Conjunctivitis

Conjunctivitis is an inflammation of the conjunctiva. The conjunctiva is a thin and clear tissue that covers the white part of the eye and lines the inside of the eyelids.

Viral conjunctivitis is the most common cause of an acutely reddened eye.
Typically, viral or bacterial conjunctivitis affects both eyes at the same time, but it can also start in one eye and spread to the other after a day or two.

It can be asymmetrical and affect one eye more than the other.
Viral conjunctivitis in children is more common than in adults.

Conjunctivitis can develop together with keratitis (infection of the cornea). It is usually caused by infection with the herpes virus.
In keratoconjunctivitis, there is eye pain, while in viral conjunctivitis, symptoms are limited to irritation of the surface of the conjunctiva and blurred vision.

Classification of conjunctivitis

Conjunctivitis can be divided in the following ways based on the secretions formed:

• Serous conjunctivitis: characterized by heavy blood circulation, swelling and low pus production.
• Catarrhal conjunctivitis: is the only type of conjunctivitis in which mucus is formed.
• Purulent conjunctivitis: is characterized by red eyes, severe eyelid swelling and abundant pus production; it can also spread to the cornea and the lymph nodes near the ears can swell.
• Pseudomembranous conjunctivitis: in this case, the conjunctiva is covered by a fine layer of fibrin. If this layer dissolves, bleeding can easily be triggered.
• Follicular conjunctivitis: it is characterized by the presence of follicles, that is, groups of lymphocytes and plasma cells that look like white, circular and slightly raised structures.

Causes of viral and bacterial conjunctivitis

There are different types of conjunctivitis, each with its own cause.

Viral conjunctivitis
Viral conjunctivitis is caused by an eye infection caused by virus.
It can be caused by various viruses, many forms are associated with an upper respiratory tract infection, such as runny nose or sore throat.
The incubation period varies widely, ranging from a few days to a month.
According to conventional medicine, viral conjunctivitis is highly infectious and spreads quickly and easily to other people.

Development of the disease

• It usually proceeds mildly with the strongest symptoms in the first 3 to 5 days of infection. The condition usually resolves after 7 to 14 days without treatment and does not cause long-term effects.
• If complications arise, it may take 2 to 3 weeks to fully recover from viral conjunctivitis.
• People with viral conjunctivitis can infect other people up to about 12 days after the onset of symptoms.

Types of infectious conjunctivitis

Viral conjunctivitis

• Conjunctivitis caused by adenovirus: can cause serious and protracted conjunctivitis. Some adenovirus groups can provoke epidemic keratoconjunctivitis, which is highly contagious and often accompanied by large epidemics in schools.
  It spreads through contact with infected people, instruments and objects.
  The incubation period is about 5 to 10 days.
  Symptoms of this type of conjunctivitis usually last one to three weeks.
  Symptoms of epidemic keratoconjunctivitis:
  • Redness and irritation of the eyes
  • Photophobia (photosensitivity)
  • Lacrimation
  • Enlarged lymph nodes on the affected side
  • Blurred vision
• Conjunctivitis caused by herpes simplex: although caused by a virus, it is slightly different from normal viral infections.
  The difference caused by conjunctivitis caused by a herpes virus is the following symptoms:
  – eye pain and burning, which can be unbearable;
  – Blistering on the conjunctiva or eyelids.
• Conjunctivitis caused by Coxsackie virus: belongs to the genus of enteroviruses and can cause conjunctivitis.

Bacterial conjunctivitis

The main bacteria that cause conjunctivitis are:

• Staphylococcus
• Strep
• Bacteria responsible for gonorrhea and chlamydiosis

This condition has an incubation period (without symptoms) of 2 to 3 days.
Symptoms of bacterial conjunctivitis appear rapidly and include, among others:

• Eyestrain
• Swollen eyes
• Itch
• Reddening
• Moderate to severe discharge, usually yellow or greenish, which often accumulates after sleep
• Swollen lymph nodes in front of the ears
• Headache in the forehead area (if the conjunctivitis is caused by sinusitis)
• Mild fever
• Affected children may have “glued eyes”.

In the case of glued eyes, according to patient reports, it is important not to open the eyes all at once, but only after the eyeballs have been rolled and moved to the side; then the eyelids can be opened with much less pain.

Conjunctivitis caused by chlamydia and gonorrhea can develop in newborns during a natural birth, when the mother is infected, but also in adults through self-infection during genital infections or contact with swimming pool water.
These sexually transmitted infections are serious and require very rapid treatment if they affect the eyes; they can also provoke inflammation of the cornea (keratitis).

Neonatal conjunctivitis should not be confused with a glued eye, which often occurs in newborns and is caused by a blocked tear duct.
A blocked tear duct with a glued eye does not cause red discoloration of the conjunctiva.

Conjunctivitis caused by chlamydiosis is a rare form of infection in the Western world, but it is very common in Africa and the countries of the Middle East.
Conjunctivitis caused by chlamydia is often treated orally with erythromycin or tetracycline, except in children under 8 years of age, because this can lead to hypoplasia (incomplete or reduced development) of tooth enamel.

Contagion and transmission

There are several things that can prevent conjunctivitis and its spread:

• wash hands frequently;
• carry out frequent bacterial disinfection, especially if you can not wash your hands with soap and water;
• make hot compresses several times a day;
• avoid direct contact of the eyes;
• avoid swimming pools or hot tubs;
• Do not share towel, make-up, sunglasses, eye drops or pillows;
• a pregnant woman with a sexually transmitted disease should undergo therapy and talk to the doctor;
• change pillowcases and towels regularly;
• frequently disinfect shared objects;
• do not use contact lenses, make-up and eye drops.

