Allergic, Bacterial & Viral Conjunctivitis Treatment
Conjunctivitis is one of the most common and treatable eye infections in children and adults. Often called "pink eye," it is an inflammation of the conjunctiva, the tissue that lines the inside of the eyelid. This tissue helps keep the eyelid and eyeball moist.
Hyperemia of the conjunctiva from infection, allergy, or chemical reactions characterizes conjunctivitis. Bacterial and viral conjunctivitis are highly contagious but are also self-limiting after two weeks duration. Chronic conjunctivitis may result in degenerative changes to the eyelids. In the Western hemisphere, conjunctivitis is probably the most common eye disorder.
Conjunctivitis may be triggered by a virus, bacteria, an allergic reaction (to dust, pollen, smoke, fumes or chemicals) or, in the case of giant papillary conjunctivitis, a foreign body on the eye, typically a contact lens. Bacterial and viral systemic infections also may induce conjunctivitis.
Signs and symptoms
Physical examination reveals injection of the bulbar conjunctival vessels. In children, possible systemic symptoms include sore throat and fever.
Monocytes are predominant in stained smears of conjunctival scrapings if conjunctivitis is caused by a virus. Polymorphonuclear cells (neutrophils) predominate if conjunctivitis stems from bacteria; eosinophils, if it's allergy related. Culture and sensitivity tests identify the causative bacterial organism and indicate appropriate antibiotic therapy.
The cause of conjunctivitis dictates the treatment. Bacterial conjunctivitis requires topical application of the appropriate antibiotic or sulfonamide.
Although viral conjunctivitis resists treatment, broad-spectrum antibiotic eye drops may prevent secondary infection.
Herpes simplex infection generally responds to treatment with trifluridine drops, vidarabine ointment, or oral acyclovir, but the infection may persist for 2 to 3 weeks. Treatment of vernal (allergic) conjunctivitis includes administration of corticosteroid drops followed by lodoxamide tromethamine (Alomide), a histamine -antagonist, cold compresses to relieve itching and, occasionally, oral antihistamines.
Instillation of a one-time dose of erythromycin into the eyes of newborns prevents gonococcal and chlamydial conjunctivitis.
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