Conjunctivitis (conjunctivitis)

Inflammation of the conjunctiva - conjunctivitis

Conjunctivitis, in Latin as conjunctivitis, is one of the most common diseases of the eye. The inflammation is caused by a number of different causes. Accordingly, there are very different treatment methods to combat the causes and symptoms. The first signs of inflammation are often red, watery and sticky eyes. These are often bacterial or viral infections that are contagious. If conjunctivitis is suspected, a doctor's visit is advised to determine the exact cause and the appropriate form of therapy.

contents

• Inflammation of the conjunctiva - conjunctivitis
• A short overview
• definition
• symptoms
• causes
• diagnosis
• treatment
• Naturopathic treatment

A short overview

Before a detailed description of the condition, with the associated symptoms and the possible treatment forms, the following summary briefly summarizes the most important facts about the disease of conjunctivitis. Also, some evidence of behavior in case of illness and preventive measures should help to minimize the risk of disease.

A red eye is often the first sign of conjunctivitis. (Image: julia_diak / fotolia.com)

Conjunctivitis - you should know that:

• A red eye does not always mean that there is conjunctivitis. Other (eye) diseases can be the cause. This should be clarified by a doctor's visit.
• Very different triggers can cause conjunctivitis. Often it is infectious infections, for example by viruses or bacteria.
• If allergies, such as hay fever, are the cause of conjunctivitis, both eyes are affected.
• The cause of conjunctivitis significantly determines the form of therapy. A medical examination is strongly advised before any treatment.
• If mucous or purulent secretions that stick to the eye form, it is usually a bacterial infection that can be treated with antibiotic eye drops or eye ointments.
• Conjunctivitis that is not caused by bacteria can not be treated with antibiotics.
• Not infrequently, a conjunctivitis sounds easily without further treatment within ten days.
• Natural home remedies can offer some relief when symptoms appear, but they must be used with caution and will not replace therapy for inflammation requiring drug treatment.

What to do if there is a suspicion of conjunctivitis?

If the suspicion is close to conjunctivitis, or the eye is probably red for other reasons, a medical examination should be performed. Only after a precise diagnosis, the treatment options can be determined.

Symptoms such as itchy and painful eyes can be alleviated with cold or warm compresses and artificial tears. Glued eyes can be gently cleaned with lukewarm water and a washcloth.

In case of problems with the eyes, an ophthalmological examination should always be carried out. (Image: sebra / fotolia.com)

How to prevent and prevent possible infection?

If an eye reacts sensitively to certain stimuli or certain allergens, these should be avoided as far as possible. It may be advisable to do without contact lenses. If a pregnancy is present, a maternal infection by gonococcal or chlamydia should be clarified before birth, in order to be able to protect the newborn from a possible conjunctivitis in a spontaneous birth.

In infectious conjunctivitis (especially adenoviruses), hygiene measures are crucial to minimize the risk of infection. These include regular, thorough hand washing, frequent use of hand sanitizers, using your own washcloths and towels, and regular thorough cleaning of used laundry by those affected. Medicines, such as eye drops, may only be used by the person infected. Limited contact between those affected and others, such as absenteeism from work, school or childcare facilities may also be necessary.

definition

The conjunctiva (tunica conjunctiva) is a protective mucous membrane that covers the inside of the eyelids and the dermis to the edge of the cornea. The main task of the conjunctiva is to form a smear layer between the dermis of the eyeball and the eyelids and thus to ensure the mobility of the eyeball. The conjunctiva also ensures that the cornea is wetted with sufficient tear fluid at each blink. In addition, it protects the eye from foreign bodies and serves the immune defense of the eye.

Conjunctivitis is a common inflammation of the conjunctiva. Different causes cause very similar clinical pictures in the acute and chronic form of this disease. If bacteria or viruses are responsible for the disease, the conjunctivitis is contagious. Infants are particularly likely to be affected by bacterial infections. Since children are often in the face and have much contact with others, the pathogens are passed on very quickly. If at first only one eye is affected at the beginning, the infection usually changes over to the other eye.

But there are also conjunctivitis, which are based on a number of other causes and are not contagious. These are, for example, allergies and external stimuli.

The conjunctiva forms a mucous membrane on the inside of the eyelids. In an inflammation their protective function is disturbed. (Image: Henrie / fotolia.com)

symptoms

The most important first sign of conjunctivitis is an eye redness. But reddened eyes are also accompanying symptoms of other diseases, which must be excluded. In acute conjunctivitis, the following symptoms often occur in different combinations and strengths:

• Red eyes,
• Itching or burning of the eyes,
• Scratching the eyes (feeling of sand in the eye),
• watery eyes,
• swollen conjunctiva and eyelids,
• watery, slimy or purulent discharges (secretions),
• limited vision (through glued eyes),
• Photosensitivity (photophobia),
• eye pain,
• convulsive eyelid closure (blepharospasm).

