Conjunctivitis is a common eye disease that is most often caused by viruses and bacteria. Treatment regimens in these cases are radically different. What helps in one form turns out to be ineffective in another case. In both cases, the infection affects the conjunctiva, eyelid and sclera. How to distinguish viral conjunctivitis from bacterial? A qualified specialist will be able to determine the causative agent of the disease after receiving the examination results.
Conjunctivitis - what is it?
Conjunctivitis is an inflammation of the conjunctiva, the mucous membrane of the eye. This thin hymen covers the eye sclera and lines the inside of the eyelids. When it becomes inflamed, edema forms, the eyelids swell, the eyes begin to hurt, water, and itch.
The cause of inflammation of the conjunctiva is various infections. By their nature, infections are divided into two large groups – viruses and bacteria. Accordingly, eye inflammations are divided into viral and bacterial.
Viruses and bacteria spread differently and are treated differently. The differences between their manifestations are so obvious and noticeable that even a person without education can determine the nature of the pathogen.
So, how do you differentiate between viral and bacterial conjunctivitis?
Treatment methods
The danger of viral conjunctivitis is that it can be complicated by bacterial infection and keratitis. This can lead not only to vision deterioration, but even to its loss. To avoid such complications, you need to see an ophthalmologist at the first signs of illness. The specialist will select the optimal treatment regimen, taking into account the patient’s age and the severity of his condition.
Medication
Inflammation of the mucous membrane of the eye requires complex treatment, which includes a number of medications. In case of a viral form of the disease, the sick child is prescribed eye drops that contain interferon. Most often, doctors prescribe the following medications:
- Ophthalmeoferon - this medicine stops the reproduction of viruses and reduces inflammation.
- Poludan - this drug contains components that have a detrimental effect on viruses.
- Actipol - this drug promotes the rapid restoration of damaged tissues and reduces inflammation.
In addition to drops, ointments with a pronounced antiviral effect can be prescribed. The most common medications are:
- Oxolinic ointment.
- Bonafton.
- Florenthal.
- Tebrofen ointment.
The vision organs are treated with such medications twice a day - in the morning and immediately before bedtime.
A small amount of ointment is placed under the lower eyelid and then gently massaged over the eyes over the eyelids
In especially severe cases, systemic drugs - Groprinosine or Isoprinosine - may be recommended. Young children are often prescribed the antiviral drug Viferon suppositories.
Traditional medicine recipes
There are many traditional medicine recipes that help quickly get rid of conjunctivitis. But before using any unconventional methods, it is recommended to consult a doctor:
Brew strong loose leaf tea and often wipe the child's eyes with the tea leaves. Instead of tea leaves, you can take used tea bags, which are applied warm to the eyes. Prepare a decoction of medicinal chamomile from a tablespoon of inflorescences and a glass of water. Leave it for 20 minutes and strain. The mixture should be used to wash the baby’s eyes several times a day. Aloe juice helps with viral conjunctivitis. It is squeezed from the leaves of a plant that is more than 3 years old
Gently rub the juice into your eyelids with your fingers 3-4 times a day. You need to make sure that the juice does not get on the mucous membrane of the eyes, as it causes severe irritation. Eyebright herb is beneficial for eye health
Take 2 teaspoons of the herb, pour it into a thermos and pour a glass of boiling water. Leave for an hour and filter through a fine sieve. Wash the mucous membrane with the solution 4 times a day. Fresh dill is crushed, the pulp is spread on pieces of bandage and applied to the eyes in the form of lotions. These lotions should be kept for 15 minutes. The potatoes are peeled and grated on a fine grater. Mix with half the white of one chicken egg and apply as compresses on the eyelids. Brew a teaspoon of yarrow and calendula in a glass of water. Leave for about half an hour and strain. Wash the eyes with the decoction before each use of medications.
A solution prepared from a teaspoon of boric acid and a glass of boiled water works well. Rub your eyes with this solution 4 times a day.
