What is Conjunctivitis?

A health article about Conjunctivitis from Your Health Online the A to Z directory of dealing with Health Problems & nutritional Self Care Strategies

This condition refers to the inflammation of the conjunctiva, the thin transparent membrane covering the front of the eye.

It is also known as " sore eyes" and is a very common form of eye trouble.

It spreads from person to person through direct contract.

Overcrowding, dirty surroundings and unhealthy living conditions can cause epidemics of this ailment.

Signs & Symptoms of Conjunctivitis

The eyeball and under side of the eyelids become inflamed. At first, the eyes are red, dry and burning. Later, there may be a watery secretion.

In more serious cases, there is pus formation. During sleep, this material dries, making the eye-lashes stick together.

Redness, irritation and watering of the eyes are symptoms common to all forms of conjunctivitis. Itch and the closing of the throat is variable.

Acute allergic conjunctivitis is typically itchy. Sometimes distressingly so, and the patient often complains of some lid swelling. Chronic allergy often causes just itch or irritation, and often much frustration because the absence of redness or discharge can lead to accusations of hypochondria.

Types of Conjunctivitis

Conjunctivitis (con•junc•ti•vi•tis) (commonly called "pinkeye" or bloodshot eyes in the USA and "Madras Eye" in India) is an inflammation of the conjunctiva (the outermost layer of the eye and the inner surface of the eyelids), most commonly due to an allergic reaction or an infection (usually bacterial or viral).

Blepharoconjunctivitis is the combination of conjunctivitis with blepharitis (inflammation of the eyelids).

Keratoconjunctivitis is the combination of conjunctivitis and keratitis (corneal inflammation).

Episcleritis is an inflammatory condition that produces a similar appearance to conjunctivitis, but without discharge or tearing.

Some forms of the condition are extremely contagious while others are not. It all depends on the etiological cause.

What Causes Conjunctivitis?

Medical science believes that the condition results from bacterial infection, viruses or eye-strain.

Prolonged work under artificial light and excessive use of the eyes in one way or the other no doubt contributes towards the disease.

But its real cause can be traced to a catarrh a condition of the system resulting from general toxaemia due to dietetic errors and faulty style of living . The patient generally suffers from colds or other ailments indicative of a general catarrhal condition.

Viral conjunctivitis is often associated with an infection of the upper respiratory tract, a common cold, or a sore throat. Its symptoms include watery discharge and variable itch. The infection usually begins with one eye, but may spread easily to the fellow eye.

Bacterial conjunctivitis due to the common pyogenic (pus-producing) bacteria causes marked grittiness/irritation and a stringy, opaque, grey or yellowish mucopurulent discharge (gowl, goop, "gunk", sleep, or other regional names) that may cause the lids to stick together (matting), especially after sleeping. Another symptom that could be caused by Bacterial Conjunctivitis is severe crusting of the infected eye and the surrounding skin.

However discharge is not essential to the diagnosis, contrary to popular belief. Many other bacteria (e.g., Chlamydia, Moraxella) can cause a non-exudative but very persistent conjunctivitis without much redness. The gritty and/or scratchy feeling is sometimes localised enough for patients to insist they must have a foreign body in the eye. The more acute pyogenic infections can be painful. Like viral conjunctivitis, it usually affects only one eye but may spread easily to the other eye.

Irritant or toxic conjunctivitis is irritable or painful when the infected eye is pointed far down or far up. Discharge and itch are usually absent. This is the only group in which severe pain may occur.

Conjunctivitis or Pinkeye in Children

Conjunctivitis or pinkeye is a common problem in school going kids. The eyes become red, itchy, and swollen. There can also be a discharge of gooey liquid from the eye which can be of the color white, clear, green or yellow.

Conjunctivitis is also known as pinkeye because the eye’s white part turns pink or red. When the child experiences itchiness and redness in the eyes, he/she should inform the elders as soon as possible, as pinkeye is very contagious and spreads very easily.

It is possible that only one eye can get affected by conjunctivitis, while the other eye dose not. In usual cases, both the eyes get infected. Conjunctivitis doesn’t hurt usually, but the eyes sure do itch badly. There can be a sensation similar to an eyelash or tiny particle getting in the eye, which can be very annoying. The infection lasts for about a week and usually goes away by itself.

