Jaymathi Dhanapal and Saraniyaa Thevy Ramachandran

Conjunctivitis(commonly known as “pink eye” in North America and “Madras eye” in India) is an inflammation of the conjunctiva which is the outermost layer of the eye and the inner surface of the eyelids), most commonly due to an allergic reaction or an infection (eg:bacteria, virus…)

VARIANTS 1. Blepharoconjunctivitis: combination of conjunctivitis and blepharitis(inflammation of the eyelids) 2. Keratoconjunctivitis: combination of conjunctivitis and keratitis (corneal inflammation) 3. Episcleritis is an inflammation condition that produces a similar appearance to conjunctivitis without tearing or discharge

WHAT CAUSES IT? There are several causes of conjunctivitis: a) Bacterial=bacterial conjunctivitis can be caused by several different types of bacteria, including Haemophilus influenzae, staphylococci (staph) and streptococci (strep). Most bacterial infections spread through contact with hands that have been contaminated with the bacteria. Children born to mothers with gonorrhea or chlamydia also can develop conjunctivitis if their eyes are infected by contaminated secretions in the birth canal during vaginal delivery. This type of conjunctivitis is also known as neonatal conjunctivitis.

b) Viral= Viral conjunctivitis often is caused by one of the adenoviruses, a family of viruses that usually causes colds (upper respiratory illnesses). In temperate climates, adenoviruses are most active during spring, early summer and mid-winter. They infect fluids in the eyes, mouth and nose, and can spread from person to person on hands and in the droplets of coughs and sneezes. In most cases, adenoviruses cause only a mild case of conjunctivitis. However, they are capable of causing a more serious infection, called kerato- conjunctivitis, that can cloud the cornea and interfere with vision. Besides adenoviruses, other viruses that cause conjunctivitis include enteroviruses, the measles virus (rubeola) and the herpes simplex virus.

c) Allergic= alllergic conjunctivitis Due to allergen causing irritation. Examples of allergens: pollen from tress, grass and ragweed, animal skin and secretions such as saliva, perfumes, cosmetics, skin medicines, air polution and smoke d) Chemical= chemical conjunctivitis Caused by irritants like air pollution, chlorine in swimming pools, and exposure to noxious chemicals.

Percentage of conjunctivitis cases in Malaysia in year 2006 Types of conjunctivitis No(%) Bacterial conjunctivitis 15 Viral conjunctivitis 35 Allergic conjunctivitis 18

 Common symptoms: - redness (hyperaemia), irritation (chemosis), watering (epiphora )  Allergic conjunctivitis -typically itchy, lid swelling  Viral conjunctivitis -infection of upper respiratory tract (common cold, sore throat), watery discharge -usually begins with one eye, but may spread easily to the other.

 Bacterial conjunctivitis (a) due to pyogenic bacteria - irritation and a stringy, opaque, yellowish mucopurelent discharge(eye crust) that may cause lids to stick (b) due to other bacteria (eg: Trachoma, Moraxella) -very persistent conjuc. Without much redness *usually affects one eye only but may spread to the other  Irritant or Toxic conjunctivitis - irritable or painful when infected eye is pointed far down or far up, discharge and itch usually absent

 Inclusion conjuctivitis of the newborn (ICN) - acute, purulent conjunctivitis - usually self –healing

Appropriate treatment depends on the cause of problem  Bacterial  usually resolves with no treatment  antibiotic eye drops or oinments (eg: chloramphenicol or fusidic acid) does however speed recovery  Allergic  Cool water poured over the face with the head inclined downward constricts capillaries  Artificial tears sometimes relieve discomfort in mild cases.  Severe cases, non-steroidal anti-inflammatory medications and antihistamines are used.

 Viral  No specific treatment  Symptomatic relief may be achieved with warm compresses and artificial tears  Worst cases, corticosteroid drops used to reduce the discomfort from inflammation. (prolonged usage of these drops increases the risk of side effects)  Antibiotic drops  Patient often advised to avoid touching their eyes or sharing towels and washcloths.  In olden times breast milk was used

 Chemical  Require careful wash-out with saline, especially bemeath the lids  May require steroids

REFERENCE  on_conjunctivitis.htm on_conjunctivitis.htm 