You should wipe your eyes in the direction from the outer corner of the eye to the bridge of the nose. For each organ of vision, take a separate cotton pad or piece of bandage; as the cotton becomes dirty, replace it with a new one. You can only rinse the mucous membrane with warm solutions, otherwise the inflammation may increase significantly.
Bacterial conjunctivitis - purulent inflammation
More often than others, a child or adult is diagnosed with a bacterial form of conjunctivitis. Moreover, regardless of the type of pathogen - streptococcus, staphylococcus or pneumococcus, the signs of the disease are similar. They can accurately diagnose bacterial conjunctivitis. This:
- Pus from the eyes;
- Severe swelling, redness and dryness of the mucous membrane;
- Itching and burning;
- Possible inflammation of one eye.
And now - in more detail about the listed signs.
Purulent discharge
Pus from the eyes is a clear sign of a bacterial infection. By its presence, viral or bacterial conjunctivitis can be distinguished. Its presence also determines a number of other symptoms - itching, dryness.
The amount of pus can vary, as can its consistency. From medium discharge to heavy discharge from the inner corners of the eyes. From liquid to thick, as well as dry, hardened pieces of pus.
Sometimes there is so much pus that it sticks to the eyelashes, and after a night’s sleep it “glues” the eyelids together. At the same time, part of the pus dries out, and it is not easy to open your eyes. You have to carefully wash off the dried pus from the eyelashes.
Note: the amount of pus depends on the extent of the lesion and the type of bacterial pathogen. A large amount of pathogen on the mucous membrane increases the secretion of pus. The type of pathogen also influences the amount of pus. It can also determine the consistency of purulent discharge.
More often, bacterial pathogens cause severe suppuration. Less commonly, a pathogenic bacterium produces a small amount of pus. More about this below, in the section on atypical bacterial conjunctivitis.
Swelling and redness
Edema (swollen) and redness of the eyelids are signs of bacterial inflammation.
With a bacterial infection, the inflammatory process is more pronounced than with a viral one. The eyelids swell significantly. The skin in the area of inflammation acquires a reddish tint. The veins of blood vessels in the eye sclera turn red. The tissue of the inflamed conjunctiva becomes red. If you bend the eyelid, the red, inflamed membrane will be clearly visible on the inside of it.
Itching, burning
Unpleasant sensations in the form of itching and burning are formed due to purulent discharge. Pus is a way of spreading a pathogenic infection. It causes itching and leads to scratching of the eyes. In this case, pathogens get on the fingers. And then they are transferred to any objects that the sick person touches. Door handles, books, dishes, towels turn out to be carriers of a bacterial pathogen. And a sick person becomes a source of infection for those closest to him.
In addition to itching, pus can cause a burning sensation and the presence of sand in the eyes. Such signs are characteristic of the purulent, bacterial form of conjunctivitis.
"Dry" inflammation
Dry eyes are a hallmark of bacterial conjunctivitis. As a result of swelling of the mucous membrane of the eye, the tear duct also swells. Its lumen narrows, complicating the natural outflow of fluid. Constant wetting of the eye sclera is disrupted. There is a feeling of dryness.
Inflammation of one eye
With bacterial conjunctivitis, only one eye may become inflamed. This is due to the characteristics of the spread of infection. Conjunctivitis is a contact disease. They can only become infected through external contact with a pathogen. The pathogen enters the eyes with fingers, a towel or common cosmetics. Inflammation of the conjunctiva is not the result of an internal infection. This is why only one eye may be infected.
Note: however, often if conjunctivitis appears in one eye, then after a few days the disease spreads to the second eye. Infection occurs when scratching the eyes with your hands, when pus and pathogen get onto the skin of your fingers.
Temperature
Fever is rare with bacterial conjunctivitis. Although its increase with the development of bacterial inflammation is also possible.
Incubation period
The timing of the development of bacterial inflammation may vary. From several hours to several days. It is difficult to say how quickly the infection will manifest itself after contact with a sick person. It depends on the immune system and the type of pathogen itself. For example, gonococci cause pus and edema (swelling) of the eyelids within 12 hours after contact with the eye sclera. Chlamydia can persist from 5 to 14 days, so conjunctivitis in newborns may appear only 2 weeks after birth. As they say, everything has its time.