But if the itching is very troublesome, it should be treated with medicine. Some children can have conjunctivitis accompanied with ear infections, as the bacteria responsible for causing pinkeye is also responsible for causing ear infection.

Conjunctivitis is caused by virus or bacteria. Viruses which cause conjunctivitis are also responsible for cold. Bacteria which cause conjunctivitis also cause ear infection. Conjunctivitis spreads by touching.

If a person touches the hand of the infected person, who has recently touched his eyes, also gets the infection. And since infected children deal with their parents and children, they also pose the risk of getting the infection. The prevention in this case is to wash hands often with warm water and disinfecting soap.

Conjunctivitis when caused by bacteria & virus, and is contagious is known as infectious conjunctivitis. Conjunctivitis can also be caused due to allergies or because of entry of irritating foreign body into the eyes. Conjunctivitis caused by this medium is not contagious.

A doctor should be approached upon if the itchiness is very irritating. The doctor will check the eyes for redness and liquid discharge. The doctor would ask about the encounter with any friend or known person who seemed to have pinkeye or whether the conjunctivitis was caused because of some allergy or entry of foreign object into the eye. The doctor can also check the ears for the possibility of ear infection.

If the pinkeye is caused because of bacterial infection, the doctor will recommend antibiotic eye ointment or drops. Usually infants are given eye ointment, whereas children and adults are given eye drops.

The parents should put the drops or ointment into the child’s eyes four to five times a day for nearly seven days or so. The dosage and timings should be maintained to get rid of the infection completely.

If the conjunctivitis is caused due to virus, there is nothing much the antibiotics can do. And if the pinkeye is caused by allergies or any foreign object, the doctor can recommend special eye drops to deal with the allergy symptoms. Warm water can also be splashed on the eyes to ease the itching.

A cool or warm washcloth can be used to clean the discharge. Parents can clean the eyes carefully with cotton balls and warm water and remove the crusty stuff which is formed at the ends of the eyes.

The towels and washcloths used for cleaning should head straight to the laundry so that the infection doesn’t spread to other family members.

When to seek Medical Advice:

Swabs for bacterial culture are necessary if the history & signs suggest bacterial conjunctivitis, but there is no response to topical antibiotics. Research studies indicate that many bacteria implicated in low-grade conjunctivitis are not detected by the usual culture methods of medical microbiology labs, so negative results are common.

Viral culture may be appropriate in epidemic case clusters. Conjunctival scrapes for cytology can be useful in detecting chlamydial and fungal infections, allergy and dysplasia, but are rarely done because of the cost and the general lack of laboratory staff experienced in handling ocular specimens. Conjunctival incisional biopsy is occasionally done when granulomatous diseases (e.g., sarcoidosis) or dysplasia are suspected.

Infection (redness) of the conjunctiva on one or both eyes should be apparent, but may be quite mild. Except in obvious pyogenic or toxic/chemical conjunctivitis, a slit lamp (biomicroscope) is needed to have any confidence in the diagnosis. Examination of the tarsal conjunctiva is usually more diagnostic than the bulbar conjunctiva.

Allergic conjunctivitis shows pale watery swelling or edema of the conjunctiva and sometimes the whole eyelid, often with a ropy, non-purulent mucoid discharge. There is variable redness.

Viral conjunctivitis, commonly known as "pink eye", shows a fine diffuse pinkness of the conjunctiva which is easily mistaken for the 'ciliary infection' of iritis, but there are usually corroborative signs on biomicroscopy, particularly numerous lymphoid follicles on the tarsal conjunctiva, and sometimes a punctate keratitis.

Pyogenic bacterial conjunctivitis shows an opaque purulent discharge, a very red eye, and on biomicroscopy there are numerous white cells and desquamated epithelial cells seen in the 'tear gutter' along the lid margin.

The tarsal conjunctiva is a velvety red and not particularly follicular. Non-pyogenic infections can show just mild injection and be difficult to diagnose. Scarring of the tarsal conjunctiva is occasionally seen in chronic infections, especially in trachoma.

