Conjunctivitis: detection and treatment


Conjunctivitis: detection and treatment

In conjunctivitis, the eye reddens, watering and often hurts or itches. This can be caused by a bacterial infection, an allergy or a disturbing foreign body in the eye. Accordingly, the treatment methods are also different. You can read here how to recognise conjunctivitis safely and how to treat it correctly.

Conjunctivitis: short overview

  • Common symptoms: reddened eyes, watery and (in the morning) sticky eye, swollen conjunctiva, foreign body sensation
  • Treatment: Always consult a doctor Depending on the causes; antibiotics (for bacterial conjunctivitis), eye drops with different active ingredients to alleviate the symptoms, also avoid allergens, remove foreign bodies, possibly use household remedies to support
  • Prevent contagion: Bacterial and viral conjunctivitis are highly contagious! As an infected person, do not rub the eye, wash hands, use your own towel, avoid direct contact with other people
  • Causes: Bacteria, viruses, allergies, foreign bodies, dirty contact lenses, excessive exposure to light, eye strain

Conjunctivitis: symptoms

The following symptoms are typical of conjunctivitis:

  • reddened eyes
  • watery eye
  • swollen conjunctiva (conjunctiva looks glassy swollen), swollen eyelid
  • Photophobia/glare sensitivity
  • Foreign body sensation or feeling of pressure in the eye
  • crampy eyelid closure (in case of severe inflammation with corneal involvement)

The various triggers of conjunctivitis cause, in addition to the general symptoms, other symptoms that characterize them.

 

Form of conjunctivitis specific symptoms
Bacterial conjunctivitis – severe mucus formation (yellowish, partly purulent accumulations in the corners of the eyes, in the morning eyes often sticky and burning)

– Domes of defence cells (dome-like protrusions on the inside of the eyelids, these are accumulated cells of the immune defence)

– often both eyes are affected (one rubs the germs unintentionally from one eye into the other)

Viral conjunctivitis – physical complaints such as those associated with a virus-related underlying disease, such as flu, measles or chickenpox (pathogens attack the conjunctiva)

– Foreign body sensation in the eye

– watery or mucous lacrimation

– swollen eyes

– intense itching

– usually occurs on both sides (the itching causes the affected persons to rub their eyes)

Allergic conjunctivitis – Conjunctiva swells in a typical, patch-like pattern

– Eyelids are thickened, can hang down easily

– Foreign body sensation (due to swollen conjunctiva)

– sudden irruptive tears

– very itchy eyes

– other allergy symptoms, such as sneezing, sniffles or itchy skin paddles

Nonspecific conjunctivitis – disturbing, rubbing sensation in the eye (due to foreign bodies such as dust, smoke or contact lenses)

– streaming eyes

– if excessive exposure to light is the cause, light sensitivity, headaches and pain in the eye also occur

 

Conjunctivitis: Treatment

The therapy depends on the causes of conjunctivitis. As with other eye diseases, a visit to an ophthalmologist is advisable. He can safely determine the type of inflammation, recommend the correct treatment and thus prevent other eye structures from being affected and permanent damage from occurring.

Treatment of bacterial conjunctivitis

Bacteria can be controlled with antibiotics. Ointments or drops containing antibiotics that are applied to the eye and thus act directly at the site of infection are suitable for this purpose. After two to three days the symptoms should improve. Important: Even if you feel that the inflammation has disappeared – in any case carry out the treatment as long as the doctor has recommended. Otherwise some bacteria will remain, which will then multiply again and cause conjunctivitis again.

Sometimes an additional antibiotic is administered in tablet form. This is necessary, for example, when physical infections with bacteria have spread to the eyes. For example, chlamydia, which is also known to cause sexually transmitted diseases, can also cause conjunctivitis. In this case the partner should also be treated. The therapy of conjunctivitis can be more lengthy in this case.

Eye drops are preferred for bacterial infections.

Treatment of viral conjunctivitis

Unlike bacteria, there are no effective drugs against many viruses that can cause conjunctivitis. These include cold viruses or the highly contagious adenoviruses.

The symptoms can be relieved with home remedies. If the symptoms are severe, you can use eye drops containing corticosteroids for a short time. In the long term, however, these are not suitable for therapy, as they suppress the body’s own defenses and thus have the risk of delayed healing or additional infection with bacteria. They are then combined with antibiotically effective eye drops.

Children often develop conjunctivitis after first contact with the herpes simplex virus (the lip herpes virus) or during chickenpox. The active ingredient Aciclovir specifically combats these viruses. The drug is available as eye drops or in the form of tablets.

