Conjunctivitis (redirected from Junctivitis)

Conjunctivitis 

Definition

Conjuctivitis is an inflammation or redness of the lining of the white part of the eye and the underside of the eyelid (conjunctiva) that can be caused by infection, allergic reaction, or physical agents like infrared or ultraviolet light.

Description

Conjunctivitis is the inflammation of the conjunctiva, a thin, delicate membrane that covers the eyeball and lines the eyelid. Conjunctivitis is an extremely common eye problem because the conjunctiva is continually exposed to microorganisms and environmental agents that can cause infections or allergic reactions. Conjunctivitis can be acute or chronic depending upon how long the condition lasts, the severity of symptoms, and the type of organism or agent involved. It can also affect one or both eyes and, if caused by infection, can be very easily transmitted to others during close physical contact, particularly among children in a daycare center. Other names for conjunctivitis include pink eye and red eye.

Causes and symptoms

Conjunctivitis may be caused by a viral infection, such as a cold, acute respiratory infection, or disease such as measles, herpes simplex, or herpes zoster. Symptoms include mild to severe discomfort in one or both eyes, redness, swelling of the eyelids, and watery, yellow, or green discharge. Symptoms may last anywhere from several days to two weeks. Infection with an adenovirus, however, may also cause a significant amount of pus-like discharge and a scratchy, foreign body-type of sensation in the eye. This may also be accompanied by swelling and tenderness of the lymph nodes near the ear.

Bacterial conjunctivitis can occur in adults and children and is caused by organisms such as Staphylococcus, Streptococcus, and Hemophilus. Symptoms of bacterial conjunctivitis include a pus-like discharge and crusty eyelids after awakening. Redness of the conjunctiva can be mild to severe and may be accompanied by swelling. Persons with symptoms of conjunctivitis who are sexually active may possibly be infected with the bacteria that cause either gonorrhea or chlamydia. There may be large amounts of pus-like discharge, and symptoms may include intolerance to light (photophobia), watery mucous discharge, and tenderness in the lymph nodes near the ear that may persist for up to three months.

Conjunctivitis may also be caused by environmental hazards, such as wind, smoke, dust, and allergic reactions caused by pollen, dust, or grass. Symptoms range from itching and redness to a mucous discharge. Persons who wear contact lenses may develop allergic conjunctivitis caused by the various eye solutions and foreign proteins contained in them.

Other less common causes of conjunctivitis include exposure to sun lamps or the electrical arcs used during welding, and problems with inadequate drainage of the tear ducts.

Diagnosis

An accurate diagnosis of conjunctivitis centers on taking a patient history to learn when symptoms began, how long the condition has been going on, the symptoms experienced, and other predisposing factors, such as upper respiratory complaints, allergies, sexually transmitted diseases, herpes simplex infections, and exposure to persons with pink eye. It may be helpful to learn whether an aspect of an individual's occupation may be the cause, for example, welding. Diagnostic tests are usually not indicated unless initial treatment fails or an infection with gonorrhea or chlamydia is suspected. In such cases, the discharge may be cultured and Gram stained to determine the organism responsible for causing the condition. Cultures and smears are relatively painless.

Treatment

The treatment of conjunctivitis depends on what caused the condition. In all cases, warm compresses

Conjunctivitis is the inflammation of the conjunctiva, a thin, delicate membrane that covers the eyeball and lines the eyelid. It may be caused by a viral infection, such as a cold or acute respiratory infection, or by such diseases as measles, herpes simplex, or herpes zoster.

(Illustration by Electronic Illustrators Group.)

applied to the affected eye several times a day may help to reduce discomfort. Some treatment choices will be based on patient preference, convenience of use, and cost to the patient.

Conjunctivitis due to a viral infection, particularly those due to adenoviruses, are usually treated by applying warm compresses to the eye(s) and applying topical antibiotic ointments to prevent secondary bacterial infections.

Viral conjunctivitis caused by herpes simplex should be referred to an ophthalmologist. Topical steroids are commonly prescribed in combination with antiviral therapy.

In cases of bacterial conjunctivitis, a physician may prescribe an antibiotic eye ointment or eye drops containing sodium sulfacetamide (Sulamyd) to be applied daily for seven to 14 days. If, after 72 hours, the condition does not improve, a physician or primary care provider should be notified because the bacteria involved may be resistant to the antibiotic used or the cause may not be bacterial.

For cases of conjunctivitis caused by a gonococcal organism, a physician may prescribe an intramuscular injection of ceftriaxone (Rocephin) and a topical antibiotic ointment containing erythromycin or bactracin to be applied four times daily for two to three weeks. Sexual partners should also be treated.