Now let's talk about viruses.
Adenoviral conjunctivitis in adults and children: causes, symptoms, treatment
Most people have contracted conjunctivitis at least once in their lives. Both adults and children are susceptible to this disease. A sluggish form of pathology occurs when an adenovirus enters the body, affecting the mucous membrane of the eyes and respiratory tract. The disease can lead to serious consequences, so leaving it unattended is unacceptable.
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Causes
Experts classify adenoviral conjunctivitis as a highly contagious infection. This means that the disease is transmitted both through direct contact with an infected person and through airborne droplets. In addition, the pathogen can get into the mucous membranes of the eyes when touching them with dirty hands, as well as during coughing or sneezing.
About the virus
Adenoviruses are the most common culprits in the development of ARVI, influenza and viral forms of conjunctivitis. Eye inflammation can be caused by serotypes Ad 5, 8, 11, 13, 19 and 37.
In case of infection with adenoviruses 3, 4 and 7, acute pharyngoconjunctivitis develops.
Viruses types 8 and 10 cause the development of epidemic keratoconjunctivitis, which in most cases affects both eyes and the respiratory tract.
Adenoviral conjunctivitis (Mironova Irina Sergeevna):
Risk factors
The risk of infection increases in the following cases:
- contact with an infected person;
- hypothermia;
- swimming in a body of water that does not meet sanitary standards;
- constant stress;
- neglect of contact lens care;
- complications after corneal surgery;
- mechanical damage to the organs of vision;
- ARVI;
- failure to comply with personal hygiene rules.
From the moment the infection enters the body until the first symptoms appear, 5-7 days usually pass.
Catarrhal
Symptoms are mild, you may notice slight inflammation with slight redness and a moderate amount of purulent discharge. With proper treatment, this form of conjunctivitis usually goes away within a week and does not lead to disruption of the structure of the cornea.
Membranous
This form is observed in a quarter of patients. The mucous membrane of the eye is covered with a grayish-white film. In mild cases, the film can be removed with a cotton swab, but in severe cases it fuses with the conjunctiva. Because of this, after removing the film, the blood vessels in the eyes may bleed.
With membranous conjunctivitis, an increase in body temperature to 38-39 0C is observed. The fever lasts for 3-10 days. In some cases, a complication occurs in the form of scarring of the mucous membrane.
Follicular
It is accompanied by the appearance of bubbles on the mucous membrane of the eye, which can be both small and large. Sometimes the follicles are concentrated only in the corners of the eyelids, but most often they cover the entire mucous membrane, making the conjunctiva loose.
Symptoms
Even before eye inflammation, a patient with adenoviral conjunctivitis has an increase in body temperature, migraines, runny nose, and dyspeptic disorders. In some cases, submandibular lymphadenitis is observed. Later, local symptoms appear, first in one eye, then in both:
- redness;
- edema;
- mucous or mucopurulent discharge;
- feeling of sand in the eyes;
- photophobia;
- burning and itching;
- profuse lacrimation;
- moderate blepharospasm.
How does pathology differ from bacterial species?
Adenoviral conjunctivitis differs from bacterial conjunctivitis, first of all, in the causative agent of the disease. In case of bacterial eye damage, the cause of inflammation is an attack by Pseudomonas aeruginosa and Escherichia coli, chlamydia, staphylococci, gonorrhea or streptococci. The disease is most often transmitted through household contact, while the adenovirus mainly spreads through the air.
With a viral infection, symptoms develop slowly, most often only one eye is affected, and over time the inflammation can spread to the second. In patients with bacterial conjunctivitis, both organs of vision become inflamed at the same time.
Laboratory research
To clarify the diagnosis, the following diagnostic methods are used:
- detection of antibodies to adenovirus;
- placing the virus pathogen in a nutrient medium to determine its nature;
- immunofluorescent analysis to determine the presence of antigens in a smear;
- Polymerase chain reaction is the most expensive method used to study adenovirus DNA.
