Conjunctivitis

The following text was provided by Claire Smith (Sweet on the forum), who is a nurse and kindly wrote this after completing a teaching session at work as part of her training, aimed at nurses based on the two most common eye complaints presenting to ‘A & E’, being foreign bodies, and conjunctivitis.

Most of us have attended an accident and emergency department at some point with an eye problem, typically due to KC and contact lenses!

Here is the second part of Claire’s teaching session after foreign bodies. I hope you find it helpful!

Conjunctivitis is an inflammation or infection of the conjunctiva, which is the thin, clear membrane over the white part of the eye and also the lining of the eyelids. It’s common name ‘pink eye’ relates to the pink or red colour the affected eye has which is due to inflammation.

This condition can be triggered by a virus, bacteria, allergic reaction (to dust, pollen, smoke or some chemicals), or as with giant papillary conjunctivitis, to a foreign body, (typically a contact lens).All forms of conjunctivitis can cause the same symptoms with the eye becoming inflammed causing it to hurt or itch. The exact cause is needed to ensure the correct treatment, with viral and allergic conjunctivitis being the most common.

Viral conjunctivitis

Usually affects one eye but can spread easily to the other. It causes excessive eye watering with a light discharge, and the eye may also sting or cause a lot of irritation. This form is often associated with an upper respiratory tract infection, cold or sore throat and can be spread rapidly.

Bacterial conjunctivitis

Usually affects both eyes though normally starting with one and spreading rapidly to the other. There may be an irritation or gritty feeling in the eye with a stinging heavy discharge,often green in colour, which may cause eyelids to stick together when sleeping. The severity depends on the type of bacteria, usually staphylococcus or streptococcus (just so you know!) which typically orginates from patients own skin, an upper respiratory tract infection, or from someone already suffering with the condition.

Giant papillary conjunctivitis

Usually affects contact lens wearers and both eyes causing itching, a heavy discharge, tearing, red bumps on the underside of the lids and an intolerance to contact lenses. See article about Contact Lense Solutions in our Spring 2011 Newsletter.

Allergic conjunctivitis

Usually affects both eyes causing itching and redness, which sometimes includes the nose, swollen eyelids and excessive tearing. It is normally seasonal and occurs more frequently among those with allergic conditions or hayfever, asthma and eczema. It may also be associated with an intolerance to cosmetics or perfumes.

Treatment

If left untreated most cases of conjunctivitis will get better in a few weeks. Gaining treatment however will speed up the process, aid comfort to the affected eye(s), and hopefully lessen the risk of infecting others.

Viral: As there is no cure, medication is not normally prescribed as antibiotic treatment is not needed. Cold or warm compresses may help, as well as some lubricating eyedrops to relieve any discomfort, (I’m sure that we know all about these!)
Bacterial: Usually treated with antibiotic eyedrops or cream to clear up any infection such as chloramphenicol. Regular eye cleansing using cool boiled water is often needed with heavy discharge.
Allergic: Mild cases may only need cool compresses although anti-histamine (to reduce itching) medication or eyedrops can help control some of the symptoms. Persistent cases may need anti-inflammatory or topical steroid drops, (to reduce inflammation). In severe cases it is better to avoid any known allergies by staying in well ventilated rooms and keeping windows closed to try to reduce potential allergens at home.
Giant papillary: Normally affecting contact lens wearers so will need to remove these for a short period of time until seen by a doctor. (Now we are blind!). May need to replace lenses with new ones or change to a different type of lens, such as from soft to gas permeable, or indeed ones that you change regularly such as daily disposables, (Not so sure that most of us here will have a choice with this!)

Avoidance

Avoiding the cause is the first line of defence to avoid re-infecting yourself or others. there are many tips to avoid spreading the condition, as conjunctivitis can be passed very easily around school children and families. The following are a few guidelines to use with an eye infection.

Wash your hands frequently, using different towels to the rest of the household.
Avoid rubbing or touching eyes and face, (No-one here rubs their eyes after suggestions about it making KC worse i’m sure!)
Use a pad and cool boiled water once to remove discharge from inside of eye outwards. Repeat if needed.
Don’t reuse hankerchiefs (or anyone else’s!)
Wash pillow cases frequently and don’t share linen (so now you are single and all alone!)
Don’t swim as bacteria can be spread in water (yes, I know all about this following surgery!)
Don’t share eyedrops or cosmetics and replace any once cleared of the infection.
If both eyes are infected, use separate eyedrops for each eye.
Discontinue contact lens wear until told you may continue by your doctor (oops – blind again!)
Handle and clean contact lenses properly (I’m sure we are pretty damn good at this by now!)
You may need to change any contact lenses and cases to prevent future infections (gee, it gets pretty expensive wearing lenses sometimes doesn’t it!)

Ok… that’s it! I’m sure that as good as we are here being that most of us need to wear lenses, that I didn’t need to tell you how to avoid an infection!

But you know, even being a nurse i have had enough of these to last me a lifetime! So no matter how good we all are, sometimes they just sneak up on you and take over! Or was it leaving lenses in too long, being lazy and not cleaning them properly, sleeping in them by mistake… LOL, I didn’t say that! But the list could go on and on…
and on!