18. Conjunctivitis

Conjunctivitis is an inflammation of the mucous membrane that lines the back of the eyelids and the eyeball.

Due to the occurrence, bacterial conjunctivitis (staphylococcal, streptococcal, gonococcal, diphtheria, pneumococcal), viral conjunctivitis (herpetic, adenovirus, epidemic keratoconjunctivitis), chlamydial conjunctivitis (trachoma), allergic and autoimmune conjunctivitis (drug, hay fever, tuberculosis-allergic) are distinguished. According to the nature of the course, conjunctivitis is divided into acute and chronic.

General symptoms characteristic of all conjunctivitis include subjective complaints of the patient and objective signs. Subjective symptoms include a burning sensation and itching in the eye, a feeling of blockage, and photophobia. Acute infectious conjunctivitis (the most common of all bacterial conjunctivitis) is caused by staphylococci and streptococci. Both eyes are involved in the pathological process, but more often not simultaneously, but sequentially. In addition to the symptoms common to all conjunctivitis, this type is characterized by the presence of purulent discharge that sticks the eyelashes together. Pneumococcal conjunctivitis: pinpoint hemorrhages in the conjunctiva, swelling of the eyelids and the formation of whitish-gray films.

Acute epidemic conjunctivitis of Koch Wicks is characterized by a very high contagiousness. The disease begins suddenly with a sharp swelling of the eyelids, redness of the conjunctiva of the eyelids and the eyeball. The discharge is at first meager, then becomes abundant and purulent. Gonococcal conjunctivitis (gonoblennorrhea) is caused by gonococcus and is clinically subdivided into gonoblenorrhea of ​​newborns, children and adults. Clinically, gonoblenorrhea is manifested by a sharp reddening of the conjunctiva with profuse bloody discharge (the color of meat slops).

Corneal ulceration is a complication of gonoblenorrhea.

Gonoblenorrhea in adults occurs with severe general symptoms: fever, damage to the joints and the cardiovascular system. In adults, complications of gonococcal conjunctivitis are quite common.

Diphtheria conjunctivitis is rare (if the diphtheria vaccination regimen is not followed) and is accompanied by severe intoxication, high body temperature, swollen lymph nodes and their soreness. Local hallmarks of diphtheria conjunctivitis are gray membranous plaques on the conjunctiva of the eyelids and the eyeball. Their removal is painful and accompanied by bleeding. Most often, herpetic conjunctivitis is unilateral and has a long course. Adenovirus conjunctivitis is caused by adenoviruses and is accompanied by fever and pharyngitis. Allergic and autoimmune conjunctivitis develops with increased sensitivity of the body to a wide variety of substances.

Treatment. For acute infectious conjunctivitis, antimicrobial drugs are prescribed: 30% sodium sulfacyl solution, antibiotic solutions, furatsilin solution at a dilution of 1:5000. On the first day of illness, drops are instilled into the conjunctival sac every hour.

Author: Shilnikov L.V.

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