With accompanying chlamydia infection, a topical antibiotic ointment containing erythromycin (Ilotycin) may be prescribed to be applied one to two times daily. In addition, oral erythromycin or tetracycline therapy may be indicated for three to four weeks. Again, sexual partners should also be treated.

Allergic conjunctivitis can be treated by removing the allergic substance from a person's environment, if possible; by applying cool compresses to the eye; and by administering eye drops four to six times daily for four days. Also, oral antihistamines may help to relieve itchy eyes. However, many of these drugs also dry the eyes. Therefore, many physicians suggest a combination of antihistamines and lubricating drops or the use of nasal corticosteroid sprays to help relieve allergic conjunctivitis, particularly when it is combined with nasal symptoms.

Alternative treatment

Conjunctivitis caused by gonococcal and chlamydial infection usually requires conventional medical treatment. With bacterial, viral, and allergic conjunctivitis, however, alternative options can be helpful. Internal immune enhancement with supplementation can aid in the resolution of bacterial and viral conjunctivitis. Removal of the allergic agent is an essential step in treating allergic conjunctivitis. As with any of the recommended treatments, however, if no improvement is seen within 48-72 hours, a physician should be consulted.

Homeopathically, there are a number of acute remedies designed to treat conjunctivitis. These include Pulsatilla (windflower, Pulsatilla nigricans), Belladonna, and eyebright (Euphrasia officinalis). Eye drops, prepared with homeopathic remedies and/or herbs, can be a good substitute for pharmaceutical eye drops. Eye washes can also be made. Herbal eyewashes made with eyebright (1 tsp. dried herb steeped in 1 pint of boiling water) or chamomile (Matricaria recutita; 2-3 tsp. in 1 pint of boiling water) may be helpful. Eyewashes should be strained and cooled before use, and close attention should be paid to make sure that any solution put into the eye is sterile.

Other simple home remedies may help relieve the discomfort associated with conjunctivitis. A boric acid eyewash can be used to clean and soothe the eyes. A warm compress applied to the eyes for five to 10 minutes three times a day can help relieve the discomfort of bacterial and viral conjunctivitis. A cool compress or cool, damp tea bags placed on the eyes can ease the discomfort of allergic conjunctivitis.

Prognosis

If treated properly, the prognosis for conjunctivitis is good. Conjunctivitis caused by an allergic reaction should clear up once the allergen is removed. However, allergic conjunctivitis will likely recur if the individual again comes into contact with the particular allergen. Conjunctivitis caused by bacteria or a virus, if treated properly, is usually resolved in 10-14 days. If there is no relief of symptoms in 48-72 hours, or there is moderate to severe eye pain, changes in vision, or the conjunctivitis is suspected to be caused by herpes simplex, a physician should be notified immediately. If untreated or if treatment fails and is not corrected, conjunctivitis may cause visual impairment by spreading to other parts of the eye, such as the cornea.

Prevention

Conjunctivitis can, in many cases, be prevented, or at least the course of the disease can be shortened by following some simple practices.

Resources

Periodicals

Prewitt, Dawn. "Keep an Eye Toward the Nose: These Treatments Can Help Stop the Charge of Rhinoconjunctivitis." Review of Optometry June 15, 2004: 125-127.

"Topical Drugs for Treating Conjunctivitis." GP June 14, 2004: 12.

Other

Griffith, H. Winter. "Conjunctivitis (Pink Eye)." ThriveOnline. http://thriveonline.oxygen.com.

Key terms

Adenovirus — A virus that affects the upper respiratory tract.

Chlamydia — The most common bacterial sexually transmitted disease in the United States that often accompanies gonorrhea and is known for its lack of evident symptoms in the majority of women.

Gonococcal — The bacteria Neisseria gonorrheae that causes gonorrhea, a sexually transmitted infection of the genitals and urinary tract. The gonococcal organism may occasionally affect the eye, causing blindness if not treated.

Herpes simplex virus — A virus that can cause fever and blistering on the skin, mucous membranes, or genitalia.

Herpes zoster virus — Acute inflammatory virus that attacks the nerve cells on the root of each spinal nerve with skin eruptions along a sensory nerve ending.

Staphylococcus — A bacterial organism, looking much like a cluster of grapes, that can infect various body systems.

Streptococcus — An organism that causes infections of either the upper respiratory or gastrointestinal tract.

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conjunctivitis /con·junc·ti·vi·tis/ (kon-junk?ti-vi´tis) inflammation of the conjunctiva.

