Conjunctivitis: Causes and Symptoms

Conjunctivitis is one of the most common diseases of the eye. It can be recognised by typical unpleasant symptoms such as itching and a foreign body sensation behind the eyelid, but also by a noticeable redness of the eye, increased itching and general discomfort in the area. 

Conjunctivitis = of the outermost layer of the white part of the eye and the inner surface of the eyelid = pink eye.

Conjunctivitis affects people across all ages, from children, teens, adults and seniors. Various external and internal factors are involved in its development. It takes place acutely with a sudden onset, however, it can flare up chronically.

FAQs: 
What causes conjunctivitis? Is it just bacteria or viruses? 
Does it affect children?
Are there any home remedies or herbs (e.g. common agrimony)?
Does a person need professional treatment, eye drops, necessary?

Basic information about the connector at a glance

The conjunctiva ranks among the protective and accessory organs of the eye. It is professionally referred to as the tunica conjunctiva. The others are the eyelashes, the orbit (orbit), the lacrimal and lacrimal apparatus and also the orbicularis oculi.

The conjunctiva is a thin, transparent and shiny membrane.
It has a salmon colour.
It covers the eye in areas such as the inside of the eyelashes, the eyelid and the front of the eyeball.
It forms a conjunctival sac.

It is connected to the nasal cavity in the lacrimal duct section.

It is divided into three structures, namely the palpebral, the bulbar, and the fornix conjunctiva that merge into the upper and lower transitional eyelashes, i.e., the formix superior (upper) and the formix inferior (lower).

Two important functions of the conjunctiva:

1. mechanical protection
   • covers the eye
   • cleans the eye
   • defends the eye immunologically, by the presence of defence cells
2. secretory - is part of the formation and protection of the tear film

The conjunctiva is richly vascularized. During normal resting state, these blood vessels are not visible. However, the reversal occurs at the moment of inflammation. At that time, its vascular pattern becomes accentuated and the eye becomes red.

As part of the introduction, it is also worth mentioning the conjunctival sac. It serves for the accumulation of tears, which wash the surface of the eye and cleanse it, defending it. 

Thus, the tear film is mechanical and immunological in nature, thus protecting the corneal epithelium. 

The tear film is the first barrier of the eye.
Its thickness is approximately 7 to 8 µm.
It has main layers, namely oil, water and mucin layers.
In addition, there are two intermediate layers between them.

Conjunctivitis is...

An inflammatory disease of the conjunctiva that is triggered by various factors, such as bacteria, viruses, allergies, and also occurs in other diseases, as inflammation and not a separate disease.

The disease is characterized by reddening of the membrane that covers the front of the eye and the inside of the eyelid. This pink to red discoloration is accompanied by a number of unpleasant discomforts. 

In addition, by rubbing and wiping the eye, we can make the whole situation even worse or, possibly, spread the microorganisms. 

And with this fact we come to the question: is conjunctivitis contagious/infectious?

Yes, it is.

Microorganisms can be spread from one eye to the other by carelessly rubbing the eyes. But also from person to person. Which is especially risky in a children's group, when playing in close contact.

Conjunctivitis can affect only one eye, but also both eyes.

In addition to occurring on its own, it can be present in other and common ailments such as colds, rhinitis or flu. 

Although it is a common disease in children and people, in a newborn it requires special attention, diagnosis and thorough treatment.

Conjunctivitis is most often caused by microorganisms, of which viruses are the most common. Bacteria come second, while mycosis or parasitic infection may also be involved.

A common cause of redness and inflammation of the conjunctiva is allergy. Seasonal pollen allergy, also known as hay fever, is typical. 

According to the course of the disease, conjunctivis is categorised as follows:

1. hyperacute - arises very rapidly, within a few hours of becoming infected.
2. acut - after contact occurs within a few days and passes within 4 weeks.
3. chronic - lasts longer than 4 weeks and may or may not have acute recurrent flare-ups (exacerbations).

The main causes of occurrence are divided into two large groups:

1. Infectious
   • viruses
   • bacteria
   • chlamydia
   • mould
   • parasites
2. Non-infectious
   • allergies
   • autoimmune diseases
   • other (dirt, smoke, shampoo, chlorine in the pool)

 Table: forms of conjunctivitis

The symptoms are well known to everyone, at least the basic and typical ones. Then, according to the specific manifestations, a possible cause can be assumed. Naturally, the exact cause will be determined by a specialist.

Difficulties may affect one eye, later moving to the other eye, or both eyes at the same time.

They are roughly divided into the objective, that is, those that are visible externally, and the subjective, which are felt by the sufferer.

Examples of objective, obvious ones are redness, swelling, tearing, purulent discharge, dried carpins.

Subjective sensations are, for example, burning, cutting, foreign body sensation, general discomfort.

Typical symptoms of conjunctivitis include:

• redness of the conjunctiva - hyperemia, accentuation of blood vessels in the eye.
• increased tearing
• feeling of a foreign body or sand in the eye.
• discomfort, discomfort that cannot be described.
• itching, burning, pain sensations
• blurred vision - for the presence of secretion and tears.
• photophobia - increased sensitivity to light.
• discharge, yellowish, whitish, purulent.
• swelling of the eyelid.
• membranes and pseudomembranes, coatings on the eye.
• scars
• pigmentation, discoloration.
• blood bruising - suffusion, bleeding under the conjunctiva.
• chemosis - swelling of the conjunctiva.
• enlarged lymph nodes.

