CONJUNCTIVATE - inflammation of the mucous membrane (conjunctiva) of the eye. It is one of the most common eye diseases. This is due to the high reactivity of the conjunctiva, which easily reacts to various endogenous and exogenous influences, as well as the accessibility of the conjunctival sac to external influences, which is due to its anatomical location.
According to the nature of the pathological process, acute and chronic conjunctivitis is distinguished; depending on the etiology, pneumococcal, diphtheria, gonococcal, adenoviral, enterovirus, chlamydial, allergic and other types of conjunctivitis are distinguished.
Acute conjunctivitis begins with the appearance of severe cramps in the eyes, the sensation of sand over the centuries, abundant discharge from the conjunctival sac. The conjunctiva is swollen, hyperemic, and eyelid edema sometimes develops.
Conjunctivitis caused by pneumococci is characterized by the defeat of one eye first, then the second. Conjunctiva may cause point hemorrhages, and sometimes the formation of thin, easily removable films; purulent discharge.
Diphtheria conjunctivitis (diphtheria conjunctiva) is characterized by the appearance of grayish, hard-to-remove films on the conjunctiva of the eyelids. Eyelids tight, swollen. Corneal lesions are often noted.
Adenoviral conjunctivitis is observed sporadically and in the form of epidemic outbreaks. The virus is transmitted by contact. The incubation period is 4 to 8 days. Often the development of conjunctivitis is preceded by inflammatory diseases of the upper respiratory tract, fever. The process is usually one-sided. Marked hyperemia and swelling of the conjunctiva; discharge mucous or mucopurulent. Possible damage to the cornea, leading to a temporary decrease in visual acuity.
Enterovirus conjunctivitis spreads quickly, the incubation period is very short (8 - 48 h). Epidemics occur "in an explosive manner," causing outbreaks. Acute conjunctivitis is accompanied by subconjunctival hemorrhages - from barely noticeable punctate to extensive, exciting all the eyeball.
Chlamydial conjunctivitis (chlamydia of the eye, bath conjunctivitis, swimming pool conjunctivitis) develops when it comes in contact with the mucous membrane of the eye infected with chlamydia, discharge from the affected eye or urinary organs. The incubation period is 5-14 days. Usually one eye is affected, copious, purulent discharge. On the lower conjunctival fold, usually there are rows of large follicles, marked hyperemia of the mucous membrane, an increase in the parotid lymph nodes.
The diagnosis is usually made on the basis of the clinical picture. To clarify the etiology of the disease, laboratory studies (bacteriological, cytological, immunological and serological) are carried out.
Treatment includes frequent washes of the conjunctival sac with a 2% solution of boric acid, solutions of sulfacyl-sodium, penicillin, kanamycin, gentamicin, 10% solution of sulfapyridazine; foundation of tetracycline or erythromycin ointment for eyelids (3-4 times a day), eye film with sulfapyridazine or kanamycin (1 time per day). In adenoviral conjunctivitis, instillations of antiviral drugs are used — interferon, pyrogenal, semi-dan (6–8 times a day) or ointment laying — 0.5% tefrofen or 0.5% florenal (3-4 times a day).
The prognosis for acute conjunctivitis in the case of timely treatment is favorable, the process ends with full recovery.
Prevention includes personal hygiene. If acute conjunctivitis occurs, the patient should be isolated; Especially dangerous is the stay of patients with conjunctivitis in children's groups. For instillation of drugs or laying ointment, use individual pipettes and glass rods, after which they are sterilized by boiling.
Allergic conjunctivitis occurs when the body is sensitive to pollen, dust (household or industrial), wool, feathers, down, household chemicals, pesticides, detergents, chemical air pollutants, cosmetic and perfume products, and drugs. Seasonal exacerbations are characteristic of conjunctivitis caused by pollen during the flowering period of grass, grass, trees. Pollinous conjunctivitis is often combined with runny nose, dermatitis, and bronchial asthma. Drug conjunctivitis most often occurs when using eye drops and ointments, less often when taking medication inside.
Diagnosis is mainly based on the allergic history. Treatment involves the complete elimination of the allergen.
Chronic conjunctivitis can occur in conditions of polluted and dusty air, under the influence of chemical impurities or with intense visual work in individuals with long-sightedness or astigmatism of the eye, when working in poor lighting conditions, with diseases of the eyelids and lacrimal ducts, chronic diseases of the nose and nasopharynx. Symptoms of chronic conjunctivitis are heaviness of the eyelids, burning sensation, foreign body sensation, tearing, photophobia . In children, chronic conjunctivitis usually occurs with the formation of numerous follicles in the lower transition fold (folliculosis). Chronic conjunctivitis is difficult to treat, often recurs. Prevention includes timely treatment of blepharitis, the correct selection of corrective glasses.