Proper hygiene of sore eyes
Proper hygiene of inflamed eyes is an important component of therapy. Before instilling drops or placing ointment behind the lower eyelid, you need to remove mucous secretions using a cotton swab. You must use a new swab for each eye.
Viral conjunctivitis
Viral conjunctivitis is the result of infection by a viral pathogen. It may be the beginning or consequence of a viral infection. And it is rarely a separate disease.
Viral infection often enters through mucous membranes. From them it gets into the blood. The virus can enter the body through any mucous membrane - the eyes or nasopharynx.
If the virus has penetrated the mucous membranes of the mouth and nose, then inflammation of the eye tissue will be the result of a general infection. If the virus penetrates the mucous membrane of the eyes, inflammation of the eyes will be the beginning of a general infection.
Note: due to the fact that the infection is common, viral conjunctivitis affects both eyes of a person. And yet, more often than others, the source of a viral eye infection is an adenovirus, which is spread by airborne droplets.
The signs of viral conjunctivitis are not as obvious as those of a bacterial infection. This:
- Inflammation of the eyes - swelling, lacrimation, possible redness;
- Temperature;
- Enlarged lymph nodes;
- Weak discharge of pus;
- Both eyes are affected.
And now - more about these signs.
Temperature
Fever is one of the main signs of a viral infection. Its increase accompanies 90% of viral conjunctivitis. At the same time, the increased temperature
is the body’s protective reaction to the penetration of a viral pathogen. It creates conditions under which it is difficult for pathogenic particles to reproduce. Thus, temperature protects the body from the formation of new viruses.
Note: fever with viral conjunctivitis occurs if the infection has become widespread. And one more thing: with bacterial eye inflammation, fever occurs much less frequently.
Enlarged lymph nodes
Enlarged lymph nodes are another hallmark of the virus. During a viral infection, the lymphatic system is actively involved in its work. It synthesizes lymphocytes that destroy invading viruses. In the nodes of the lymphatic system, fluid is filtered and dead pathogens accumulate.
Viral conjunctivitis causes inflammation of the lymph nodes close to the site of infection. The cervical, submandibular, and occipital lymph nodes are enlarged.
Tearing
A viral infection is accompanied by a profuse runny nose. Excessive mucus discharge from the nose is a protective reaction. It complicates the introduction of new viruses through the nasopharynx.
Excessive mucus from the nose initiates the release of fluid from the lacrimal sac. A constant runny nose is accompanied by leakage of tears. The eyes become watery, especially in bright light.
Increased tear production is also a protective reaction. It also complicates the introduction of new viral particles.
Pus
Discharge of pus with viral conjunctivitis is weak or absent altogether. This is due to the peculiarities of the “work” of the viral pathogen. A particle of the virus does not release so much toxic waste into the space around it. Unlike a pathogenic bacterium, which literally suffocates surrounding tissues with toxic secretions.
Treatment
Before prescribing treatment, the doctor examines the patient and clarifies the complaints. If necessary, bacteriological examination or biomicroscopy may be prescribed.
The most effective medications for detecting viral conjunctivitis are:
- eye drops (with their help, unpleasant symptoms are eliminated, the general condition is alleviated and the activity of viruses is suppressed);
- Tebrofen ointment (actively used for various viral attacks: adenovirus, herpes virus, etc., widely used by medical workers);
- Acyclovir (used for conjunctivitis caused by the herpes virus).
If the viral form is caused by any disease (measles, rubella, influenza, etc.), then first of all you need to direct all your efforts to fight it. Otherwise, the effect of treatment will not be achieved.
Bacterial conjunctivitis is treated with the following medications:
- bactericidal ointments (Erythromycin, Tetracycline, etc.);
- eye drops containing an antibiotic (Moxifloxacin, etc.);
- broad-spectrum antibiotics (used in cases where local treatment is ineffective).
