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Eye diseases. Features of the course of conjunctivitis of various ethnologies (the most important)

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19. Features of the course of conjunctivitis of various ethnologies

Acute epidemic conjunctivitis occurs in children, mainly toddlers, more often in the morning, after sleep, against the background of general symptoms characteristic of conjunctivitis, pronounced swelling (chemosis) of the lower transitional folds, petechial hemorrhages in the conjunctiva of the eyelids and transitional folds can be observed. In older children, against the background of hyperemic mucous membrane of the eyeball, ischemic densified white areas in the form of two triangles are formed, the base facing the cornea. When examining the cornea, infiltrates can be detected. Recovery occurs within five to seven days.

Sometimes, along with the general symptoms of conjunctivitis in children, pinpoint hemorrhages are found in the conjunctiva of the eyeball and transitional folds, and gentle pinpoint infiltrates are visible on the cornea near the limbus. With such changes, one can think of acute pneumococcal conjunctivitis.

The presence of delicate gray films on the conjunctiva of the eyelids and vaults, weakly associated with the underlying tissue and, when removed, do not leave bleeding surfaces, will indicate a false-membrane form of pneumococcal conjunctivitis.

There is a sharp swelling of both eyes on the second or third day after birth; when the palpebral fissure opens, watery fluid is ejected almost like a fountain from the conjunctival cavity, the conjunctiva is thickened and bleeds slightly. This clinical picture is typical for the initial period of gonoblenorrhea. If the disease lasts more than a week, then a sharp infiltration of the conjunctiva and pyorrhea are observed, swelling and hyperemia of the eyelids decrease at this stage. The discharge is purulent, yellowish-green in color. The conjunctiva of the eyeball is swollen and surrounds the cornea in the form of a shaft. During this period, changes in the cornea are possible due to disruption of its nutrition due to severe infiltration of the eyelids and mucous membrane, as well as as a result of the melting effect of pus on its tissue. In the third or fourth week of the disease, papillary hypertrophy of the conjunctiva may be detected. The eyes are almost calm, the swelling of the eyelids and conjunctiva is slight, and a liquid greenish discharge appears again. Papillae form on the conjunctiva, it becomes uneven and rough. The process can be protracted or chronic. However, usually in the second month the phase of reverse development of all signs of the disease begins, resulting in clinical recovery.

Diphtheria conjunctivitis is manifested by the fact that the eyelids resemble plums in appearance, and upon palpation they are dense and painful. The conjunctiva is pale due to compression of the vessels, or there are grayish-yellow films with numerous hemorrhages on it. Removal of films is accompanied by bleeding. When the disease lasts seven to ten days, sloughing films and granulation tissue with a large amount of pus are visible. Subsequently, star-shaped scars form at the site of granulation. Sometimes less pronounced symptoms of eyelid edema, more delicate films on the conjunctival cartilage and scanty discharge are observed.

Author: Shilnikov L.V.

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