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acute contagious conjunctivitis , acute epidemic conjunctivitis pinkeye; a highly contagious form of conjunctivitis caused by Haemophilus aegyptius.

acute hemorrhagic conjunctivitis  a contagious form due to infection with enteroviruses.

allergic conjunctivitis  conjunctival inflammation, itching, tearing, and redness caused by allergens.

atopic conjunctivitis  allergic conjunctivitis of the immediate type, due to airborne allergens such as pollens, dusts, spores, and animal hair.

gonococcal conjunctivitis , gonorrheal conjunctivitis a severe form due to infection with gonococci.

granular conjunctivitis  trachoma.

inclusion conjunctivitis  conjunctivitis affecting newborn infants, caused by a strain of Chlamydia trachomatis, beginning as acute purulent conjunctivitis and leading to papillary hypertrophy of the palpebral conjunctiva.

neonatal conjunctivitis  ophthalmia neonatorum.

phlyctenular conjunctivitis  that marked by small vesicles surrounded by a reddened zone.

spring conjunctivitis , vernal conjunctivitis a bilateral idiopathic form usually occurring in the spring in children.

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con·junc·ti·vi·tis (kn-jngkt-vts)

n.

Inflammation of the conjunctiva, characterized by redness and often accompanied by a discharge.

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conjunctivitis (kn·jnk·ti·vīˑ·tis),

n condition, typically contagious, in which the conjunctiva, the tissue surrounding the eye, is inflamed. Also called
pink eye.

Conjunctivitis.

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conjunctivitis (kon´junktivī´ts),

n an inflammation of the conjunctiva, caused by bacterial or viral infection, allergy, or environmental factors. Also called
pinkeye.

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conjunctivitis

inflammation of the conjunctiva. Extension of the inflammation to the cornea is common, hence keratoconjunctivitis. Individual cases may be due to trauma or to grass seed or other foreign body intrusion. The most serious conjunctivitides are the infectious ones, including those in which conjunctivitis is only an incidental lesion to more serious problems, e.g. rinderpest, malignant catarrhal fever, canine distemper, infectious bovine rhinotracheitis. The common specific conjunctivitides are Moraxella bovis infection in cattle, Rickettsia conjunctivae in sheep, goats and pigs, but there is no such infection in horses. In cats, feline herpesvirus and Chlamydophila felis cause a conjunctivitis. Parasitic conjunctivitis may be caused by Habronema spp. in horses and Thelazia spp. in all species. Classical signs of the disease are ocular discharge, serous at first, purulent later, and blepharospasm. Both eyes may be affected. Under-running of the conjunctiva and permanent opacity, even rupture of the eyeball, may follow.

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equine seasonal conjunctivitis

irritation caused by flies (Musca domestica) or release of Habronema larvae; called also summer conjunctivitis.

fetal conjunctivitis

present in many cases of intrauterine infection and the causative organism can be cultured from the site.

follicular conjunctivitis

proliferation of lymphoid tissue on the bulbar surface of the third eyelid, often extending to the adjacent bulbar and palpebral conjunctiva in response to any chronic inflammation or stimulation such as dust, entropion, ectropion, distichiasis or bacterial infection.

ligneous conjunctivitis

a chronic, membranous conjunctivitis involving the lids and third eyelid with deposition of amorphous eosinophilic hyaline material in the subconjunctival tissues. Young female Doberman pinschers may be predisposed.

conjunctivitis neonatorum

neonatal kittens infected by feline herpesvirus may have severe ocular involvement, even before their eyelids become unsealed. Ulcerative keratitis and panophthalmitis are common sequelae.

primary conjunctivitis

caused by infectious agents, parasites or toxic agents affecting the conjunctiva in the first instance.

secondary conjunctivitis

associated with foreign bodies or diseases of the cornea, lacrimal system, eyelids, orbit, or body as a whole.

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conjunctivitis Pink eye Ophthalmology Conjunctival inflammation, the single most common eye disease Etiology Infection—bacterial, viral, fungal, parasitic; immunologic–hypersensitivity or autoimmune; chemical/irritative–occupational, iatrogenic; 2º to systemic diseases–Reiter syndrome, dermatitis herpetiformis, epidermolysis bullosa, Kawasaki disease, gout, thyroid disease, carcinoid; mechanical issues–eg, canaliculitis, dacryocystitis Clinical Conjunctival hyperemia, fluid discharge, tearing, exudate, pseudoptosis, papillary hypertrophy, chemosis Management Antibiotics, management of systemic disease, vasoconstrictors, cold compresses; corticosteroids may be indicated, but are linked to glaucoma, cataracts Complications Corneal ulceration. See Allergic conjunctivitis, Keratoconjunctivitis, Neonatal conjunctivitis, Shipyard conjunctivitis.