Chronic conjunctivitis – it is long, persistently proceeding Qatar conjunctivas of a noninfectious or infectious etiology. Subjectively chronic conjunctivitis is shown by a constant itch, burning, a photophobia, feeling of "sand" after centuries, fatigue of eyes; objectively – hyperaemia and poor mucopurulent separated. Diagnosis of chronic conjunctivitis is carried out on the basis of the analysis of the complaints given biomicroscopy and a research of a refraction, bacteriological crops from a conjunctiva, statement . In treatment of chronic conjunctivitis elimination of the reason of an inflammation, local use of medicines of etiopatogenetichesky and symptomatic action has paramount value (a thaw, ointments).
Conjunctivitis makes about a third of all eye pathology in ophthalmology and is the most frequent inflammatory damage of eyes. Unlike sharp conjunctivitis which develops at children more often people of middle and advanced age are more subject to chronic conjunctivitis. Chronic conjunctivitis can be combined with blefarita, keratita, meybomeity, a syndrome of a dry eye and other damages of eyes.
Reasons of chronic conjunctivitis
Chronic conjunctivitis is divided by an etiology on infectious and noninfectious; endogenous and exogenous. Noninfectious exogenous chronic conjunctivitis is in most cases connected with long irritation of eyes physical or chemical factors: dust, smoke, vapors of alkalis and acids, cosmetics, hard and long visual work at insufficient lighting, etc. Chronic conjunctivitis can occur at the workers occupied on the coal, cement, flour-grinding, sawing, sherstobitny, paper industry in hot shops, chemical productions. Can lead constant mechanical irritation of an eye to chronic conjunctivitis the foreign matters (which are incorrectly growing at eyelashes at a trikhiaza, grains of sand, particles of loose substances etc.).
Nekorregirovanny anomalies of a refraction (astigmatism, far-sightedness, presbiopiya), syndrome of a dry eye, snow blindness (elektrooftalmiya) can be the reasons of recurrent chronic conjunctivitis of a noninfectious etiology. The helminthic invasion, , seborrhea, chronic gastrointestinal diseases (gastritises, enetrokolita, cholecystitises), anemias, avitaminosis, a hyperglycemia and diabetes quite often acts as endogenous factors. On chronic type allergic conjunctivitis proceeds. In this case eye manifestations can be combined with allergic rhinitis, bronchial asthma, atopic dermatitis and have seasonal dependence.
Infectious chronic conjunctivitis can be caused by inflammatory diseases of eyes (blefarity, meybomeity, dakriotsistity), diseases of ENT organs (sinusitis, chronic tonsillitis, etc.). In certain cases leads inadequate treatment of sharp conjunctivitis to synchronization of process. In tsitogramma and crops from a conjunctiva at patients with chronic conjunctivitis staphylococcal flora, proteas, an enetrobakteriya, a pseudo-monad, moraksella, hlamidiya and pathogenic microorganisms usually comes to light.
Symptoms of chronic conjunctivitis
The symptomatology of chronic conjunctivitis accrues gradually and the long time remains. Patients are disturbed by weight a century, feelings of burning and "contamination" of an eye, a photophobia and dacryagogue, bystry fatigue of eyes when reading and visual work. All these displays of chronic conjunctivitis usually amplify by the evening and when using artificial lighting. Depending on an etiology of chronic conjunctivitis separated a conjunctival cavity can be poor or moderate, more often it has mucous or mucopurulent character. Objectively not expressed conjunctiva hyperaemia, an insignificant roughness of a surface mucous comes to light.
Chronic allergic conjunctivitis proceeds with education on a conjunctiva of nipples or follicles which are followed by an itch, sometimes – violation of sight and defeat of a cornea. In certain cases allergic conjunctivitis is combined with allergic dermatitis a century, blefarity, keratity, uveity, retinity, neuritis.
Chronic conjunctivitis carries a long persistent current and can proceed for years.
Diagnosis of chronic conjunctivitis
Feature of chronic conjunctivitis is discrepancy of expressiveness of clinical signs to objective changes that complicates identification of a cause of illness. It is possible to establish the right diagnosis only at internal consultation of the ophthalmologist, clarification of complaints and associated diseases, external survey of an eye, performing special ophthalmologic and laboratory diagnostics.
Vizometriya at chronic conjunctivitis can reveal decrease in visual acuity or its relative norm. At biomicroscopy changes of a conjunctiva and transitional folds come to light a century: insignificant hyperaemia, razrykhlennost, velvet of a surface, sosochkovy growths, etc.
For an exception of anomalies of a refraction the skiaskopiya and refractometry is carried out. At suspicion on the accompanying syndrome of a dry eye tests for a slezoproduktion research are carried out: Norn's test, Shirmer's test, flyuorestseinovy instillyatsionny test.
For definition of causative agents of chronic conjunctivitis carrying out bacteriological crops of dab from a conjunctiva is shown.
At the chronic conjunctivitis caused by associated diseases additional consultations (the otolaryngologist, the gastroenterologist, the endocrinologist, the dermatologist, the allergist) and a research can be required (a X-ray analysis of additional bosoms of a nose, from a nasopharynx; The REEF, PTsR, research IFA on clamidiosis; blood sugar definition, statement skin , a research of eyelashes on and so forth).
Treatment of chronic conjunctivitis
Treatment at chronic conjunctivitis can be successful only if the cause of an eye disease is found and removed.
So, at identification of ametropiya, selection of points or contact lenses is made, carrying out laser correction of sight is recommended. At constant irritation of eyes elimination of provocative factors, removal of foreign matters from the conjunctival arch, carrying out an epilation of eyelashes is necessary. Treatment of the revealed accompanying chronic pathology under control of the expert of the corresponding profile is obligatory.
Locally at chronic conjunctivitis cold lotions of the knitting solutions and herbs (infusion of tea, a camomile, resorcin solution) are appointed. Instillations in a conjunctival cavity of disinfecting, antibacterial, vitamin drops, corticosteroids, an artificial tear are made. For the night mazevy applications for eyelids are applied. Treatment of chronic conjunctivitis long that quite often demands change of medicines in order to avoid accustoming.
Forecast and prevention of chronic conjunctivitis
Hroyoniyocheyosky konjyunkyotiyovit to treatment with truyody, an inflammation recurrence is celebrated. Successful treatment is possible only at full elimination of the reasons and performing persistent systematic therapy. Long (for many months and years) the course of chronic conjunctivitis can limit professional suitability and working ability of patients.
Prevention of chronic conjunctivitis demands elimination of professional vrednost, use of individual means of protection on production, carrying out timely correction of refraction violations of sight, treatment of associated diseases.