There are three main types of conjunctivitis:
Irritant conjunctivitis: this happens when a foreign body or substance (such as dust or chlorine from a swimming pool) gets into the eyes and causes them to redden. It usually resolves once the irritant is removed.
Allergic conjunctivitis: this happens when the eyes come into contact with an allergen (anything that causes an allergic reaction). A typical example is the reddened, streaming and itchy eyes that can occur as part of the condition of hayfever during pollen season.
Infective conjunctivitis: is caused by bacteria, virus, or a sexually transmitted infection (STI) such as Chlamydia or Gonorrhoea. It is a common condition seen in GP surgeries, and one of the more common eye problems that doctors in general practice treat. Infective conjunctivitis is more common in children and the elderly, as their immune (defence) systems are less able to fight off infections, and children often play in very close contact with one another.
Causes
The cause of conjunctivitis will be the result of a virus, bacteria or an STI. There is no way of knowing just by looking at the eye which element has caused your condition but you may be more likely to get conjunctivitis if:
• You are very young or very old
• You have a weaker immune system (for example, if you have diabetes)
• You are recovering from an infection
• You are taking corticosteroid medication
• You have been in contact with someone who has had the condition
Symptoms of conjunctivitis
Normally, the symptoms will begin in one eye, and may spread to the other eye, and, as with any condition, your symptoms may be mild or severe. Watch out for:
• A red eye: there is irritation and widening of the tiny blood cells in the conjunctiva (the clear layer of cells that we mentioned at the beginning of this article)
• Watering eyes: irritation causes little glands in the conjunctiva to produce more mucous
• Soreness: this can feel like there is something in your eye
• Sticky eyelashes: you might notice this stickiness on your eyelashes when you first wake up, and it is due to mucus and pus produced by the infection
If you have a newborn baby who displays these signs, you should contact your doctor as soon as possible, as infective conjunctivitis in a baby less than a month old can develop into a more serious eye infection that can threaten their vision.
Diagnosing conjunctivitis
In most cases, your GP will be able to diagnose your conjunctivitis based on a description of your symptoms, and an examination of your eye. It is important to describe, if you can, how your think your symptoms started, as it may help your doctor pinpoint the cause of your condition.
In some cases, a swab of the eye will be taken, and this is usually done if the cause of your condition is unclear or if your condition hasn't responded well to previous treatment. A swab is a small piece of absorbent material (like a cotton bud) which samples a small amount of pus from the infection.
Sometimes, certain problems affecting the eyes can suggest that a more serious condition is happening. If you suffer from any changes in vision, develop a severe pain or pressure behind the eye, or suddenly become highly sensitive to light, you should contact your doctor to be assessed.
Treatment of conjunctivitis
There are some things you can do at home to treat conjunctivitis. Try some of the tips below to help speed up your recovery:
• Remove your contact lenses, and stick to glasses until your condition has cleared up
• Clean the eye using cotton wool and cooled boiled water morning and evening
• Ensure your hands are clean before touching your eyes, and wash your hands thoroughly after touching the eye(s) - this prevents the infection from spreading
• Lubricant eye drops (available from your local pharmacy without a prescription) can help relieve the soreness or gritty feeling in your eyes
Even though your conjunctivitis may be due to an infection, antibiotics may not be prescribed. This is because you are likely to fight off the infection yourself in a week to ten days. If your condition is long- lasting, not responding to treatment, or especially severe, you may benefit from a course of antibiotics, and you can decide on this with your doctor.
If you are prescribed an antibiotic, it will often be given to you in the form of an eye drop, and the most commonly used one is called Chloramphenicol.
In special groups of people (such as children, the elderly or pregnant women) an alternative treatment called Fusidic Acid might be recommended.
Most cases of conjunctivitis clear up on their own with the self-care measures outlined above, and there are rarely any complications to worry about.
Dr Seth Rankin is founder of London Doctors Clinic
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