Irritant or toxic conjunctivitis show primarily marked redness. If due to splash injury, it is often present only in the lower conjunctival sac. With some chemicals—above all with caustic alkalis such as sodium hydroxide—there may be necrosis of the conjunctiva with a deceptively white eye due to vascular closure, followed by sloughing of the dead epithelium. This is likely to be associated with slit-lamp evidence of anterior uveitis.

Treatment/Therapy:

Conjunctivitis symptoms and signs are relatively non-specific. Even after biomicrosopy, laboratory tests are often necessary if proof of aetiology is needed.

A purulent discharge strongly suggests bacterial cause, unless there is known exposure to toxins. Infection with Neisseria gonorrhoeae should be suspected if the discharge is particularly thick and copious.

A diffuse, less "injected" conjunctivitis (looking pink rather than red) suggests a viral cause, especially if numerous follicles are present on the lower tarsal conjunctiva on biomicroscopy.

Scarring of the tarsal conjunctiva suggests trachoma, especially if seen in endemic areas, if the scarring is linear (von Arlt's line), or if there is also corneal vascularisation.

Clinical tests for lagophthalmos, dry eye (Schirmer test) and unstable tear film may help distinguish the various types of dry eye.

Other symptoms including pain, blurring of vision and photophobia should not be prominent in conjunctivitis. Fluctuating blurring is common, due to tearing and mucoid discharge. Mild photophobia is common. However, if any of these symptoms are prominent, it is important to exclude other diseases such as glaucoma, uveitis, keratitis and even meningitis or caroticocavernous fistula.

Many people who have conjunctivitis have trouble opening their eyes in the morning because of the dried mucus on their eyelids. There is often excess mucus over the eye after sleeping for a long period of time.

Conjunctivitis sometimes requires medical attention. The appropriate treatment depends on the cause of the problem. For the allergic type, cool water constricts capillaries, and artificial tears sometimes relieve discomfort in mild cases. In more severe cases, non-steroidal anti-inflammatory medications and antihistamines may be prescribed. Some patients with persistent allergic conjunctivitis may also require topical steroid drops.

Bacterial conjunctivitis is usually treated with antibiotic eye drops or ointments that cover a broad range of bacteria (chloramphenicol or fusidic acid used in UK). However evidence suggests that this does not affect symptom severity and gains only modest reduction in duration from an average of 4.8 days (untreated controls) to 3.3 days for those given immediate antibiotics. Deferring antibiotics yields almost the same duration as those immediately starting treatment with 3.9 days duration, but with half the two-week clinic reattendance rate.

Although there is no cure for viral conjunctivitis, symptomatic relief may be achieved with cool compresses and artificial tears. For the worst cases, topical corticosteroid drops may be prescribed to reduce the discomfort from inflammation. However prolonged usage of corticosteroid drops increases the risk of side effects.

Antibiotic drops may also be used for treatment of complementary infections. Patients are often advised to avoid touching their eyes or sharing towels and washcloths. Viral conjunctivitis usually resolves within 3 weeks. However in worst cases it may take over a month.

Conjunctivitis due to burns, toxic and chemical require careful wash-out with saline, especially beneath the lids, and may require topical steroids. The more acute chemical injuries are medical emergencies, particularly alkali burns, which can lead to severe scarring, and intraocular damage. Fortunately, such injuries are uncommon.

Self Care strategies for Living with Conjunctivitis

Also known as conjunctivitis, pinkeye is a highly contagious inflammation of the eyelid membrane, and causes the white of the eye to appear pink. Pinkeye usually clears up within several days.

Sties are small pimples or blocked hair follicles on the eyelid, and can be painful. They open and go away in several days. There are some herbal remedies that can be effective in the treatment of both eye conditions.

• Eyebright – This herb is effective in helping soothe many eye problems. It has anti-bacterial properties, and should be used as eyewash or in a compress. Soak a clean cloth in the warm liquid and hold on closed eyes.

• Green Tea – This helps aid in the reduction of inflammation and fights infections. Use as a compress. Steep the tea for 10 minutes in hot water, and soak a clean towel with the liquid and place on closed eyes. Hold on the eyes for at least 10 minutes.

• Herbal Eyewash – Make eyewash using a mixture of herbs. Steep the herbs in piping hot water for ten minutes. Strain the herbs, leaving the warm liquid. Soak a clean washcloth in the liquid, ring out the excess and place on your closed eyes for 10 minutes.