Important! The selection of drugs should be carried out exclusively by a specialist. Self-medication can lead to hazardous health consequences
In addition to medications, physical therapy may be prescribed: UV irradiation, electrophoresis (including medicinal), microwave therapy.
Traditional medicine methods are often used. Medicinal plants that can affect the disease:
- chamomile (decoctions are prepared from it, which are used to wash the eyes);
- onions (prepare a decoction and add honey to it);
- cornflower (for preparing medicinal infusions and decoctions);
- green tea (has long been known as a good anti-inflammatory agent).
The dangers of ignoring the disease:
- Development of ulcerative or bacterial keratitis. Both types of disease cause discomfort, and ulcerative keratitis can lead to blindness.
- Clouding of the cornea. In this case, vision deteriorates significantly and the person sees poorly and distinguishes objects not only at a distance, but also near.
- The appearance of orbital cellulite. This condition not only impairs vision, but also threatens the patient’s life.
- Blindness. Ignoring the disease leads to the development of dangerous diseases such as cataracts and glaucoma. Irreversible processes are initiated and vision is difficult and sometimes impossible to restore.
Who is at risk: children, the elderly, pregnant women, doctors, people working or living in unfavorable conditions, and people with weakened immune systems.
Basic recommendations for preventing the development of conjunctivitis (all types) are as follows:
It is necessary to wash your hands regularly after visiting places with large crowds of people and walking; You cannot use other people’s cosmetics; Don’t dry yourself with someone else’s towels; when using vision correction products (contact lenses), strictly follow the operating instructions; it is important to protect your eyes while swimming in pools and ponds (in such cases it is better to wear special glasses); wet cleaning of the premises should be carried out regularly; It is necessary to observe safety precautions in the workplace (this is especially true for welders, carpenters, etc.).
Eyes help us see the beautiful world around us and enjoy a full life. Only a responsible attitude towards health will help avoid the development of diseases
In addition to the above preventive measures, it is also important to remember about regular visits to the ophthalmologist
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Incubation period
The time that passes between contact with the source of infection and the onset of the disease is called the incubation period. For viral conjunctivitis, this period is determined by the infectious agents. Most often, the causes of viral eye inflammation are adenovirus and herpes. The incubation time of the herpes virus extends from 1 day to 3 weeks. Adenovirus – from 1 day to 2 weeks.
The speed of virus penetration and the manifestation of inflammation on the mucous membrane is determined by the human immune system. If the defenses actively “fight”, not allowing the virus to manifest itself in full force, signs of inflammation appear later.
They may also not appear at all - if the immune system has worked well enough. Then they say that the disease passed in a latent form. If the immune system is weakened, but the invading virus forms inflammation the very next day after infection.
Etiology of the disease
The etiology or causes of the disease may be associated with the entry of viruses into the body as a whole. There are up to 150 types of viruses, 45 of which can cause conjunctivitis.
Types of conjunctivitis
More often, the disease develops due to the entry and activation of herpes viruses and adenoviruses. The disease develops primarily in those people who:
- have low immunity;
- underwent surgery;
- have chronic diseases of various kinds;
- lead a sedentary lifestyle, which is reflected in disruptions in metabolic processes;
- after the age of 40, when hormonal imbalances occur;
- non-compliance with personal hygiene rules.
The infection can get into the eyes through household means - through shared towels, glasses, napkins. You can also get an infection in your eyes with dirty hands. Then the body can be healthy, and only the eyeballs suffer from the disease.
Conjunctivitis
How to determine viral or bacterial conjunctivitis
And now, for ease of use, let’s summarize the knowledge gained in a general comparative table. We will indicate in it only obvious signs that are distinctive. By which you can accurately name the causative agent of the infection - a virus or bacteria.
