Protect urself from Conjunctivitis

[SUMAN-SAJAN]

Conjunctivitis



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Conjunctivitis is rampant in the city these days.

What protective measures and prophylaxis be adopted to avoid getting conjunctivitis?

Before getting this answer lets know something about conjunctivitis.



Conjunctivitis is the inflammation of conjunctiva.



Common organisms :
• Staph epidermidis
• Staph aureus
• gram +ve:Strep pneumoniae
• gram –ve:H. influenzae
• Moraxella lacunata



Classification

1. Based of onset
Acute
Sub acute
Chronic

2. Based on type of exudates
Serous (viral)
Catarrhal (allergic)
Purulent (bacterial)
Membranous (bacterial)
Pseudo membranous (bacterial)
Mucopurulent (bacterial, chlymidal)


3. Based on conjunctival response
Follicular (viral, Chlamydia)
Papillary (allergic)
Granulomatous (fungal, TB, Syphilis, foreign body)



4. Based on etiology

Infectious- Bacterial
Viral
Chlamydia
Fungal
Parasitic


Non infectious
Allergic
Irritant
Endogenous
Dry eye
Idiopathic




Route of infection:

hand – eye contact
infiltration from lids / sinus



CLINICAL FEATURES

SYMPTOMS
acute redness , grittiness/ burning sensation/ discharge
stickiness of lids
usually B/L


Signs:
• lids crusted/edematous
• mucopurulent discharge
• conjunctiva-velvety beefy-red
• subconjunctival haemorrhage




Treatment


Bacterial conjunctivitis


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 eye should not be bandaged
 dark goggles should be worn
 patient must keep his hand clean
 No one else allowed using his/her towel, handkerchief, pillow, fomites etc.
 drugs- broad spectrum antibiotics (4-6 times a day)
-Chloramphenicol
-Lomefloxacin
-Ciprofloxacin
-Antibiotic ointment to be applied over lower fornix.


"Never use topical steroid in bacterial conjunctivitis."



Viral conjunctivitis
 Topical lubricating drug (artificial tear) 4-6 times a day till complete resolution.
 if cornea is involved
Acyclovir 3%
Vidarabine 3%
Trifluorothumidine 1% (5 times a day)


Fungal conjunctivitis
Topical Miconazole/ clotrimazole 1%



Allergic
 cold compress
 antihistamine eye drops
 topical steroids 4-6 hourly
 Sub tarsal injection Triamcinolone




• Hospitalization if cornea involvement.
• Conjunctival swab & discharge culture & sensitivity.
• Irrigation of involved eye with saline frequently.
• Systemic antibiotic: Cefotixin /Ceftriaxone 1gm IV stat/ Cefotaxime 500mg IV QID 1day.




Topical treatment
• Drop: Gentamicin/Ciprofloxacin/Bacitracin 1-2 hrly
• Ointment: Ciprofloxacin/Erythromycin/Bacitracin at night.
• 1/3 associated with Chlamydial venereal disease.








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OTHER MEASURES THAT SHOULD BE FOLLOWED:


Apply cold compresses to the infected eye(s) three to four times per day for 10-15 minutes using a clean washcloth each time. This should help reduce itching and swelling and provide some comfort.


Wash your hands frequently and keep them away from your eyes in order to reduce or prevent recontamination.


Avoid rubbing your eyes to decrease irritation of the area.


Wear sunglasses if your eyes are sensitive to the light.


Avoid exposure to the irritants that may be causing the conjunctivitis.


Dispose of old eye makeup if the culture for bacteria is positive.



Avoid wearing contact lenses while you are using medications or if your eyes are uncomfortable. Cleanse contact lenses and contact lens care thoroughly before wearing.


Thoroughly clean your contact case before placing new contacts in it.



PREVENTION


Do not share eye makeup or cosmetics of any kind with anyone.

Avoid sharing washcloths or towels.

Wash hands frequently and keep away from the eyes.

Wear protective goggles (i.e., for swimming or working) if you must be exposed to chemicals that are irritating.

Do not use medication (eye drops, ointment, etc.) that has been prescribed for someone else.

Avoid swimming in non-chlorinated pools or stagnant lakes or ponds.

Do not save medication - dispose of it when treatment is completed and check for expiration date.



CONCERNS

If any of the following problems should occur, notify your clinician:

Visual changes
Severe eye pain
Pain when moving eyes
Fever
No improvement with medication within 48 hours
Drainage continues after you have completed full course of medication
Roommates or other family members develop symptoms
Eyes become very sensitive to light






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Compiled By: Suman Prasad Adhikari