Depending on the cause of the illness, the symptoms may vary and may provide important clues in the diagnosis. In the case of a bacterial infection, for example, the eyes usually have a purulent or mucous secretion and are often glued in the morning. In viral infections, however, the secretion is rather watery and photosensitivity occurs more often.

The symptoms usually appear unilaterally, especially with a bacterial cause. Within a few days, the symptoms usually spread to both eyes. If the disease remains one-sided, it often runs more seriously. If an allergy is the cause of conjunctivitis, the symptoms always show in both eyes. If it is a chronic conjunctivitis, it shows a similar but often milder symptoms. A chronic course usually lasts for more than three to four weeks.

Conjunctivitis is characterized by a variety of eye complaints and may also cause pain. (Image: sebra / fotolia.com)

causes

The different causes of conjunctivitis can be distinguished in whether it is an infectious or non-infectious form of the disease. If an infection is present, various pathogens are the trigger in question.

Infectious conjunctivitis due to viruses

Overall, viral conjunctivitis is the most common cause of infectious disease. Since symptoms usually appear only a few days after infection, this form is particularly contagious. Local and viral conjunctivitis is usually caused by adenoviruses and sometimes by enteroviruses. However, conjunctivitis can also occur in conjunction with a cold or other viral infections (especially measles, chickenpox and rubella). Also, certain herpesviruses can cause conjunctivitis, which may cause fluid-filled blisters on the eyelids.

In severe adenovirus conjunctivitis (also called epidemic conjunctivitis) sufferers often complain of a painful photosensitivity (photophobia) and a foreign body sensation. Possible complications include longer-term corneal opacities.

Infectious conjunctivitis by bacteria

Frequently, especially in children, bacterial infection is responsible for the development of acute conjunctivitis. Various pathogens come here as cause of disease into consideration, such as staphylococci, pneumococci, streptococci or bacteria of the species Haemophilus.

Less likely to be an infection with gonococcal or chlamydia. These bacteria can be transmitted during intercourse and in poor hygienic conditions. Even during a spontaneous birth, these pathogens can be transmitted to the newborn. In infected mothers, about 20 to 40 percent of babies get sick. In the case of so-called "swimming pool conjunctivitis", bath water infected with chlamydiae is responsible for the disease. Are Chlamydia (Chlamydia trachomatis) the triggers, it can be an inclusion conjunctivitis. It causes inflammation of the inside of the eyelid with swelling of the eyelid and the formation of small follicles on the conjunctiva. A related pathogen can lead to the formation of a trachoma, especially in tropical regions and under poor hygiene. This, often chronic, eye infection leads to the formation of typical inclusion bodies, which can cause scars on the cornea in the healing process. Blindness often occurs in this scarring process and without treatment of the disease.

In addition, it is not uncommon to find the so-called "hospital germ" in open packs of drops, creams and contact lens solutions. Pseudomonas aeruginosa. These bacteria multiply very quickly and can also cause conjunctivitis.

If bacteria are the cause of the disease, the pathogens can be treated with antibiotics. In complicated infections, a determination of the pathogens may be necessary. (Image: Alexander Raths / fotolia.com)

Other infectious conjunctivitis

Very rarely, infections by fungi or parasites are also associated with conjunctivitis. Parasitic conjunctivitis, for example, by worms or fly larvae, occur especially in the tropics. In tropical Africa, especially the so-called river blindness (onchocerciasis) is known in this context. This disease is caused by roundworms that are transmitted by blackfly. This infection can lead to blindness.

Non-infectious conjunctivitis

A common cause of conjunctivitis, which is not an underlying infection, represent allergies. A conjunctivitis then occurs by a hypersensitivity to certain allergenic substances (allergens) on. In particular, an occurrence of the disease in connection with a pollen allergy and hay fever, as well as seasonal accumulations of the disease (spring) are known. An allergic rhinoconjunctivitis along with hay fever is one of the most common allergic diseases of the nasal and eye mucous membranes. The symptoms are mainly itching and tearing of the eye, sneezing and runny nose.

Furthermore, various external stimuli can lead to inflammation of the conjunctiva. Often, wind, drafts, or dry air cause conjunctivitis, as the eye is not well supplied with tears. This can also be the result of too little blinking, for example, if those affected do longer work on the computer.

Dry eyes as a cause can also arise without additional stimuli. Hormonal changes in the menopause come here into consideration, but also the so-called sicca syndrome (keratoconjunctivitis sicca). An inflammation of the cornea or conjunctiva is caused by a lack of tear secretion or an altered composition of the tear fluid.

In addition, smoke, dust, chlorine in swimming pools, strong light and UV rays can lead to inflammation of the conjunctiva. If foreign objects in the eye are the cause of an inflammatory process, the symptoms usually resolve quickly after the professional removal.