Table “Viral and bacterial conjunctivitis - differences”
| Sign of conjunctivitis | Bacterial | Viral |
| Pus | abundant | little or not at all |
| Swelling | strong | weak |
| Itching and burning | strong | average |
| Dryness or tears | dry eyes | lacrimation and photophobia |
| Temperature | usually normal | almost always elevated |
| Enlarged lymph nodes | minor | noticeable |
| Spread of infection between the eyes | Perhaps only one eye is sick | both eyes are inflamed |
Here are the signs of standard conjunctivitis. There are exceptions among them.
Prevention
Absolutely everyone is susceptible to eye disease, regardless of age or condition of the visual organ. But children are most predisposed to developing the disease. This is especially true for preschoolers and schoolchildren. Infection occurs within a few hours, and an entire group or class may be affected.
Therefore, it is very important to know what precautions will help avoid infection for both children and adults:
- Try to touch your eyes as little as possible, especially with dirty hands.
- Wash your hands often with soap.
- If something gets into your eye, remove the foreign particles immediately. Use a clean cotton pad or paper towel for this.
- Change bed linen and towels regularly. In addition, wash such items in hot water with added detergent.
- Try not to wear decorative or colored lenses.
- Never wear someone else's lenses.
- Ophthalmologists recommend using glasses instead of contact lenses to correct vision, so the eye is less susceptible to infection.
- Before using eye drops or ointments, be sure to wash your hands thoroughly. The same should be done when treating an eye disease in your child.
- Do not use other people’s household and hygiene items (glasses, towels, cosmetics).
- If you or your baby develops infectious conjunctivitis, isolate yourself and your child from others until complete recovery.
Conjunctivitis is a serious eye disease. Therefore, do not neglect preventive recommendations, this will keep your eyes healthy.
Since conjunctivitis is very contagious, in order to avoid its spread, it is necessary to immediately isolate the infected person, primarily from children, and begin treatment.
If a doctor prescribes treatment at home, then the infected person needs to allocate separate household items - a towel, bedding, dishes. All things he touched, especially door handles, must be wiped with water and a disinfectant solution.
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Atypical conjunctivitis
The main difference between bacterial conjunctivitis and viral conjunctivitis is pus. However, during infection with some bacterial pathogens, this sign may be absent. The most striking example is chlamydial inflammation.
Chlamydial conjunctivitis
Chlamydia is a bacterial pathogen that settles on the mucous membranes of the genitals and urinary tract. When it gets into the eyes (with the hands in adults or during passage through the birth canal in newborns), chlamydia forms inflammation of the eye tissues or so-called chlamydial conjunctivitis. It differs from other bacterial pathogens in its indirect course. With chlamydial conjunctivitis there is almost no pus, there is slight swelling and redness. The lymph nodes in the ear area also become enlarged.
Note: enlarged lymph nodes often accompany a viral infection. And it is diagnosed with chlamydial bacterial inflammation.
Viral conjunctivitis with pus
Typically, viral eye inflammations are not accompanied by purulent discharge. The appearance of pus on some (not the first) day of illness indicates the addition of a bacterial infection. That is, about a complication. Why is this happening?
Viral invasion is accompanied by the destruction of human mucosal cells. The virus uses living cells to reproduce itself. Based on them, the invading virus releases hundreds of new pathogenic particles. Then it leaves the used cells to die.
Destroyed dead cells become a breeding ground for bacteria. If a large number of mucosal cells are damaged as a result of a virus attack, then the consequence will be a secondary bacterial infection. Against the background of viral conjunctivitis, pus will appear in the eyes.
Diagnostics
A qualified specialist knows exactly how to distinguish one form of conjunctivitis from another. It can also reveal the attachment of bacterial microflora to a viral eye infection.
An experienced ophthalmologist can distinguish one form of conjunctivitis from another based on patient complaints
The examination begins with a medical history and an ophthalmological examination. Biomicroscopic examination will help to detect damage to the eye, the depth of the lesion, and the presence of foreign bodies. During its implementation, a slit lamp is used, with which hyperemia and looseness of the conjunctiva, corneal defects, and vascular injections are visible. Bacteriological analysis of purulent exudate can identify the type of bacterial infection and determine the sensitivity of pathogens to antibiotics.
