Conjunctival Problems

ALLERGIC CONJUNCTIVITIS Symptoms are variable. A mild seasonal allergic conjunctivitis results in mild itching without discharge, while a severe allergic conjunctivitis might result in a reaction so great that the eye is swollen shut. Treatment includes antihistamine, anti-inflammatory, and decongestant medicines. The newer mast cell inhibitors are wonderful for seasonal allergies and chronic allergies. Steroids may be used for extreme reactions. Cold compresses will reduce the reaction.

BACTERIAL CONJUNCTIVITIS Bacterial conjunctivitis is a result of a bacterial infection. It is normal for some bacteria to exist on the surface of the body and in the eye, which is called normal flora. Bacterial invasion can occur when the normal body defenses fail to keep the normal flora in balance; or by airborne bacteria, cosmetics or touching the eye with your hand; or by touching another person with a bacterial conjunctivitis’s, or an item that they used. It is extremely contagious and found much more commonly in children. It is common for bacterial infections to be passed throughout a household by using the same towels. Antibiotics rapidly cure the condition.

GIANT PAPILLARY CONJUNCTIVITIS (GPC)Giant papillary conjunctivitis (GPC) is a hyper (increased) allergic response of the conjunctival tissue that lines the inside of the upper eyelid. This type of inflammation generally involves a immune reaction to contact lens or the protein deposits on the contract lens. It may also occur with artificial eyes or loose sutures present after surgery.

GPC tends to be chronic in nature. If contact lenses are the cause, it usually requires changes in contact lens wear. These changes include a reduction or discontinuation of wear, change in lens material, medication to reduce the inflammation and/or a change in lens cleaning habits. GPC will cause contact lens discomfort, excessive movement of lenses and the development of filmy coatings on the surface of the contact lens. Patients who resume contact lens wear too soon run the risk causing a more permanent GPC.

VERNAL CONJUNCTIVITIS A seasonal conjunctivitis of allergic origin which typically occurs more in the warm months. Patients with vernal conjunctivitis report intense itching, the classic signs of this disorder. In addition, a very thick or stringy discharge is also experienced. Vernal conjunctivitis is allergic in nature, and symptoms are relieved through the use of antihistamines, decongestants and the judicous use of steroid drops.

VIRAL CONJUNCTIVITIS Viral conjunctivitis is an inflammation of this tissue, which results from viral infection. The condition might by primary (by itself) or secondary to upper respiratory infection that may present initially with a sore throat. Although there is no treatment to kill the virus it is common to prescribe drops to decrease symptoms and prevent a secondary infection. A virus usually runs a 14-day course before resolution.

BLEPHAROCONJUNCTIVITIS Blepharoconjunctivitis is an inflammation of the lid margin, and the transparent membrane that covers the inner eye lid and the eye ball. This inflammation may be caused by bacteria, virus or allergy. The symptoms include a mucus discharge (eyelids sticking together), redness, burning and a foreign body sensation. Treatment depends on the cause of the inflammation.

EPIDEMIC KERATOCONJUNCTIVITIS (EKC) Epidemic keratoconjunctivits (EKC) is an acute inflammation involving the cornea and the conjunctiva. The cause of this type of infection of the cornea and conjunctiva involves infection from different adenoviruses. After the live virus is gone particles left by the virus remain and may cause a hypersensitivity reaction called infiltrates. These corneal lesions may remain present for a period of months, or even up to several years. Epidemic keratoconjunctivitis is highly contagious. You must wash your hands, and towels and face cloths must not be shared.

Therapy for EKC can include drops to improve comfort. Depending on severity, topical steroids may be used for a short period of time to reduce inflammation and improve comfort.

Children should stay home from school and adults should remain home from work because of the contagious nature of this disease.

CONJUNCTIVAL CHEMOSIS Conjunctival chemosis is a dramatic swelling of the tissue surrounding the eye. The appearance of the eye is often quite frightening since there are large bubbles of fluid on the surface of the eye. This inflammation is usually the result of either an acute allergic response or viral conjunctivitis. Treatment includes antihistamines, cold compress, and steroid drops. The tissue that has been stretched by the initial inflammation may take days to shrink back to its normal size.

CONJUNCTIVAL CYST (RETENTION CYST) A conjunctival cyst is a thin-walled sac or vesicle that contains fluid. This vesicle may develop either on or under the conjunctiva. Since they may resolve on their own, conjunctival cysts generally require no treatment. On occasion, it is necessary for them to be drained or treated with anti-inflammatory medications.

OCULAR PEMPHIGOID (Pem’-fi-goid) Ocular pemphigoid is a rare chronic inflammatory systemic condition that affects mucous membranes of the eye. There can be scarring and shrinkage of the conjuntiva which results in extreme dry eye.

Treatment includes hygiene of the eyelids along with topical lubricating drops or ointments.

PINGUECULUM A pingueculum is a localized, degeneration or thickening of this conjunctival tissue covering the white part of the eye. Typically, pinguecula are located on either side of the cornea but is more common on the nasal side. Pinguecula are very common in adults who spend a lot of time in sunny and/or windy environments. They consist of a fatty elastic tissue. They usually stay relatively small but they can cause inflammation of the eyes. Recent studies indicate that pinguecula may be stimulated by ultraviolet light from the sun. All spectacle eyewear corrections should contain an ultraviolet coating to help prevent further irritation.

Pinguecula are a concern only from a cosmetic standpoint. Should a pingueculum become red or irritated, drops may relieve the redness or the mild irritation.

PINGUECULITIS Pingueculitis describes a condition in which these pinguecula become inflamed and swollen. This inflammation is represented by increased redness and irritation of the eye. This increased redness. The treatment for pingueculitis involves removing the source of irritation and the application of drops.

PTERYGIUMA pterygium is a fleshy triangular shaped tissue located on the sides the eye. If the condition progresses, its growth extends onto the front clear surface of the eye, the cornea. The cause for pterygia is not completely known. Like pinguecula they are stimulated by dirty, dusty, smoky, windy and environments and/or ultraviolet light from the sun. All spectacle eyewear corrections should contain an ultraviolet coating.

Pterygia are typically not dangerous. Symptoms include a gritty or a sandy sensation upon blinking. They contain numerous blood vessels, making the eye will look much redder than normal. Treatment involves drops to decrease the symptoms. However, if the pterygium continues to grows threatening vision, or if it presents a cosmetic problem, it may be surgical removed.