Sharp bacterial conjunctivitis
Sharp bacterial conjunctivitis – infectious damage mucous eyes, caused by grampolozhitelny or gramotritsatelny bacteria. At sharp conjunctivitis the expressed photophobia and dacryagogue, puffiness and hyperaemia mucous an eye, dot gemorragiya, mucopurulent separated from a conjunctival cavity are noted. Diagnosis of sharp conjunctivitis of a bacterial etiology includes biomicroscopy of a forward piece of an eye, coloring of a cornea fluorescein, bacteriological crops separated from a conjunctiva. At sharp bacterial conjunctivitis local antimicrobic treatment (eye drops and ointments) taking into account sensitivity of the activator to medicines is carried out.
Sharp bacterial conjunctivitis
About 30% of all pathology of eyes fall to the share of conjunctivitis in ophthalmology. Among them bacterial conjunctivitis makes 73%; allergic conjunctivitis – 25%; viral conjunctivitis – 2% respectively. Sharp bacterial conjunctivitis is quite often combined with an infectious blefarit and keratity. Incidence of sharp conjunctivitis has seasonal dependence (it is more often noted during the autumn and winter period). Sharp infectious conjunctivitis, in view of high contageousness, most often develops at children of 2-7 years and in children's collectives often gains the nature of epidemic flashes. Danger of sharp bacterial conjunctivitis at children consists in probability of development of a keratit, dakriotsistit, phlegmon of a plaintive bag and phlegmon of an orbit.
Even healthy people as a part of microflora of edges have a century and surfaces of a conjunctiva are present various microorganisms: staphylococcus, propionibakteriya, difteroida, etc. Resistance of a conjunctiva to infections is provided, mainly, thanks to antibacterial activity of the plaintive liquid containing protective factors – immunoglobulins, complement components, , lizotsy, a beta lysine. The blink movements promote a century updating of plaintive liquid and mechanical removal of bacteria from the surface of an eye.
Act as the main causative agents of sharp bacterial conjunctivitis staphylococcus (epidermalny, golden, saprofitny), a streptococcus, a pneumococcus, sinegnoyny and colibacillus, a hemophilic stick, Koch's bacterium — Uiksa, diphtheria korinebakteriya, . Special difficulties for treatment are presented by mikst-infections: virus and bacterial, virus and bacterial and fungal conjunctivitis.
Development of sharp bacterial conjunctivitis is promoted by weakening of the general and local immune answer, mechanical injuries of eyes, hit of foreign matters in eyes, the postponed viral diseases, stresses, overcooling, long local use of glucocorticoids, etc. Developing of sharp bacterial conjunctivitis can be connected with skin diseases (mnogoformny eritemy), ENT organs (otitis, tonsillitis, sinusitis), pathology of eyes (blefarity, a syndrome of a dry eye, defeat of slezootvodyashchy ways). Transmission of infection happens through polluted purulent separated objects (scarfs, towels, bed linen, toys), hands, water.
Sharp conjunctivitis, the caused sinegnoyny stick, often occurs at the persons using contact lenses. At violation of recommendations about care of lenses, the activator can be sowed from a surface of lenses, from solutions, containers for storage. Sharp conjunctivitis of newborns develops at children with pre-natal infection, the premature, given rise from mother with inflammatory diseases genitals more often (gonorrhea, tuberculosis, etc.).
Sharp conjunctivitis develops promptly and violently – from the moment of introduction of the activator before emergence of the developed clinical symptomatology passes from several hours to several days.
The current of various forms of bacterial conjunctivitis is characterized by hyperaemia, infiltration and puffiness of all departments of a conjunctiva, burning sensation, "sand" and an itch, eye pain, plentiful mucopurulent separated from a conjunctival bag. At sharp conjunctivitis the conjunctival injection is expressed, hemorrhages, formation of nipples and follicles on mucous eyes are noted. At considerable hypostasis can develop conjunctivas - its infringement in an eye crack at a smykaniye a century. Damage of eyes at infectious conjunctivitis in the beginning unilateral; the second eye is involved in an inflammation a bit later.
Sharp conjunctivitis proceeds with plentiful office of a purulent secret from a conjunctival cavity which sticks together eyelashes, the century, forming crusts dries up at edges. Sharp conjunctivitis constitutes danger in the development plan for infectious defeats of a cornea - a bacterial keratit, a purulent ulcer of a cornea with perforation threat. Deep keratita and ulcer defeats of a cornea arise mainly against the background of weakening of an organism – at anemia, dystrophy, hypovitaminoses, a bronkhoadenita etc.
The diagnosis of sharp conjunctivitis is established by the ophthalmologist on the basis of epidemiological data and clinical manifestations. For the purpose of clarification of an etiology of infectious conjunctivitis the microscopic and bacteriological research of dab from a conjunctiva with antibiotikogrammy is made.
Survey of a forward piece of an eye by means of a slot-hole lamp (eye biomicroscopy) reveals hyperaemia and friability of a conjunctiva, a vascular injection, sosochkovy and follicular growths, defects of a cornea. For an exception of ulcer defeat of a cornea instillyatsionny test with flyuorestseiny is carried out.
treatment should be carried out only under the supervision of a doctor. Self-treatment is unacceptable!!!
At sharp infectious conjunctivitis local treatment taking into account type of the allocated activator and its antibiotikochuvstvitelnost is appointed. The careful toilet of eyes is carried out: wiping century, jet washing of a conjunctival bag antiseptic solutions (Furacilin, boric acid). At the same time for each eye separate wadded balls, pipettes, eye sticks, syringes are used.
After careful mechanical clarification a century and a conjunctival cavity instillations of antibacterial eye drops (solutions of a tetratsiklin, levomitsetin, Neomycinum, lincomycin, an ofloksatsin, etc.) in each 2-3 h are made. For the night for eyelids it is recommended to put antibacterial ointment. At the expressed hypostasis and inflammatory changes of a conjunctiva add antiallergenic and anti-inflammatory drops to treatment.
At sharp bacterial conjunctivitis it is categorically forbidden to apply a bandage as it complicates evacuation of contents from a cavity of a conjunctiva eyes and increases probability of infection of a cornea. Treatment of sharp conjunctivitis is carried out within 10-12 days before total and permanent disappearance of symptoms then carrying out repeated bacteriological control of contents of a conjunctival cavity is desirable.
Forecast and prevention
Etiologicheski reasonable and timely therapy of sharp conjunctivitis allows to achieve permanent treatment of an inflammation. At a failure the course of sharp infectious conjunctivitis can be complicated by a bacterial keratit, turbidity of a cornea, decrease in sight, development of an ulcer of a cornea, orbital cellulitis. Transition of a sharp form to chronic conjunctivitis is possible.
Prevention of sharp bacterial conjunctivitis consists in respect for hygienic norms, the prevention of injuries of eye, the correct care of contact lenses, timely sanitation of the centers of an infection of skin and a nasopharynx. In children's collectives where sharp conjunctivitis is registered, all contact persons (instillation of antiseptic eye drops) need purpose of preventive treatment.