Diet change strategies:

Using Ayurveda Therapy:

The treatment of conjunctivitis through salves and ointments does not cure the disease. To be effective, treatment must be constitutional. A thorough cleansing of the system and adoption of natural laws in diet and general living alone can help eliminate conjunctivitis.

The best way to commence the treatment is to adopt an exclusive fresh fruit diet for about seven days. The diet may consist of fresh juicy fruits in season such as apple, orange, pears, grapes, pineapple and grapefruit. Banana should, however, not be taken. No other foodstuff should be added to this diet.

Those who have a serious trouble should undertake a juice fast for three or four days. The procedure is to take the juice of an orange, in a glass of warm water, if desired, every two hours from 8 a.m. to 8 p.m. Nothing else should be taken as otherwise the value of the fast will be lost. If orange juice disagrees, carrot juice may be taken. A warm water enema should be taken daily during the period of fasting.

The short juice fast may be followed by an all-fruit diet for further seven days. Thereafter, the patient may adopt a general diet scheme on the following lines :-

Breakfast : Any fresh fruits in season, except bananas.
Lunch : Large mixed raw vegetable salad with whole meat bread or chapatis and butter.
Dinner : Two or three steamed vegetables, other than potatoes, with nuts and fresh fruit.

The patient should avoid an excessive intake of starchy and sugary foods in the form of white bread, refined cereals, potatoes, puddings, pies, pastry, sugar, jams and confectionery, which cause the general catarrhal condition as well as conjunctivitis.

He should also avoid the intake of excessive quantities of meat and other protein and fatty foods, strong tea and coffee, too much salt, condiments and sauces. Raw juices of certain vegetables, especially carrots, and spinach, have been found valuable in the treatment of conjunctivitis. The combined juices of these two vegetables have proved very effective. 200 ml. of spinach juice should be mixed with 300 ml. of carrot juice in this combination.

Vitamin A and B2 have also been found valuable in the treatment of conjunctivitis. The patient should take liberal quantities of natural foods rich in these two vitamins. Valuable sources of Conjunctivitis

http://www.healthlibrary.com/reading/ncure/chap37.htm (1 of 2) [5/19/1999 9:21:17 PM] vitamin A are : whole milk, curds, butter, carrots, pumpkin, green leafy vegetables, tomatoes, mangoes and papaya. Foods rich in vitamin B2 are green leafy vegetables, milk, almonds, citrus fruits, bananas and tomatoes.

As regards local treatment to the eyes themselves, a cold foment renders almost immediate relief by chasing away an overactive local blood supply. The procedure is as follows :

Fold a small hand towel. Saturate it with cold water. Squeeze out excess water and mould toweling gently over both eyes. Cover it with a piece of warm cloth to retain the temperature. Repeat the process as soon as the foment gets warmed. Carry out the procedure for one hour. After terminating the wet pack, treatment cover the eyes with a dry towel. Lie back and relax. The damaged eye tissues will quickly return to normal. The treatment should be repeated every night for a week, even though the problem may clear up with the first treatment itself.

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Further reading through our articles on Conjunctivitis health issues will give you a body of information that will help you decide what options you have to deal with the underlying causes of your problem through giving your body the nutrition products that will assist you body to heal from the inside out.

We wish you well in your search for solutions to this Conjunctivitis problem and your movement towards better health in all areas.

More Resources available about Conjunctivitis :

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Like the skin and hair, the eyes tell a great deal about the state of your health, your habits and lifestyle. Illness, nutritional deficiencies, lack of sleep, anxiety and stress can all be reflected by eyes that are dull, tired and strained. Eye care has increased in importance and relevance in modem times. Progress has certainly taken its toll. Never before have we put the eyes to as much strain as we do now, has focusing on television and computer screened, on intense reading or pouring over figures. During the ancient times, the eyes were used in occupations that actually exercised them and kept them healthy. The farmer, hunter, fisherman, used a variety of natural eye movements, focusing on distant-objects. We hardly exercise the muscles of the eyes. And, this kind of eye strain begins at an early age. With immobility, the eye muscles are tired and tense. With time, they get distorted and cramped. Unless we consciously exercise them and help them to relax, they cannot perform well, stay healthy, or look beautiful.
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