Conjunctivitis is a condition in which the eyes get inflammation of the mucous membrane that lines the surface of the eyeball and inner eyelids.
It may be acute or chronic. Most cases are due to viral or bacterial (including gonococcal and chlamydial) infection.
The mode of transmission of infectious conjunctivitis is usually via direct contact of contaminants.
SYMPTOMS
Pink or red color in the white of the eye(s).
Swelling of the conjunctiva (the thin layer that lines the white part of the eye and the inside of the eyelid) and/or eyelids.
Increased tear production.
Feeling like a foreign body is in the eye(s) or an urge to rub the eye(s).
Itching, irritation, and/or burning.
Discharge (pus or mucus).
Crusting of eyelids or lashes, especially in the morning.
Contact lenses that feel uncomfortable and/or do not stay in place on the eye.
Depending on the cause, other symptoms may occur. Symptoms of conjunctivitis (pink eye).
1. VIRAL CONJUNCTIVITIS
Adenovirus is the most common cause of viral conjunctivitis. Usually, copious watery discharge and a follicular conjunctivitis.
Infection can spread easily.
May result in decreased vision from corneal sub epithelial infiltrates, which is usually caused by adenovirus. The active viral conjunctivitis lasts up to 2 weeks.
Infection with adenovirus with pharyngitis, fever, malaise, and preauricular adenopathy (pharyngoconjunctival fever).
The disease usually lasts 10 days.
There is no specific treatment for contagious viral conjunctivitis.
Artificial tears and cold compresses may help reduce discomfort.
Frequent hand and linen hygiene are encouraged to minimize spread.
2. BACTERIAL CONJUNCTIVITIS
Most commonly in bacterial conjunctivitis are staphylococci, including methicillin-resistant S aureus (MRSA); streptococci, particularly Streptococcus pneumoniae; Herophilus species; Pseudomonas; and Moraxella.
All may produce a copious purulent discharge.
There is no blurring of vision and only mild discomfort.
The disease is usually self-limited, lasting about 10–14 days if untreated. Most topical antibiotics hasten clinical remission.
This infection is typically self-limited and benign, and no topical antibiotic has proven superiority over another.
3. GONOCOCCAL CONJUNCTIVITIS
Gonococcal conjunctivitis, usually acquired through contact with infected genital secretions, typically causes copious purulent discharge.
It is an ophthalmologic emergency because corneal involvement may rapidly lead to perforation.
The diagnosis should be confirmed by stained smear and culture of the discharge.
Systemic treatment is required. A single 1-g dose of intramuscular ceftriaxone is usually adequate. Fluoroquinolone resistance is common.
Eye irrigation with saline may promote resolution of conjunctivitis.
Topical antibiotics such as erythromycin and bacitracin may be added.
Other sexually transmitted diseases, including chlamydiosis, syphilis, and HIV infection, should be considered. Routine treatment for chlamydial infection is recommended.
4. CHLAMYDIAL KERATOCONJUNCTIVITIS
TRACHOMA
Trachoma is the most common infectious cause of blindness worldwide.
A single 1-g dose of oral azithromycin is the preferred drug for mass treatment campaigns, but improvements in hygiene and living conditions probably have contributed more.
Local treatment is not necessary. Surgical treatment includes correction of lid deformities and corneal transplantation.
INCLUSION CONJUNCTIVITIS
The eye becomes infected after contact with genital secretions infected with chlamydia.
The disease starts with acute redness, discharge, and irritation. The eye findings consist of follicular conjunctivitis with mild keratitis.
Treatment is with a single dose of azithromycin, 1 g orally. All cases should be assessed for genital tract infection and other sexually transmitted diseases.