Itching is most typical for allergic forms of conjunctivitis.

A red eye or hyperemic eye is a typical sign that something is wrong. The blood vessels of the conjunctiva are normally not visible or are subtly drawn.

However, as a result of inflammation, a reaction occurs that causes them to spread. The blood supply to the area increases. 

The blood vessels are well and distinctly visible.

You may also encounter a designation such as increased injection. Medically, it is referred to as superficial (an example is a condition where the blood vessels move with the conjunctiva) or deep (blood vessels do not move) injection. Alternatively, several features of both come together, hence mixed injection.

Caution, with sudden onset of intense pain, photophobia = suspicion of corneal inflammation.

Some signs of conjunctivitis by origin:

1. Virus
   • watery secretion
   • superficial injection - reddening of the coils
   • the presence of boils on the eyelash - with herpes virus
2. Bacteria
   • purulent whitish discharge
   • after a night of dried carpins, yellow, green
   • superficial injection - reddening of the coils
   • transfer from one eye to the other mostly within 2 days
3. Mould
   • white and soft bearings, resembling cottage cheese on the surface of the conjunctiva
   • the eye can be free of redness
4. Non-infectious
   • tear flow
   • stabbing sensation
   • mild spraying of the conjunctiva, injection of superficial vessels
   • swelling of the eyelashes
   • the secretion is serous, mucous-like, pale, stretching
5. Allergy
   • itching, burning sensations
   • swelling of the eyelashes
   • chemosis
   • serous or mucous discharge

Alternatively, blepharoconjunctivitis can occur, which is a combination of conjunctivitis and inflammation of the eyelid. In this case, both redness and swelling of both parts are present.

Diagnosis of the disease is based on medical history. A person complains of subjective discomfort. It is followed by an examination by a doctor. The latter sees objective manifestations, when he can assume the underlying cause. 

However, as can be seen from the above information, red conjunctivae can be a symptom of other diseases. Therefore, especially in the case of long-lasting, persistent and recurrent problems, a medical examination is necessary. This may include ophthalmological and other according to the problems present.

It is necessary to differentiate or confirm a number of other diseases that can affect the eye (glaucoma, keratitis, uveitis), but also other systemic diseases or autoimmune diseases.

The following methods are used to establish the diagnosis:

• medical history
• examination of the anterior segment of the eye
• eversion - eyelid rotation
• swab from the eyelid, in case of doubt and persistence of inflammation - bacterial culture (possibly viral)
• blood collection
• allergy tests

How does the disease progress?

Of course, it depends on the provoking cause. At the first moment, irritation of the eyes may be present, which manifests itself in itching, burning, cutting or other discomfort. 

The heaviness is accompanied by the sensation of a foreign body in the eye, often even the sensation of sand in the eye. 

Redness of the conjunctiva occurs. It can manifest itself in varying degrees and severity. Increased lacrimation, secretion from the eye is added, according to which it is possible to assume whether it is a virus or bacteria. 

Purulent secretion strongly white, gray and yellow colored marks bacterial microflora. The manifestation is especially in the morning after waking up dried yellow carpels and on the eyes, i.e. eyelids and eyelashes.

In addition, bacterial infections are typical in that they first affect one eye and then spread to the other eye within 2 days (the period can be extended to 6 days). 

Conjunctivitis affects one or both eyes.

Viral conjunctivitis very often runs together with an upper respiratory tract infection. Either the beginning of the disease, but also a possible complication with the later onset of difficulties.

Also, the infection can spread from one eye to the other.

An allergy is characterized by an exaggerated and disproportionate reaction to an allergen. In this case, symptoms occur after exposure. An example is the seasonally recurring problem of rhinitis, itchy eyes and the like. 

Of course, the difficulties subside after a period of time without its action. Antihistamines, i.e. medicines against allergy symptoms, help.

The allergic person complains mainly of itchy eyes, excessive tearing, which is accompanied by increased nasal discharge. The conjunctivae have an accentuated pattern of blood vessels, as due to the influence of histamine and other vasoactive substances (substances acting on blood vessels) the blood vessels are dilated and the area is more congested.

Other forms depend on the underlying disease. Of course, if the problem with the conjunctiva recurs, a professional examination is necessary.

Severe forms can lead to permanent damage to the conjunctiva and the eye.
In addition, the infectious microorganism can also spread to other parts of the body.

Prevention is important

Even in the case of the eyes, prevention against diseases is important. What will help your eyes more, you ask?

Prevention includes:

• regular hand washing, with soap and water
• not to catch your eyes with dirty hands
• not to use other people's towels, each member of the household should have his/her own face towel
• custom eye drops
• custom make-up
• take proper care of contact lenses
• use sunglasses when outdoors, in the sun, in the wind
• sufficient fluid intake
• vitamins (especially A) and multimineral
• use protective equipment for hazardous work
• infected people, especially children, should stay at home in isolation for the duration of the illness
• vaccination against Haemophilus influenzae, Pneumococcus and Neisseria meningitidis