Treatment of allergic conjunctivitis

In case of an allergic conjunctivitis, the best general measures against the allergy help. The most important strategy here is: If possible, you should avoid the triggering allergens.

You can use eye drops containing cortisone for a short time to combat watery and swollen eyes. Anti-allergic eye drops or medications that suppress the overactive immune system can also relieve the symptoms. Some products are used before contact with the allergens so that they can take effect.

The allergy can only be fought with a so-called hyposensitization. The body slowly gets used to the allergen that causes the disease.

Treatment of unspecific conjunctivitis

Whether foreign bodies, contact lenses or sunlight are the causes of conjunctivitis – the therapy always consists of removing or avoiding the trigger. Rinse out foreign bodies or corrosive substances as quickly as possible, remove rubbing contact lenses or avoid further sunlight.

The unspecific conjunctivitis then usually heals on its own within a few days.

If dry eyes are behind the complaints, tear substitutes help. You moisten the eye and keep it moist. Eye drops with hyaluronic acid provide additional moisture because the substance binds water. Take care not to use eye drops containing cortisone, as these increase the dryness of the eye.

Treat conjunctivitis with home remedies

Regardless of the causes of conjunctivitis, you can support healing with home remedies. For example, cool compresses help against swelling, such as a quark compress.

In addition, certain medicinal plants have anti-inflammatory effects. These include eyebright and calendula.

Caution: Nevertheless, you should have the cause of your conjunctivitis clarified by a doctor. In the case of bacterial or viral inflammation, additional medication may be necessary. This will help prevent more serious damage to the eye.

You can read more about home remedies for conjunctivitis and how to use them here: Conjunctivitis – household remedies

Conjunctivitis: Prevent infection

A viral or bacterial conjunctivitis is very contagious. Patients rub their eyes because it itches and then bring the pathogens to door handles with their hands or pass them on to others. You can reduce the risk of infection with the following tips:

  • Avoid rubbing your eyes: If conjunctivitis has already affected one eye, the pathogens can be quickly transmitted to the other eye. Try to resist the urge to rub.
  • Wash your hands: Frequent, proper hand washing and disinfecting the hands reduces the germ count.
  • Your own towel: Use your own towel or even better disposable towels, which you can dispose of immediately after use. This way you protect family members who live in the same household.
  • No shaking hands: Even if it seems unfriendly – avoid shaking hands if you have conjunctivitis. In this way you can effectively contain the transmission to others.

Conjunctivitis: causes and risk factors

The conjunctiva is traversed by numerous fine blood vessels and thus also supplies the anemic cornea with nutrients. If it is irritated, the blood circulation of the otherwise colourless conjunctiva increases and it reddens.

Irritations of various kinds can lead to conjunctivitis. Doctors distinguish between infectious, i.e. conjunctivitis caused by bacteria or viruses, and non-infectious, i.e. caused by allergies or mechanical stimuli. The former are very contagious. Here you should observe the strictest hygiene measures and in any case be treated by a doctor.

Conjunctivitis is very common. The causes range from bacterial or viral infections to allergic and chronic conjunctivitis with poor tear film function (“dry eye”). Hygiene also plays an important role – conjunctivitis is often very contagious. Especially in school or kindergarten there are always large waves of illness.

It is important that the cause is clarified by the ophthalmologist so that a seemingly harmless conjunctivitis does not become a major problem. Depending on the cause, antibiotic or anti-inflammatory eye drops will help. In most cases, moistening eye drops (tear substitutes) alleviate your complaints.

Bacterial conjunctivitis usually heals within a few days with antibiotic eye drops. Nevertheless, since conjunctivitis is highly infectious in many cases, you should not go back among people until the symptoms have subsided. And: Do not use towels together and wash your hands well after you have had contact with your tear fluid.

Bacterial causes of conjunctivitis

  • Staphylococci, pneumococci and streptococci: These pathogens are the most common cause of bacterial conjunctivitis in adults and children.
  • Bacteria in cosmetics: The germ Pseudomonas aeruginosa can grow in opened eye drop bottles, cosmetics or contact lens solutions. It leads to conjunctivitis, which spreads at lightning speed, spreads to the cornea and can have dramatic consequences.
  • Chlamydia: Chlamydia transmitted during sexual intercourse easily reaches the eye via the hands. In rare cases, people are also infected with the pathogens in swimming pools. They cause conjunctivitis, which doctors refer to as inclusion body conjunctivitis. Especially in countries with poor hygienic conditions, this conjunctivitis can grow into the so-called trachoma, which spreads to the cornea and leads to blindness in the long term. Conjunctivitis caused by Chlamydia is still the main cause of blindness in developing countries.
  • Conjunctivitis in newborns: During birth, infected mothers can transmit bacteria such as gonococcus or chlamydia to the newborn. The bacteria are literally pressed into the baby’s eyes in the narrow birth canal and cause severe conjunctivitis after a few days. In contrast, newborns are usually treated preventively.

