it
was 3.3 days, and with delayed antibiotics
3.9 days. No serious effects were noted
either with or without treatment. As they do
speed healing in bacterial conjunctivitis, their
use is also reasonable.
The number of bacterial eye infections
related to sexually transmitted disease is
steadily rising. Chlamydial eye infections are
the world’s leading cause of blindness, and
these cases will not resolve without
antibiotics
Conjunctivitis due to chemicals is treated via
irrigation with Ringer’s lactate or saline
solution. Chemical injuries (particularly alkali
burns) are medical emergencies, as they can
lead to severe scarring and intraocular
damage. People with chemically induced
conjunctivitis should not touch their eyes,
regardless of whether or not their hands are
clean, as they run the risk of spreading the
condition to another eye.
Conjunctivitis can be a frustrating condition
– especially allergic conjunctivitis – but in
most cases it doesn’t pose a serious threat
to health.