Conjunctivitis

Overview of Conjunctivitis

When small blood vessels in the conjunctiva become inflamed, they are more visible. Additionally, This is what causes the white of the eyes to appear reddish or pink. Also known as “pink eye”.

Moreover, Conjunctivitis resulting from irritation

Irritation from a either chemical splash or foreign object in the eye is also associated with conjunctivitis.

Lastly, Sometimes flushing and cleaning the eye is done to get rid of the chemical or object causing redness and irritation. [1]

Indian epidemiology then other

Causes of Conjunctivitis

• Viruses
• Bacteria
• Allergies
• A chemical splash especially, in the eye
• A foreign object in the eye
• In new-borns, a blocked tear duct [1]

Types of Conjunctivitis

Viral:

May affect one or both eyes. Furthermore, Viral conjunctivitis usually produces a watery discharge. It can associate with colds or with symptoms of a respiratory infection, such as sore throat. Generally, It can spread through direct or indirect contact with the eye secretions of someone who’s infected. Lastly, Adults and children alike can develop both of these types of pink eye secretions of someone who’s infected.

Bacterial:

It may affect one or both eyes. Specifically, Bacterial conjunctivitis produces a thick, yellow-green discharge. It can spread through either direct or indirect contact with the eye secretions of someone who’s infected. Adults also children alike can develop both of these type of pink eye secretions of someone who’s infected.

Allergic conjunctivitis:

Allergic conjunctivitis affects both eyes and a response to allergens, the body produces an antibody call immunoglobulin E (in other words, Ig.E). Most allergic conjunctivitis can control with allergy eye drops. [1]

Risk factors of Conjunctivitis

• Explore to something for which the person has an allergy (in other words, allergic conjunctivitis).
• Explore to someone infected with either viral or bacterial form of conjunctivitis.
• Using contact lenses.

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Pathophysiology of Conjunctivitis

Microbes enter the eye on contact with infected objects that produce Inflammation of the eye also Dilation of blood vessels of eye that leads to Swelling, redness, exudates also discharge of eyes.[1]

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Sign & Symptoms of Conjunctivitis

• Pain
• Redness in one or both eyes
• Itching in one or both eyes
• A discharge in one or both eyes that forms the crust during the night that may prevent your eye or eyes from opening in the morning i.e., exudation.
• Tearing
• Photophobia
• Dropping of upper eyelid
• Periorbital cellulitis
• Fever
• Sore throat
• Runny nose
• A gritty feeling in one or both eyes. [1]

Clinical examination of Conjunctivitis

Physical examination of patients with conjunctivitis is usually remarkable for conjunctival injections, epiphora, hyperemia, chemosis, and muco-purulent or watery discharge. However, ophthalmologic examination may be varies based on conjunctivitis subtypes.

Viral Conjunctivitis

Patients with viral conjunctivitis usually appear febrile, and they have preauricular adenopathy. Ophthalmologic examination of patients with viral conjunctivitis is usually remarkable for:

• Epiphora
• Hyperemia
• Chemosis
• Lymphoid follicle on the under-surface of the eyelid
• Follicular conjunctival reaction
• Pseudomembrane formation (occasionally)
• Cicatricial conjunctival reaction
• Eyelids ecchymosis
• Corneal epithelial defect (in severe cases)

Acute Hemorrhagic Conjunctivitis

Ophthalmologic examination of patients with acute hemorrhagic conjunctivitis is usually remarkable for:

• Eyelid edema
• Eye pain in palpation
• Bulbar conjunctival hemorrhage

Bacterial Conjunctivitis

Ophthalmologic examination of patients with bacterial conjunctivitis is usually remarkable for:

• Bulbar conjunctival injection
• Palpebral conjunctival papillary reaction
• Watery or mucopurulent discharge
• Chemosis
• Lid erythema
• Corneal involvement

Neonatal Conjunctivitis

Ophthalmologic examination of patients with neonatal conjunctivitis or ophthalmia neonatorum is usually remarkable for:

• Neisseria gonorrhea
  • Chemosis
  • Severe lid edema
  • Mucopurulent discharge
  • Corneal involvement (diffuse epithelial edema, ulceration, corneal perforation, and endophthalmitis
• Chlamydia trachomatis
  • Mild hyperemia
  • Mucoid discharge
  • Chemosis
  • Pseudomembrane formation
• Chemical
  • Mild conjunctival injection
  • Epiphora

Allergic Conjunctivitis

Ophthalmologic examination of patients with allergic conjunctivitis is usually remarkable for:

• Bilateral conjunctival injection
• Chemosis
• Watery discharge or mild mucous discharge
• Large cobblestone papillae under upper eyelid

Keratoconjunctivitis Sicaa

Examination should include evaluation of the face, eyelids, blinking patterns, eyelid margins, eyelashes, conjunctiva, cornea, and tear film. Examination of patients with keratoconjunctivitis sicaa is usually remarkable for:

• Conjunctival redness
• Damage to the ocular surface with punctate epithelial
• Thickened eyelid margins and telangiectasia (signs of meibomian gland dysfunction)
• Meibomian gland orifices are obstructed with a cloudy or granular secretion (expressed by exerting considerable pressure on the lower lid)
• Blepharitis (associated with meibomian gland dysfunction)
• Meibomitis (inflammation of the meibomian glands)

Superior Limbic Keratoconjunctivitis

Ophthalmologic examination of patients with superior limbic keratoconjunctivitis (SLK) is usually remarkable for

• Hyperemia
• Micro-papillary reaction in the upper tarsal conjunctiva
• Thickening of the superior bulbar conjunctiva
• Ciliary injection in the upper bulbar conjunctiva
• Corneal erosion in the upper quadrants
• Diffuse superficial corneal erosions
• Eyelid edema (4)

Diagnosis of Conjunctivitis

To determine whether the patient have pink eye, the doctor will examine the eyes.

Take a sample of eye secretions from the conjunctiva for laboratory analysis if the patient has a very severe case of conjunctivitis, if the corneas are affected or if the person had repeated infections that are not responding to treatment.

Differential diagnosis of Conjunctivitis

• Acute viral conjunctivitis.
• Blepharitis.
• Allergic conjunctivitis.
• Toxic and chemical conjunctivitis.
• Anterior uveitis
• Episcleritis
• Scleritis. (5)

Complications are what happen after you have a disease. They are the negative consequences of the disease process.

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Treatment of Conjunctivitis

Treatment for bacterial conjunctivitis-

In detail, If the infection is bacterial, the doctor may prescribe antibiotic eye drops as pink eye treatment, and the infection should go away within several days. Additionally, Antibiotic eye ointment, in place of eye drops, is sometimes prescribed for treating bacterial pink eye in children.

With either form of medication, expect signs also symptoms to start getting better in a few days.

Treatment for viral conjunctivitis-

There is no treatment for most cases of viral conjunctivitis. Instead, the virus needs time to run its course- up to two or three weeks. Viral conjunctivitis often begins in one eye and then infects the other eye within a few days. Moreover, The signs and symptoms should gradually clear on their own.

In brief, Antiviral medications may be an option if the doctor determines that the viral conjunctivitis is caused by the herpes simplex virus.

Treatment for allergic conjunctivitis-

These may include medications that help control allergic reactions, such as antihistamines or drugs that help control inflammation, such as steroids and anti-inflammatory drops. [1]

Prevention of Conjunctivitis

• Wash your hands often with soap and warm water for at least 20 seconds. Wash them especially well before and after cleaning, or applying eye drops or ointment to, your infected eye. If soap and water are not available, use an alcohol-based hand sanitizer that contains at least 60% alcohol to clean hands.
• Avoid touching or rubbing your eyes. This can worsen the condition or spread it to your other eye.
• With clean hands, wash any discharge from around your eye(s) several times a day using a clean, wet washcloth or fresh cotton ball. Throw away cotton balls after use, and wash used washcloths with hot water and detergent, then wash your hands again with soap and warm water.
• Do not use the same eye drop dispenser/bottle for your infected and non-infected eyes.
• Wash pillowcases, sheets, washcloths, and towels often in hot water and detergent; wash your hands after handling such items.
• Stop wearing contact lenses until your eye doctor says it’s okay to start wearing them again.
• Clean eyeglasses, being careful not to contaminate items (like hand towels) that might be shared by other people.
• Clean, store, and replace your contact lenses as instructed by your eye doctor.
• Do not share personal items, such as pillows, washcloths, towels, eye drops, eye or face makeup, makeup brushes, contact lenses, contact lens storage cases, or eyeglasses.
• Do not use swimming pools. (5)

Homeopathic Treatment of Conjunctivitis

Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines selected after a full individualizing examination and case-analysis.

Which includes

• The medical history of the patient,
• Physical and mental constitution,
• Family history,
• Presenting symptoms,
• Underlying pathology,
• Possible causative factors etc.

A miasmatic tendency (predisposition/susceptibility) also often taken into account for the treatment of chronic conditions.

