Conjunctivitis is one of the most common ophthalmological disorders. It can occur in adults, children and babies.

What is conjunctivitis?

The conjunctiva is a thin, smooth, transparent membrane that covers the eyeball to the edge of the cornea. The conjunctiva fulfils several roles:

  • Protects against bacterial infections with the help of enzymes, mucus and saprophytic flora;
  • Defend the body from allergic contact reactions;
  • Forms and maintains the tear film.

Conjunctivitis is an inflammatory disorder caused by conjunctival hypersecretion.

  • It can occur in adults, children and babies.
  • It is not a serious disease as long as it is treated as soon as the first symptoms appear.
  • It may initially affect one eye and then spread to the other.
  • Not all types of conjunctivitis are contagious.
  • It usually does not affect visual acuity.

What causes conjunctivitis?

Conjunctivitis can be caused by:

  • Allergic reactions to irritants such as dust, pollen, smoke, chlorine from swimming pools or cosmetics that come into contact with the eye;
  • Viruses, bacteria – more on this in the “bacterial conjunctivitis” section;
  • Sexually transmitted infections (chlamydia, gonorrhea) – less common causes (more on this under “conjunctivitis in babies” section).

There are also a number of causes that can favor the development of conjunctivitis:

  • Poor hygiene;
  • Moisture;
  • Heat.

What are the symptoms of conjunctivitis?

The most common symptoms are:

  • Eye redness – inside the eyelids and the whites of the eyes;
  • Foreign object sensation;
  • Heavy tearing;
  • Blurred vision;
  • Sensitivity to light;
  • Greenish or yellowish-white eye discharge, especially in bacterial conjunctivitis;
  • Discomfort and itching;
  • Burning sensation in the eyes.

How many types of conjunctivitis are there?

Allergic conjunctivitis

Allergic conjunctivitis is the most common form and occurs as a result of hypersensitivity to certain allergens: dust, fungi, mites, pollen or mold. Sometimes it can also be caused by cosmetics, medicines, or improper use of contact lenses.

  • In most cases, it occurs in spring or autumn.
  • Allergic conjunctivitis is not contagious.
  • It can sometimes be associated with allergic rhinitis, which involves sneezing, watery nasal discharge and itchy nose and throat.
  • Allergic conjunctivitis has symptoms similar to those of dry cornea conjunctivitis, so it is recommended to evaluate the tear secretion to determine the type of disorder and appropriate treatment.

Bacterial conjunctivitis

Bacteria such as staphylococcus, streptococcus, haemophilus and chlamydia are the most common in conjunctivitis of this type.

  • The first sign is when you wake up with your eyelids glued shut and notice a mucous discharge at the base of your eyelashes. It can also manifest as stinging or foreign object sensations in the eye, and hyper-tearing.
  • First, one eye is affected, and after 24-48 hours, the other becomes infected.
  • Acute bacterial conjunctivitis creates a whole membrane on the inside of the eyelid and, if not treated in time, leads to complications: it affects the tear ducts and causes corneal infections.

Cold conjunctivitis or viral conjunctivitis

It is caused by contagious viruses, often associated with colds.

  • Viral conjunctivitis is transmitted by: direct hand-to-eye contact, contaminated respiratory particles or insufficiently chlorinated swimming pool water. This form of conjunctivitis is most common in institutions or crowded places: hospitals, schools, swimming pools.
  • In addition to the classic symptoms (red eyes, heavy tearing, discharge, itching), cold conjunctivitis can also manifest itself by: eyelid oedema and preauricular adenopathy (lymph node near the ear).
  • Complications of viral conjunctivitis can lead to keratitis (inflammation of the cornea), which involves decreased quality of vision, eye pain and sensitivity to light.
  • If vesicular skin lesions are seen, conjunctivitis may be caused by Herpes or Varicella-zoster virus.

Conjunctivitis in babies

One form of conjunctivitis in babies is neonatal conjunctivitis. This occurs in naturally born babies who are exposed to chlamydia or gonorrhea.

  • Neonatal conjunctivitis is serious and requires urgent treatment, even in the maternity ward. Otherwise, your baby’s vision may be affected for life.
  • It is manifested by muco-purulent discharges and conjunctival follicles on the inner eyelid membrane.
  • In the absence of treatment, neonatal conjunctivitis progresses chronically and can affect the cornea.

Conjunctivitis in children

  • Allergic conjunctivitis is the most common conjunctivitis in children. It occurs mainly in spring and may be accompanied by ear infections. Symptoms fade once they reach puberty.
  • Children can also suffer from bacterial conjunctivitis because of the groups they spend long periods of time in – nursery, kindergarten or school. Here, the risk of contagion is higher. Bacterial conjunctivitis in children is not painful and is treatable in about a week.
  • “Cold conjunctivitis” can also occur in children, following infection with viruses from the adenovirus family or through contact with another infected person.

How is conjunctivitis treated?

Depending on the form of the disease, the treatment is different. Usually:

  • Allergic conjunctivitis involves treatment with antihistamines or corticosteroids.
  • Bacterial conjunctivitis requires antibiotics.
  • In the case of viral conjunctivitis, treatment is symptomatic.

How is allergic conjunctivitis treated?

A visit to the allergist is necessary to determine the triggering substance. Is treated with:

  • Antihistamines, eye drops and tablets;
  • Cortisone eye drops;
  • Cold compresses applied to the eyes.

It is recommended to avoid the allergen as much as possible.

How is bacterial conjunctivitis treated?

Depending on the stage of the disease, bacterial conjunctivitis is treated with antibiotics in the form of eye drops.

  • As a rule, it is applied 3-4 times/day, but in severe forms it can also be administered every 1-2 hours.
  • If after 10 days or less, the treatment does not work, another visit to the ophthalmologist is recommended.
  • Antibiotic ointments are contraindicated because they stagnate eye secretions and create a breeding ground for germs.
  • Eye dressing is not recommended.

How is viral conjunctivitis treated?

Viral conjunctivitis is treated by relieving the patient’s symptoms until complete remission of the disease. Being contagious, the infected person should be isolated.

  • Superinfection is combated with local antibiotics.
  • Red eyes, itching and stinging are relieved with artificial tears, vasoconstrictor drops and antihistamines.
  • Keratitis involves a corneal investigation and treatment with steroid anti-inflammatories.
  • If the patient also has eyelid oedema, cold compresses are indicated.
  • Complete healing can range from 15 to 20 days.

How can you prevent conjunctivitis?

  • Change pillowcases and bed linen regularly.
  • Don’t borrow cosmetics. If you have a form of conjunctivitis, stop using them until you have fully recovered.
  • Pay attention to contact lens handling and proper contact lens hygiene. If you have a form of conjunctivitis, throw away the lenses, the container you keep them in and the storage solution.
  • If you have a contagious form, don’t shake hands with other people.
  • If you have conjunctivitis, try not to touch the affected eye(s). Wash your hands regularly with warm water and soap.

If you have symptoms of conjunctivitis or any other ophthalmological disorder, don’t hesitate to contact Dr. Holhos clinic. The ophthalmology network is waiting for you in Cluj-Napoca, Sibiu, Alba Iulia, Turda and Mediaș, with an extremely well-trained team, quality services and state-of-the-art technologies.

Text medically reviewed by Dr. Teodor Holhoș, Ophthalmic Surgeon
Written by Dr. Holhos Team

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