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5. Eye diseases
Conjunctivitis
C onju nc tiv itis is a n a c u te in fla m m a tion of the c on ju nc tiv a d u e to a b a c te r ia l
or v ir a l
infe c tion, a lle r gy, or ir r ita tion. E nd e m ic or e p id e m ic , c onju nc tiv itis m a y b e
a s s oc ia te d
w ith m e a s le s or r hinop ha r yngitis in c hild r e n. In the a b s e nc e of hygie ne a nd
e ffe c tiv e
tr e a tm e nt, s e c ond a r y b a c te r ia l infe c tions m a y d e v e lop , a ffe c ting the c or ne a
(ke r a titis )
a nd le a d ing to b lind ne s s .
Clinical features 5
– C linic a l s igns of a ll c on ju c tiv ite s inc lu d e : r e d n e s s of the e ye a n d ir r ita tion .
V is u a l
a c u ity is not a ffe c te d .
– D e p e nd ing on the c a u s e :
•a b u nd a n t a n d p u r u le n t s e c r e tion s , e ye lid s s tu c k toge th e r on w a kin g,
u n ila te r a l
infe c tion a t ons e t: b a c te r ia l c onju nc tiv itis
•w a te r y (s e r ou s ) s e c r e tions , no itc hing: v ir a l c onju nc tiv itis
•e xc e s s iv e la c r im a tion, e ye lid oe d e m a , inte ns e itc hing: a lle r gic c onju nc tiv itis
– I n e nd e m ic a r e a s , tu r n b oth u p p e r e ye lid s u p to c h e c k for s igns of
tr a c hom a ( s e e
Trachoma, p a ge 1 2 6 ).
– S u s p e c t ke r a titis if p a tie nt r e p or ts inte ns e p a in (m or e tha n is u s u a lly
a s s oc ia te d w ith
c on ju n c tiv it is ) a n d p h ot op h ob ia . I n s t ill on e d r op of 0.5% fluorescein t o c h e c k
for
p os s ib le u lc e r a tions .
– A lw a ys c h e c k for for e ign b od ie s ( s u b c on ju n c tiv a l or c or n e a l) a n d
r e m ov e a ft e r
a d m in is te r in g 0.4% oxybuprocaine a n a e s th e tic e ye d r op s . N e v e r giv e b ottle of
e ye
d r op s to the p a tie nt.
Treatment
– Bacterial conjunctivitis
•C le a n e ye s 4 to 6 tim e s / d a y w ith b oile d w a te r or 0 .9 % s od iu m c hlor id e .
•A p p ly 1% tetracycline eye ointment 2 tim e s / d a y into b oth e ye s for 7 d a ys .
•Ne v e r u s e c or tic os te r oid d r op s or ointm e nt.
– Viral conjunctivitis
Conjunctivitis
C onju nc tiv itis is a n a c u te in fla m m a tion of the c on ju nc tiv a d u e to a b a c te r ia l
or v ir a l
infe c tion, a lle r gy, or ir r ita tion. E nd e m ic or e p id e m ic , c onju nc tiv itis m a y b e
a s s oc ia te d
w ith m e a s le s or r hinop ha r yngitis in c hild r e n. In the a b s e nc e of hygie ne a nd
e ffe c tiv e
tr e a tm e nt, s e c ond a r y b a c te r ia l infe c tions m a y d e v e lop , a ffe c ting the c or ne a
(ke r a titis )
a nd le a d ing to b lind ne s s .
Clinical features 5
– C linic a l s igns of a ll c on ju c tiv ite s inc lu d e : r e d n e s s of the e ye a n d ir r ita tion .
V is u a l
a c u ity is not a ffe c te d .
– D e p e nd ing on the c a u s e :
•a b u nd a n t a n d p u r u le n t s e c r e tion s , e ye lid s s tu c k toge th e r on w a kin g,
u n ila te r a l
infe c tion a t ons e t: b a c te r ia l c onju nc tiv itis
•w a te r y (s e r ou s ) s e c r e tions , no itc hing: v ir a l c onju nc tiv itis
•e xc e s s iv e la c r im a tion, e ye lid oe d e m a , inte ns e itc hing: a lle r gic c onju nc tiv itis
– I n e nd e m ic a r e a s , tu r n b oth u p p e r e ye lid s u p to c h e c k for s igns of
tr a c hom a ( s e e
Trachoma, p a ge 1 2 6 ).
– S u s p e c t ke r a titis if p a tie nt r e p or ts inte ns e p a in (m or e tha n is u s u a lly
a s s oc ia te d w ith
c on ju n c tiv it is ) a n d p h ot op h ob ia . I n s t ill on e d r op of 0.5% fluorescein t o c h e c k
for
p os s ib le u lc e r a tions .
– A lw a ys c h e c k for for e ign b od ie s ( s u b c on ju n c tiv a l or c or n e a l) a n d
r e m ov e a ft e r
a d m in is te r in g 0.4% oxybuprocaine a n a e s th e tic e ye d r op s . N e v e r giv e b ottle of
e ye
d r op s to the p a tie nt.
Treatment
– Bacterial conjunctivitis
•C le a n e ye s 4 to 6 tim e s / d a y w ith b oile d w a te r or 0 .9 % s od iu m c hlor id e .
•A p p ly 1% tetracycline eye ointment 2 tim e s / d a y into b oth e ye s for 7 d a ys .
•Ne v e r u s e c or tic os te r oid d r op s or ointm e nt.
– Viral conjunctivitis