Diagnosis of conjunctivitis

Conjunctivitis is usually diagnosed and treated by the family doctor.
In most cases, the doctor diagnoses the disease on the basis of an eye examination and anamnesis.
Sometimes an eye bandage must be worn, especially if the condition does not improve.

Treatment of viral or bacterial conjunctivitis

Most infected cases of conjunctivitis do not require medical treatment and pass after a week or two.

Treatment of patients with conjunctivitis There are several measures by which it is possible to treat infectious conjunctivitis
at home:

1. Remove contact lenses. Avoid the use of contact lenses until 24 hours after completion of treatment. Do not use the old lenses again after the infection has subsided, as they can be a potential source of re-infection.
2. Use eye drops that have a sliding effect. They are available over the counter or by prescription.
   They can relieve the pain and other symptoms in the eyes.
3. Gently remove adhesive discharge on the eyelids and eyelashes with a firm paper handkerchief

Viral conjunctivitis
If the cause of infection is a virus, no treatment is required.
The doctor may prescribe eye drops to relieve symptoms. In the case of conjunctivitis caused by herpes virus, the ophthalmologist may recommend antiviral eye drops and medications (famciclovir, valaciclovir).

Eye drops in bacterial conjunctivitis

Antibiotics

Usually, antibiotics are not prescribed for infectious conjunctivitis because they make little difference in recovery, and there is a very low risk of complications with untreated conjunctivitis.
However, if the infection is particularly severe or lasts longer than two weeks, the doctor may prescribe antibiotics.

There are two main types of antibiotics that are prescribed:

1. Chloramphenicol
2. Fusidic acid

Chloramphenicol is preferred and applied in the form of eye drops.
These are administered as follows:

1. For the first two days, drizzle a drop into the infected eye every two hours.
2. For the next five days, drip a drop into the infected eye every four hours.
3. Apply the drops when you are awake.
4. If the symptoms improve in the first five days, you should use the eye drops for another two days.
5. If you do not like eye drops, you can have the doctor prescribe an antibiotic ointment.

Fusidic acid
Fusidic acid may be prescribed if chloramphenicol is not suitable for the patient.
Often it is more suitable for children and the elderly, as it does not need to be administered as often. This remedy is also preferred in pregnant women.
Fusidic acid is available in the form of eye drops, usually given twice a day for seven days.

Side effects
The eye drops can lead to blurred vision.
After using eye drops, you should avoid using machines.
Usually, neither fusidic acid nor chloramphenicol cause side effects, although they can leave a burning sensation in the eyes. This feeling should not last long.

Nutrition and natural remedies for viral and bacterial conjunctivitis

Diet plays a fundamental role in fighting infections.
Doctors do not talk about this topic, but natural medicine and blood type diet cure their patients through a change in diet.

According to natural medicine, one should not take medication, it is sufficient to design the meal plan with the following foods:

• Raw vegetables
• Fruit, especially seasonal and organic fruit
• Nuts and seeds
• Pulses
• Potatoes

Processed and transformed foods from the supermarket have been prepared at very high temperatures and contain various mixed ingredients.
This slows down digestion because the stomach can only produce one type of stomach acid at a time.
Animal proteins should be avoided for the same reason.

Food combinations:

• Acidic foods inhibit the formation of acidic gastric juice and should therefore be consumed alone.
• Fruits should not be eaten along with vegetables or carbohydrate-rich foods.
• Do not eat carbohydrate-rich foods along with protein foods (such as meat with rice).

According to the blood group diet, proteins are a fundamental part of the diet.
The patient should eat the foods that are allowed to him depending on the blood group, but the others should be avoided, for example:

1. Members of blood type 0 easily digest meat (except pork) and fish, but should avoid cereals and fruit.
2. People of blood type A have no problems with the consumption of fruits and cereals, but can get sick if they regularly consume meat, milk, cheese and gluten.
3. Those belonging to blood type B are allowed to eat vegetables, fruits, meat and fish, but cereals containing gluten, corn, buckwheat and tomatoes can cause health problems.
4. Blood type AB has to do without red meat because it has a low proportion of stomach acid. Dairy products and cereals containing gluten can promote the occurrence of tumors.

Remedies for conjunctivitis include:

Oral supplements to strengthen the immune system and heal faster, but only under the supervision of the doctor:

• Vitamin C
• Zinc

Packs directly on the eyelids and eye washes are treatments that are performed several times a day.
The warm water can be supplied with herbs with a soothing effect, which help to relieve the symptoms.

Herbs
The use of herbs is a natural remedy to strengthen the body and treat a disease.
However, herbs can also trigger side effects and interact with other herbs, supplements, and medications.
For these reasons, they should be used with caution and under the supervision of an expert.
The most common herbs for conjunctivitis are:

• Euphrasia (Euphrasia officinalis): helps fight infections and dry excess fluid;
• Chamomile (true chamomile): helps fight infections;
• fennel seeds (Foeniculum vulgare): helps fight infections;
• Calendula (Calendula officinalis): soothes irritation;
• Plantain (Plantago lanceolata, P. principalis): has an astringent and soothing effect. Fresh leaves are most effective on this plant.

• Burning eyes
• Excessive lacrimation
• Eye pain and headache