Conjunctivitis

 

   Pink eye (conjunctivitis) is an inflammation or infection of the transparent membrane (conjunctiva) that lines your eyelid and covers the white part of your eyeball. 

When small blood vessels in the conjunctiva become inflamed, they're more visible. This is what causes the whites of your eyes to appear reddish or pink, that’s why Conjunctivitis, also known as pinkeye.

Bacterial conjunctivitis is the most common type of ocular infection.

History

Kirk Patrick , A former superintendent of the Regional Institute of Ophthalmology in Madras (the present-day Chennai) in India, , was the first to have found the adenovirus that caused conjunctivitis.

Infectious agents

Conjunctivitis has a number of different causes including:

• Viruses i.e.

v  Adenoviruses;

v  Herpes simplex (HSV)

v  Varicella zoster

• Bacteria i.e.

v  Streptococcus pneumoniae;

v  Haemophilus influenzae;

v  S. aureus;

v  Haemophilus spp.,

v  Chlamydia trachomatis;

v  Neisseria gonorrhoeae;

v  Streptococcus pyogenes;

v  Moraxella spp.;

v  Corynebacterium spp.

• Irritants such as shampoos, dirt, smoke and swimming-pool chlorine
• Allergies such as dust and pollen, or a special type of allergy that affects some contact lens wearers

Symptoms  

The symptoms of conjunctivitis differ depending on the cause of the inflammation, but can include:

·         Redness in the white of the eye or inner eyelid

·         Increased amount of tears

·         Thick yellow discharge that crusts over the eyelashes, especially after sleep

·         Green or white discharge from the eye

·         Itchy eyes

·         Burning eyes

·         Blurred vision

·         Increased sensitivity to light

Complications

Conjunctivitis can be a frustrating condition - especially allergic conjunctivitis - but in most cases it doesn't pose a serious threat to health.

Complications of conjunctivitis are rare but when they do occur they can be serious and include:

·         A severe case of allergic conjunctivitis can lead to scarring in the eye

·         In cases of infective conjunctivitis, the infection can spread to other areas of the body, triggering more serious secondary infections such as meningitis (an infection of the outer layer of the brain)

Epidemiology

Conjunctivitis commonly affects males and females of all ages. It is usually treated by general practitioners and is estimated to account for almost 1% of all primary care consultations. In England there are 13 to 14 cases per 1000 people each year. The incidence rate appears to be higher in children <1 year old (80 cases per 1000 patient-years) than in children >4 years of age (12 cases per 1000 patient-years). Up to 1.3% of the US population has been reported to have the condition. In the US, 3% of all accident and emergency department visits are ocular related, with 30% of these due to conjunctivitis. Two percent of all visits to primary care physicians are for eye conditions, with 54% of these being either conjunctivitis or corneal abrasion. Similarly, seasonal conjunctivitis represents more than 90% of cases of allergic conjunctivitis.  Perennial conjunctivitis is less common, but 80% of these patients have seasonal flares. Atopic allergic conjunctivitis disease is more common in adults, and vernal allergic conjunctivitis (a more severe, chronic form of allergic conjunctivitis) is more common in boys. Atopic and vernal conjunctivitis together represent 2% of ocular allergic disease; atopic dermatitis occurs in 3% of the population, and 25% of these have ocular involvement. 

Bacterial conjunctivitis is more common in children, and viral conjunctivitis is more common in adults. Of infectious conjunctivitis, 42% to 80% is bacterial, 3% is chlamydial, and 13% to 70% is viral.  Viral conjunctivitis represents up to 50% of all acute conjunctivitis in primary care. Ocular cicatricle pemphigoid and neoplastic conjunctivitis are rare.

Exams and Tests

·         Examination of the eyes

·         Swab of conjunctiva for analysis

Treatment

Treatment of conjunctivitis depends on the cause.

·         Allergic conjunctivitis may respond to allergy treatment. It may disappear on its own when you avoid your allergy triggers. Cool compresses may help soothe allergic conjunctivitis.

·         Antibiotic medication, usually eye drops, is effective for bacterial conjunctivitis. Viral conjunctivitis will disappear on its own. Many doctors give a mild antibiotic eyedrops for pink eye to prevent bacterial conjunctivitis.

·         You can soothe the discomfort of viral or bacterial conjunctivitis by applying warm compresses (clean cloths soaked in warm water) to your closed eyes.

Prevention

·         Good hygiene can help prevent the spread of conjunctivitis:

·         Change pillowcases frequently.

·         Do not share eye cosmetics.

·         Do not share towels or handkerchiefs.

·         Handle and clean contact lenses properly.

·         Keep hands away from the eye.

·         Replace eye cosmetics regularly.

·         Wash your hands often.