Acute bacterial conjunctivitis

Illness description

This is an inflammation of the eye’s conjunctiva (the conjunctiva covers the inner surfaces of the upper and lower eyelids and the front part of the eyeball up to the cornea, it does not cover it). The causative agents can be staphylococci, streptococci, pneumococci, gonococci, diphtheria bacilli.

Symptoms

Usually both eyes are affected, they are swollen, reddened – more around the edge of the eyeball. There may be hemorrhages. The discharge is purulent, mostly in the mornings, so the eyelids stick together, there are many crusts. There is a feeling of itching, burning, as if there is a foreign body in the eyes, they tear. The salivary glands near the ears (parotid) and under the lower jaw (submandibular) may swell. Vision usually does not deteriorate if the course of the disease is not severe.

Gonorrheal conjunctivitis is characterized by secretions resembling meat washings. It affects newborns during childbirth when the mother has gonorrhea. Also young adults with gonorrhea. In cases of diphtheritic conjunctivitis, membranes form on the conjunctiva of the eye, which are difficult to remove, and when removed, they bleed. Staphylococcal eye damage can occur in individuals of any age, pneumococcal and Haemophilus influenzae – in children.

Diagnosis

A general practitioner diagnoses conjunctivitis based on the listed clinical symptoms. Attention is paid to the age of the patient, concomitant diseases, medications being taken. If necessary, an ophthalmologist consultation is recommended.

Treatment

When the causative agent is golden staphylococcus, antibiotics of the sulfonamide group are prescribed, if they do not help – aminoglycosides (gentamicin). If these also do not help, cephalosporin group antibiotics are prescribed in drops.

Conjunctivitis caused by Streptococcus pyogenes is treated with chloramphenicol drops. Gonorrheal conjunctivitis is treated systemically, penicillin is prescribed, third-generation cephalosporins, and for newborns, albucid is instilled locally. Topical antibiotics are usually not needed. In the case of diphtheritic conjunctivitis, treatment is done with antitoxin serum, later with antibiotics, vitamin A drops.

It is forbidden to cover the eyes as it can harm the cornea.

Source | Author Doctor Nikas Samuolis, reviewed by Prof. Virginijus Šapoka | Vilnius University | Faculty of Medicine | Head of the Department of Internal Medicine, Family Medicine, and Oncology