Chronic conjunctivitis

Description:

Chronic conjunctivitis is the inflammatory reaction of a conjunctiva which is characterized by a hyperemia and hypostasis of a mucous membrane a century, formation of follicles or nipples on a conjunctiva and followed by an itch, feeling of "sand in eyes", sometimes with defeat of a cornea and a vision disorder.

Symptoms of Chronic conjunctivitis:

Clinical picture of allergic conjunctivitis.
Depending on features of a course of the allergic conjunctivitis connected with season allocate the seasonal conjunctivitis which is usually becoming aggravated in a certain season (in the spring, in the early or late summer), and year-round, arising at all seasons of the year. Special forms of allergic conjunctivitis are the spring keratoconjunctivitis, the allergic conjunctivitis developing when carrying contact lenses, conjunctivitis as display of a medicinal allergy and krupnopapillyarny conjunctivitis.

Seasonal allergic conjunctivitis (as one of manifestations, is more rare — the only clinical implication of a pollinosis) is the seasonal allergic disease of eyes caused by pollen of plants in a blooming period of trees, cereal herbs or weed and a thistle family of plants. Exacerbations of this disease repeat from year to year at the same time and accurately match a calendar of dusting of plants in each climatic region. More than 700 species of allergenic plants and their pollen are known. Diameter of pollen grains makes from 20 to 50 microns that is optimum for development of a sensitization. Except a certain size pollen has to possess a volatility and collect in air in significant amounts. In the Midland of Russia allocate 3 main periods: spring (April-May) when at air there is a pollen of trees (a birch, an alder, an oak, a hazel grove, etc.), summer (June-July), caused by pollen of cereal herbs (a meadow grass, a wheat grass, a fescue, a hedgehog, a foxtail, a timothy, etc.), and late summer or aestivo-autumnal (August-October), connected with blossoming of a thistle family and goosefoot family (a wormwood, an orach, an ambrosia). Seasonal conjunctivitis can sharply begin and be characterized by an intolerable itch in the field of a century, burning under centuries, a photophobia, dacryagogue, hypostasis and a hyperemia of a conjunctiva.

Year-round allergic conjunctivitis has a chronic current: moderate burning of eyes, an insignificant discharge, periodically arising itch a century. Often numerous complaints to unpleasant feelings are combined with insignificant clinical manifestations that complicates diagnosis. Hypersensitivity to allergens of house dust, wool, dandruff and other biological components of domestic animals, foodstuff, medicines, cosmetics and other agents whom the patient faces regularly is the main reason for a persistent course of pathological process. In differential diagnosis of this disease an important role is played by establishment temporary and relationship of cause and effect of an aggravation of this pathological process with contact with causal and significant allergen. A specific place is held by allergic conjunctivitis when carrying contact lenses. It is considered that 55-65% of the patients carrying contact lenses surely have sooner or later an allergic reaction of a conjunctiva: irritation of eyes, a photophobia, dacryagogue, burning under centuries, an itch, discomfort at insertion of a lens. At survey the oculist will find small follicles, small or large nipples on a conjunctiva of upper eyelids, a hyperemia of a mucous membrane, hypostasis and dot erosion of a cornea.

Spring keratoconjunctivitis (spring Qatar). The disease usually develops at children at the age of 5–12 years, is more often at boys, has preferential chronic persistent, exhausting current. The most characteristic sign are papillary growths on a conjunctiva of a cartilage of an upper eyelid (a conjunctival form), as a rule, small, flattened, but can be and large. Less often papillary growths are located along a limb (a limbalny form). Quite often the cornea is surprised, the epiteliopatiya, an erosion or a helcoma, a keratitis, a hyperkeratosis develop. Potentially this form of a disease can become the heaviest option of allergic reaction of 1 type from eyes and lead to decrease in sight.

Medicinal allergic conjunctivitis. The disease can sharply arise after the first use of any medicine, but usually develops chronically at prolonged treatment, and allergic reaction both to medicine, and to chemicals (preservative, the stabilizer) which are a part of eye drops is possible. The acute reaction arises within 20–60 min. after administration of drug (acute medicinal conjunctivitis, it is rare — an acute anaphylaxis, an acute small tortoiseshell, a Quincke's edema, a system capillary toxicosis, etc.). The delayed reaction develops within a day. Reaction of the slowed-down type is shown for several days or weeks, usually at prolonged topical administration of medicines. Eye reactions of the last type occur most often (at 90%) and have chronic character. The same medicine can cause unequal manifestations in different patients. At the same time, various drugs are capable to cause a similar clinical picture of a medicinal allergy.

Traditionally carry krupnopapillyarny conjunctivitis (huge papillary conjunctivitis) to group of allergic conjunctivitis. The disease represents inflammatory reaction of a conjunctiva of the upper eyelid, during the long period which is in contact with a foreign body, krupnopapillyarny conjunctivitis is not connected with the IgE-mediated reaction. Developing of krupnopapillyarny conjunctivitis is possible when carrying contact lenses (rigid and soft), use of eye prostheses, existence of seams after extraction of a cataract or a keratoplasty, the pulling together scleral seals. Patients complain of an itch and a mucous discharge. The ptosis can appear in hard cases. Large (huge — with a diameter of 1 mm and more) nipples are grouped in all surface of a conjunctiva of upper eyelids. Patients with this nosological form are under observation of the ophthalmologist.

Reasons of Chronic conjunctivitis:

Very often the allergic reaction developing at the patients having hypersensitivity (sensitization) to this or that allergen is the reason of development of chronic conjunctivitis. Conjunctivitis represents the most often found localization of allergic reaction from an organ of sight and makes up to 90% of all allergic damages of eyes [9]; less often the allergic blepharitis, dermatitis meet a century, is even more rare — an allergic keratitis, an iritis, a uveitis, a retinitis, neuritis.

Treatment of Chronic conjunctivitis:

You should not begin topical treatment of chronic conjunctivitis without one additional research: in bacteriological laboratory it is necessary to make a smear and crops of contents of a conjunctival sac on flora and sensitivity to antibiotics (it is called an antibiotikogramma). Practically, not to mention the cities, it is possible to find such laboratory in any regional center, it usually happens at infectious department of hospital or at a sanepidstantion. One BUT: before a research at least for 2 weeks it is necessary to stop treatment of conjunctivitis, otherwise crops of growth will not give. In several days which will leave on cultivation of bacteria you learn who lives at you in a conjunctival cavity and what antibiotics to fight with them. Then it will already be possible to use precisely drops and ointment by the principle: two antibiotics, to which the highest sensitivity. It is very useful to do washings of a conjunctival cavity by infusion of a pharmaceutical camomile (to fill in a tablespoon of flowers of a camomile with a glass of boiled water, to insist, cool and use for washings).

It is not possible to sow chlamydias which even more often become recently the conjunctivitis reason. These microorganisms take the intermediate place between bacteria and viruses and on usual mediums do not grow. But they can be found in a smear as large inclusions in conjunctiva cells. Unlike others Chlamidia conjunctivitis can be unilateral. It is very difficult to treat Chlamidia conjunctivitis, the combination of a kolbiotsin and the drops containing dexamethasone is necessary, it is necessary to continue treatment not less than a month, different complications are possible.