Conjunctivitis

Conjunctivitis is an inflammation of the mucous membrane (conjunctiva) eyes. One of the most common eye diseases.
All conjunctivitis divided into exogenous and endogenous. The former include infectious conjunctivitis (acute and chronic), trachoma (see), to the second - conjunctivitis arising metastatic by, and allergic diseases of the conjunctiva (phlyctenular conjunctivitis and other). Depending on the etiology there are epidemic (caused by Bacillus Koch - weeks), diphtheria, gonococcal, adenovirus conjunctivitis and other

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Fig. 4. Normal conjunctiva. Fig. 5. Acute catarrhal conjunctivitis. Fig. 6. Littermaid conjunctiva. Fig. 7. Melanoma conjunctiva of the eyeball. Fig. 8. Tuberculosis conjunctiva. Fig. 9. Phlyctenular conjunctivitis. Fig. 10. Difteriticheskoe conjunctivitis. Fig. 11. Epitelioma conjunctiva of the eyeball.

Acute infectious conjunctivitis. The causative agent can be Bacillus Koch - weeks, pneumococci, streptococci, diphtheria Bacillus and other Process begins acutely severe pain in the eyes, feeling of sand for centuries, the appearance of abundant separated from the conjunctival SAC. Conjunctiva swollen, hyperemic ( Fig. 1), it is sometimes swelling of the eyelids. At epidemic conjunctivitis caused by Bacillus Koch - weeks, inflammation is expressed most sharply. Amazed usually both eyes. May damage the cornea. The disease is very contagion, is widespread in countries with a hot climate.
For conjunctivitis caused by pneumococci, characterized by loss of the first one eye, then the second. The process is critical. The conjunctiva is possible dotted haemorrhage, sometimes gentle, easy to remove the film. Detachable purulent. Gonococcal conjunctivitis - see the Infections. Diphtheria conjunctivitis (Fig. 3) is more common in children. Characterized by the appearance of the conjunctiva century grayish, hard to shoot films. Eyelids tight, swollen. There is often a defeat cornea. The diagnosis is based on bacteriological research on the wand Leffler.
Adenovirus conjunctivitis observed sporadically and in the form of epidemic outbreaks. The virus is transmitted by contact way, sometimes through eye drops, tools. Often the development of conjunctivitis precede the phenomena of a respiratory catarrh, increased body temperature. The process is usually unilateral. There is a marked redness and swelling of the conjunctiva, serous discharge. You can defeat cornea, causing a temporary reduction of vision.
Paratracheal (conjunctivitis adults with inclusions, bathroom conjunctivitis, swimming pool conjunctivitis, infections of newborns with inclusions) is characterized by the appearance of the conjunctiva large follicles, increase predelnykh lymph nodes.
The prognosis for acute conjunctivitis if timely treatment favorable, the process is terminated full recovery.
Treatment. Patients with conjunctivitis should be treated as instructed by the doctor-ophthalmologist. Depending on the type of conjunctivitis appoint frequent washing kongungualny bag 2% solution of boric acid, solution of oxycyanide mercury 1:5000; burying 5-6 times a day drops of one of the following solutions: 30% solution of sodium sulfatsila, penicillin, neomycin or hydrochloride tetracycline (solutions of antibiotics at the rate of 10 000 IU in 1 ml of the solvent), 0,3% solution of syntomycin, 10% solution sulfapiridazina sodium; laying for ages 3-4 times a day for 1% tetracycline ointment. When diphtheria conjunctivitis patients should be isolated and treated, as diphtheria (see). Locally appointed lotions from a solution of potassium permanganate 1:5000, burial 30% solution of sodium sulfatsila. When adenovirus conjunctivitis prescribe antibiotics and sulfa drugs inside, local - 1% tetracycline or 0.25% of oxolinic ointment 3-5 times a day, instillation solution DNA-ASE (deoxyribonuclease), interferon 5-8 times a day. When paratrahome shown laying in the eyes of 1% tetracycline ointment, if severe - antibiotics and sulfa drugs inside.
Prevention: the observance of rules of personal hygiene, use of individual towel. At occurrence of acute conjunctivitis patient must be isolated from the team (at home; especially dangerous stay patients with conjunctivitis in children groups - in nurseries, kindergartens, schools), to strictly observe the rules of hygiene. After putting drops or laying ointment pipettes and glass rods should be sterilized by boiling.
Chronic conjunctivitis, catarrhal or follicular, can occur in the conditions of a dirty and dusty air, under the action of chemical substances or when intense visual work in the case of hyperopia and astigmatism, when working in low light conditions, diseases of the eyelids and lacrimal ducts, chronic diseases of the nose and nasopharynx. Symptoms: difficulty century, burning, foreign body sensation, tearing, photophobia, detachable little. In childhood chronic conjunctivitis usually runs with multiple follicles in the lower transition fold (follicles). The treatment should be aimed at addressing the causes of the disease. Local - 0.25% solution sulfate zinc, better with adrenaline, 0.5% hydrocortisone cream.
Phlyctenular conjunctivitis (Fig. 2) tuberculosis is an allergic disease that occurs mainly in children. On the mucous membrane formed small grey nodules are likteni. Treatment: General anti-tuberculosis and anti-allergic; local - 30% solution of sodium sulfatsila, 1% emulsion of cortisone in combination with drops of streptomycin (10 000-20 000 IU/ml) or 2.8% solution PAS.
The forecast. Chronic conjunctivitis is difficult therapy, often recurs. Only sustained long-term treatment may bring success.
Prevention: early treatment of acute conjunctivitis, blepharitis, corrective glasses.
Cm. Spring Qatar, Trachoma.