What Homoeopathic doctors do?

A homeopathy doctor tries to treat more than just the presenting symptoms. The focus is usually on what caused the disease condition? Why ‘this patient’ is sick ‘this way’?

The disease diagnosis is important but in homeopathy, the cause of disease not just probed to the level of bacteria and viruses. Other factors like mental, emotional and physical stress that could predispose a person to illness also looked for. Now a days, even modern medicine also considers a large number of diseases as psychosomatic. The correct homeopathy remedy tries to correct this disease predisposition.

The focus is not on curing the disease but to cure the person who is sick, to restore the health. If a disease pathology not very advanced, homeopathy remedies do give a hope for cure but even in incurable cases, the quality of life can greatly improve with homeopathic medicines.

Homeopathic Medicines for Conjunctivitis:

The homeopathic remedies (medicines) given below indicate the therapeutic affinity but this is not a complete and definite guide to the homeopathy treatment of this condition. The symptoms listed against each homeopathic remedy may not be directly related to this disease because in homeopathy general symptoms and constitutional indications also taken into account for selecting a remedy, potency and repetition of dose by Homeopathic doctor.

So, here we describe homeopathic medicine only for reference and education purpose. Do not take medicines without consulting registered homeopathic doctor (BHMS or M.D. Homeopath).

Medicine:

Argentum nitricum:

• Especially, Purulent, protargol more useful.

Belladonna:

• Bright redness, photophobia.

Boric acid:

• Specifically, for Saturated solution, with cocaine two to three grains to the ounce.

Rhus tox:

• it is indicated especially in much swelling of lids.

Hepar sulfurious:

• Purulent conjunctivitis, with marked chemosis, profuse discharge, great sensitiveness to touch and air. Moreover, Eyes and lids red also inflamed. Pains in the eyes as if pulled back into the head. Vision obscured by reading; field reduced one-half. Worse – from dry, cold winds; cool air; slightest draught, touch. On the other hand, Better – in damp weather; from wrapping head up; warmth; after eating.

Mercurius Corrosivus:

• Excessive photophobia and acrid lachrymation. Little tendency to pus formation. Pain severe at night; burning, shooting, tearing. Lids oedematous, red, excoriated. Especially, Soreness of the eyes.

Apis mellifica:

• For acute conditions, lids swollen, red, oedematous, everted, inflamed, burn also sting. Conjunctiva bright red, puffy. Lachrymation hot. Photophobia. Sudden piercing pains. Suppurative inflammation of eyes. Keratitis with intense chemosis of ocular conjunctiva.

Euphrasia:

• Catarrhal conjunctivitis.; discharge acrid, thick, also  excoriating. Eyes water all the time. Additionally, Burning and swelling of the lids. Lastly, Frequent inclination to blink. Pressure in eyes.

Diet & Regimen of Conjunctivitis

• Apply a compress to the eyes
• Try eye drops
• Stop wearing contact lenses
• Refuse exposure to light
• Prevent rubbing of the eye
• Clean the eyes using sterile water and cotton swabs, from inner canthus to outer canthus
• Use of dark sunglasses is advised, in presence of photophobia [2]

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Reference

[1] The concise textbook of surgery by S.das.

[2]https://www.mtatva.com/en/disease/conjunctivitis-treatment-diet-and-home-remedies/

[3] Homoeopathic Body-System Prescribing – A Practical Workbook of Sector Remedies

[4]https://www.wikidoc.org/index.php/Conjunctivitis_physical_examination

[5]Preventing Pink Eye (Conjunctivitis) | CDC

Frequently Asked Questions

What is Conjunctivitis?

Conjunctivitis is an inflammation or infection of the transparent membrane (in other words, conjunctiva) that lines the eyelid and covers the white part of the eyeball.

Homeopathic Medicines used by Homeopathic Doctors in treatment of Conjunctivitis?

• Argentum nitricum
• Belladonna
• Boric acid
• Rhus tox
• Hepar sulph
• Mercurius Cor
• Apis mell
• Euphrasia

What are the symptoms of Conjunctivitis?

• Pain
• Redness in one or both eyes
• Itching in one or both eyes
• A discharge in one or both eyes
• Tearing
• Photophobia
• Dropping of upper eyelid
• Periorbital cellulitis
• Fever
• Sore throat
• Runny nose
• A gritty feeling in one or both eyes

What are the causes of Conjunctivitis?

• Viruses
• Bacteria
• Allergies
• A chemical splash in the eye
• A foreign object in the eye
• In new-born, a blocked tear duct