Viral causes of conjunctivitis

  • Adenoviruses: Subtypes 8 and 19 of adenoviruses cause a highly contagious form of conjunctivitis. Initially only one eye is affected, but after a few days the virus usually spreads to the other eye. The lymph nodes in the face are also swollen. Conjunctivitis is still contagious about two weeks after infestation of the second eye. Thorough hygiene measures are important here!
  • Herpes simplex: Especially when children are infected with the herpes simplex virus for the first time, conjunctivitis and small herpes blisters on the edge of the eyelid can occur.
  • Other viruses: Influenza, measles, rubella and chickenpox also repeatedly irritate the conjunctiva. In addition, Enterovirus 70 and the Dell’s wart virus cause conjunctivitis.

Other causes of infectious conjunctivitis

  • Fungal infections: They are only very rarely the cause of conjunctivitis.
  • Parasites: The simulium fly transmits a parasite that triggers the so-called onchocerciasis. This form of conjunctivitis is the most common cause of blindness in tropical Africa. Also the eye worm, which can also cause inflammation of the conjunctiva, is more common in this area.

Causes of allergic conjunctivitis

In allergic conjunctivitis there is a connection with the excessive reaction of the immune system against an actually harmless substance. The following allergies can also affect the conjunctiva:

  • House dust mite allergy
  • Animal hair allergy
  • Allergy to cosmetics
  • atopic diseases, such as neurodermatitis or psoriasis

Non-specific causes of conjunctivitis

  • External stimuli: Dust, smoke or sand, but also dry air or UV light can irritate the conjunctiva.
  • Dry eyes: Extensive screen work, hormonal changes during menopause, autoimmune diseases (Sjögren’s syndrome), contact lenses and other causes can limit the function of the tear glands. The consequence of dry eyes is increased friction and reduced resistance. Conjunctivitis is often the result.
  • Insect stings: A rare but possible cause of persistent conjunctivitis is the penetration of insect stings or caterpillar hairs into the mucous membranes. These can hook persistently onto the conjunctiva and thus penetrate deeper with every blink of the eye. There is an increased risk in areas populated with, for example, the oak processionary moth.
  • uncorrected vision problems: Astigmatism, loss of vision or incorrectly adjusted glasses often lead to conjunctivitis.
  • Malpositioned eyelids
  • inward growing eyelashes
  • Overexertion: Overnight stay or strenuous eye work
  • Contact lenses: If they have been in the eye for too long or are dirty

Conjunctivitis: examination and diagnosis

Weeping red eyes belong in the care of the ophthalmologist. He gets to the bottom of the cause of conjunctivitis and determines the appropriate treatment. In addition, conjunctivitis can be contagious – in this case, the right measures must be taken to prevent infection of fellow human beings.

In a personal interview (anamnesis) the ophthalmologist first asks about allergies, foreign bodies in the eye, injuries or the use of contact lenses. Often the reason for the red eyes can already be narrowed down. The doctor examines the eye with the help of a light lamp.

Afterwards the eyes are carefully examined: By looking into the eyes with a lamp, doctors can already detect the first changes in the otherwise transparent and shiny conjunctiva. The reddening of the eyes also gives the doctor clues as to whether the inflammation originates from the conjunctiva or whether the iris and ciliary body are possibly affected. If these deeper layers are affected, the eye appears bluish-reddish, especially at the edge of the iris. Since the vessels are located in the layer below the conjunctiva, they cannot be moved.

Careful folding of the eyelids can reveal inflammation – they leave typical marks on the inside of the eyelids. Foreign bodies can also be found in this way. This examination is rarely really unpleasant for the patients.

Finally, the causative bacteria, viruses, fungi or parasites can be determined by means of a pathogen smear.

Conjunctivitis: risks

The conjunctiva is also known as the “lymph node of the eye” – so many inflammations are mild or are nipped in the bud. Nevertheless, conjunctivitis can take on stubborn, serious forms, especially in people with a weak immune system. In the poorer regions of the world, these still frequently lead to blindness.

 

Sandra Eades

Hello I am Sandra Eades, physician, researcher and author from Australia. I am working currently as researcher for a private institution. I have studied in Britain and Australia, where I currently reside. I write about research topics in the organization of the public health government agencies. For the iMS I write about general medical conditions. I also research scholar sources to provide information to writers of other articles. I also check the citations of scholar papers. Finally, I read other articles before they are published. I am also a mother of three children!

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