Conjunctivitis also known as “pink eye” refers to the inflammation of the conjunctiva. The inflammation is in the inner part of the eyelids and outer most layer of the eye. It is usually caused by viral infection but sometimes bacterial and allergic reaction in some cases.
Signs and symptoms
· Viral conjunctivitis
In viral conjunctivitis, it is often associated with upper respiratory tract infection, common colds, and sore throat. Watery itch and watery discharge are the symptoms. It usually begins in one eye and spreads to the other eye. A fine pinkness in the conjunctiva is commonly seen.
· Bacterial conjunctivitis
Bacterial conjunctivitis produces pus because of pus-producing bacteria which causes irritation and stringy, greyish or yellow, opaque mucopurulent discharge causing the eye lids to stick together. Severe crusting of the infected eye may also happen in bacterial conjunctivitis. Moraxella and Chlamydia trachomatis causes a non-exudative persistent conjunctivitis. Pyogenic infections or infections with pus are more painful. It also affects one eye and spreads to the other easily like viral conjunctivitis
In toxic conjunctivitis, the person experiences irritation and pain if the infected eye is looking far up or far down. No itch and discharge present but severe pain may occur. Chemicals like sodium hydroxide causes conjunctiva necrosis with a false white eye because of vascular closure then dead epithelium sloughing follows.
Diagnosing of conjunctivitis is not done frequently because it is usually treated practically at home which is usually successful.
Diagnosis is done through swabs to be used for bacterial culture if the signs and symptoms suggest of bacterial conjunctivitis that doesn’t respond to topical antibiotics. Research shows that bacteria are not detected in low-grade conjunctivitis with the usual methods of culture. False negative results usually happen in this test. Viral cultures may be good for epidemic causes. Conjunctiva scraping is done to detect fungal and Chlamydia infections, dysplasia and allergy. But this is rarely done because of the lack to finance the cost and the lack in staff experienced in ocular specimen handling. Conjunctival incision biopsy is done if a granulomatous disease is suspected.
In most cases, 65% resolves without treatment within two to five days. Prescription of antibiotics is not necessary.
In allergic type, discomfort can be relieved by pouring cool water over the face and the head should be inclined downward which constricts the capillaries. Artificial tears are also helpful.
Bacterial conjunctivitis subsides without doing any treatment. If there is no improvement observed within 3 days, ointment, eye drops or antibiotics may be used. A patient with no antibiotics used recovers in 4.8 days, 3.3 days with immediate antibiotics, and 3.9 days for delayed antibiotics. Both with and without treatment has no side effects noted.
There is no treatment for viral conjunctivitis but artificial tears and cold compress can relieve the symptoms. It is advisable not to touch the eyes and to avoid sharing of clothes or towels.
Conjunctivitis caused by chemicals is treated with lactated ringers irrigation or saline solution.