Conjunctivitis treatment

Conjunctivitis is already a very common eye disease. It is not very serious and does not have much impact on our vision. However, if other inflammations occur and affect the cornea, it will cause damage to vision. Everyone should be able to understand the treatment methods of conjunctivitis in time. At the same time, they should be able to do a good job of preventing this disease in daily life and do not rub their eyes constantly with their hands.

Everyone should know about conjunctivitis. After suffering from conjunctivitis, you will feel like there is a foreign body in your eyes, and there will also be a burning sensation. When it affects the cornea, there will be symptoms of tearing, and it will also cause certain damage to vision. Everyone should actively learn about some treatments for conjunctivitis.

(1) Local treatment

1) Rinse the conjunctival sac: When there is secretion in the conjunctival sac, it should be rinsed. Its main function is to clean. The cleaning agent used should be non-irritating. Commonly used ones are normal saline, 2%~3% boric acid solution or 1:5000~1:10000 liters of mercury (or potassium permanganate) solution. Rinse with an eyewash bottle. The flushing fluid must have an appropriate temperature. When flushing, turn over the eyelids and flush the conjunctival surface. At the same time, push the upper and lower face with your fingers to flush out the secretions in the dome. At the same time, turn the head to the same side to avoid the flushing solution flowing into the opposite eye.

2) Do not cover the affected eye: Because conjunctivitis produces a lot of secretions, if you cover the affected eye, the secretions will not be easily discharged and will accumulate in the conjunctival sac. Covering the eye will increase the temperature of the conjunctival sac, which is more conducive to the reproduction of bacteria and aggravates conjunctivitis. If the patient is afraid of light, they can wear light-blocking glasses.

3) Topical medication:

① Antibacterial or antiviral eye drops: Select the appropriate therapeutic drugs based on the etiological diagnosis.

② Eye ointment: The drug concentration in the eye ointment is high and the effect lasts for a long time, so it is suitable for application before bedtime.

③Corrosive agents: Corrosive agents have strong bactericidal power, and they also corrode the surface tissue of the conjunctiva and cause necrosis. For example, silver nitrate should be applied directly to the affected area when used, and must not touch the cornea. After application, it should be rinsed immediately with physiological eye drops. 0.5~1% silver nitrate is commonly used. When dropping eye drops, turn over the eyelids and drop the eye drops on the conjunctiva. Wait for a while after dropping the eye drops and rinse with normal saline. Or use a cotton swab to dip a small amount of liquid medicine, apply it to the surface of the conjunctiva, and then rinse with normal saline. It is very effective for those with excessive secretions in the acute phase, but it cannot be used for a long time.

(2) Systemic treatment: For severe conjunctivitis, such as gonococcal conjunctivitis and trachoma, systemic medication is required.

Conjunctival congestion and increased secretions are common characteristics of various conjunctivitis. The inflammation can occur in one eye or both eyes simultaneously/sequentially.

Symptoms of conjunctivitis

1. Symptoms include foreign body sensation, burning sensation, heavy eyelids, and increased secretions in the affected eye. When the lesion involves the cornea, photophobia, tearing, and varying degrees of vision loss may occur.

2. Signs The physical signs of conjunctivitis are an important basis for the correct diagnosis of various types of conjunctivitis.

(1) Conjunctival congestion: The characteristic of conjunctival vascular congestion is that the closer to the fornix, the more obvious the congestion is, and the closer to the corneal margin, the lighter the congestion is. The blood vessels are distributed in a reticular manner and are bright red in color. They can extend into the periphery of the cornea to form corneal pannus. The congestion disappears quickly after the application of epinephrine.

(2) Secretions: The nature of the secretions may vary depending on the cause of conjunctivitis. Purulent discharge is more common in gonococcal conjunctivitis; mucopurulent or catarrhal discharge is more common in bacterial or chlamydial conjunctivitis, and often sticks firmly to the eyelashes, making it difficult to open the eyelids in the morning; watery discharge is usually seen in viral conjunctivitis.

(3) Conjunctival edema: Conjunctival inflammation causes conjunctival vasodilation and exudation, leading to tissue edema. Since the bulbar conjunctiva and fornix conjunctiva tissues are loose, they bulge out significantly when edematous. However, the palpebral conjunctiva is closely connected to the tarsal plate, so edema is not obvious.

(4) Subconjunctival hemorrhage: It is mostly in the form of dots or small patches. Epidemic hemorrhagic conjunctivitis caused by viruses is often accompanied by subconjunctival hemorrhage.

(5) Papilla: It is a nonspecific sign of conjunctival inflammation and can be located on the palpebral conjunctiva or corneal limbus. It presents as a raised polygonal mosaic appearance with congested areas separated by pale grooves. Under the slit lamp, it can be seen that there is a central blood vessel inside each nipple, which spreads out like spokes on the surface of the nipple. The papilla is actually a swelling of the conjunctiva caused by exudation from the central blood vessels and infiltration of inflammatory cells, mainly polymorphonuclear leukocytes. Histologically, the fine connective tissue septa that anchor the conjunctival epithelium to its underlying tissue play an important role in the formation of the papilla, and these connective tissue septa limit the size of the papilla to less than 1 mm. This anchor-like septum becomes less and less towards the upper edge of the tarsal plate. Therefore, when the upper eyelid is turned over, the conjunctiva at the upper edge of the tarsal plate may appear wavy, resembling a giant papilla or follicle, but in fact this may be a normal phenomenon. Therefore, it is not appropriate to use the upper edge of the tarsal plate area to analyze the clinical signs of papillae or follicles. Trachoma is often accompanied by obvious papillary hyperplasia. The formation of giant papillae is due to the disintegration and rupture of the tiny connective tissue septa that play an anchoring role. The diameter of the giant papillae is greater than 1 mm. They mostly occur in the upper eyelid conjunctiva. Common cases are spring catarrhal conjunctivitis and contact lens-induced giant papillary conjunctivitis.

(6) Follicles: Follicles are yellow-white, smooth, round protrusions with a diameter of about 0.5-2.0 mm, but in some cases such as chlamydial conjunctivitis, larger follicles may also appear; the center of the follicle is a lymphoid germinal center and fibrous tissue, with no blood vessels, but there are blood vessels distributed on the surface. In children and young people, physiological follicles can also be seen in the conjunctiva under normal circumstances, especially in the inferior temporal fornix conjunctiva. Viral conjunctivitis and chlamydial conjunctivitis are often referred to as acute follicular conjunctivitis or chronic follicular conjunctivitis because of the obvious follicular formation.

Conjunctivitis is also a contagious disease. Everyone should wash their hands frequently and avoid rubbing their eyes. Towels and other daily necessities should be separated and disinfected regularly. If patients with conjunctivitis are found, they should be isolated in time and close contact with them should be avoided to avoid cross infection.