Contact lens wearers are at an increased risk of disease because contaminants on the contact lens can be transmitted to the eye. (Image: RRF / fotolia.com)

Contact lens wearers have an increased risk of illness. Contamination of the lens can cause mechanical friction and it is possible for accumulated bacteria to be transmitted to the eye.

In addition to the above reasons, infectious general diseases or other serious eye diseases are possible triggers for conjunctivitis. Also not (completely) corrected refractive errors and blurred vision and a special form of reactive arthritis (Reiter syndrome) are associated with the disease. The list of possible causes is long.

diagnosis

A red eye can be symptomatic for many diseases, which is why a doctor's visit is usually advisable in this context. If conjunctival inflammation is already suspected by further indications, an ophthalmological examination is also advisable in this case, because the individual therapy depends on the cause which has to be determined first.

On the basis of a detailed patient survey (medical history) and the further medical evaluation of the typical symptoms and complaints, an attempt is made to determine the cause of the illness as precisely as possible. An important criterion is whether the inflammation from the beginning was bilateral or initially only one eye was affected. If it is a (permanent) unilateral conjunctivitis in most cases an infection is the cause.

As a rule, an examination of the eyes takes place with the aid of a slit lamp. The eye can thus be viewed in high magnification and also the eyelid side of the eye, by carefully folding the eyelid. Appearances that occur in conjunctivitis are usually already detected in this relatively simple examination. Also foreign bodies are to be found like that. If an infectious conjunctivitis is suspected, the pathogen can be determined if necessary via a smear. However, this is usually considered only in more serious cases. On the other hand, if an allergy is suspected, an allergy test may help identify the allergens.

In the ophthalmological examination, the enlarged view of the eyes through the slit lamp helps in the diagnosis. (Image: mmphoto / fotolia.com)

treatment

A simple acute conjunctivitis usually clears to about ten days after the onset of disease without further consequences. In particular, in the so-called "physiological conjunctivitis" deliberately dispensed with drugs. This is a "normal" conjunctivitis as a typical phenomenon in children and young adults, without in the true sense of a disease arises, it should be treated.

In certain cases, untreated conjunctivitis can take a long time or have more serious consequences. If therapeutic measures are taken, they are based on the causes and the symptoms that occur and their severity. The most common treatment is with eye drops or ointments. In the case of strongly bonded eyes, such as those commonly found in secretion of bacteria, it is advisable to wash the eyes carefully with lukewarm water and a washcloth before using eye drops.

In bacterial conjunctivitis, antibiotic eye drops or eye ointments that are effective against a broad spectrum of different bacteria (broad-spectrum broads antibiotics) will often shift. If it is a more complicated form, with which this therapy has no effect, it may be necessary to determine the pathogens and use antibiotics targeted. If it is chlamydia, the disease is usually longer or even chronic and may have serious consequences. In this case, it always requires appropriate treatment of the patients and their partners, as these pathogens can be transmitted in intimate contacts.

If viruses are the cause of the inflammation therapy is usually not possible to fight the pathogens. However, much of this inflammation heals on its own and only the symptoms are treated. Warming or cold compresses can help against itching and burning in the eye. Eye drops with artificial tear fluid can also help to reduce the irritation in the eye. Only with some herpesviruses that can cause conjunctivitis, the drug aciclovir can be used to relieve the symptoms. When it comes to adenoviruses, sometimes one speaks of the highly contagious "eye flu". Here, hygiene measures and the least possible contact with other persons are particularly important in order to prevent further spread.

If the allergens are known in allergic conjunctivitis, these should be avoided in the first place. If this is not possible or only partially possible, decongestants, cortisone-containing eye drops and so-called antihistamines can help to reduce the allergic reactions. It can also be clarified whether a hyposensitization has possible prospects of success.

Antibiotic eye drops are used in most bacterial infections, but artificial tears can also help alleviate the symptoms of conjunctivitis. (Image: Cpro / fotolia.com)

If other stimuli are responsible for the inflammation, contact with them should be avoided. Goggles (for example, sunglasses or swimming goggles) can minimize the effects of some harmful stimuli. Acute symptoms can also be alleviated by compresses or artificial tears.

In principle, it is advisable to abstain from contact lenses when conjunctivitis in order to protect the eye. In addition to the mechanical stimulus and possible contamination of the contact lens solution, there is a reasonable presumption that contact lenses cause or at least promote eye infections and serious eye damage.

Naturopathic treatment

Conjunctivitis should not be taken lightly and a visit to the doctor is strongly advised as it may require medication or other therapies to effectively combat the causes. It should be noted, however, that not every bacterial conjunctivitis requires treatment with antibiotics. In addition, funds from natural medicine can bring about a relief of the discomfort as well as an acceleration of the healing. In another article you can find detailed information about natural home remedies for conjunctivitis. (jvs, cs; Updated on 30.08.2018)