How to distinguish viral conjunctivitis from bacterial - how to determine if there are differences

Conjunctivitis is an inflammatory process in the outer layer of the eye that not only causes significant discomfort to the patient, but can also cause severe complications. If the disease is caused by viruses or bacteria, it can be transmitted from person to person.

Anyone can get conjunctivitis; however, the chronic form of the disease is typical for adult patients, and in children the disease often occurs in an acute form.

In order to prevent the development of complications, it is important to start treatment on time, but it is also important to determine the source of the disease, the type of medicine will depend on this - antiviral drugs or antibiotics.

In this article you will learn: what are the forms and types of the disease, how to identify viral or bacterial conjunctivitis, causes and symptoms, principles of treatment and prevention.

What is conjunctivitis?

Source: meditalk.ru

How to determine viral or bacterial conjunctivitis.
Source: linza.guru The human eye has a very complex and multifaceted structure. Wise nature has created a truly unique optical apparatus, which consists of many different biological elements. Every detail of this complex mechanism is aimed at solving certain problems, and a malfunction of even the most seemingly insignificant element can cause the development of serious pathologies.

Conjunctiva

The conjunctiva is the most important part of the appendage apparatus of the eye. It looks like the thinnest mucous tissue, which, as if with a transparent film, gently envelops the inner surface of the eyelids, forms the arches of the eye folds, forms the lacrimal sac and covers the outer part of the eyeball.

This film is only 0.1 mm thick and performs two very important functions. Firstly, it produces tear fluid components that moisturize and disinfect the surface of the eyeball. And secondly, the conjunctiva protects the eye from dust, dirt, pathogenic infections and other pathogens.

It is also necessary to take into account the fact that the eye is the only human organ whose mucous membrane is in direct contact with the external environment. This factor, combined with its complex optical structure, makes the visual apparatus the most vulnerable part of the human body.

The organ of vision is especially susceptible to external irritants and infections, which most often affect the mucous membrane of the eyeball. And one of these ophthalmological diseases is acute conjunctivitis, which usually affects both eyes and occurs with equal probability in both adults and children.

Conjunctivitis is a general name for all inflammatory diseases that affect the mucous membrane of the eye. According to statistics, almost a third of all ophthalmological pathologies are due to conjunctivitis, and what is most interesting is that about 15% of the entire population of the planet suffers from this disease.

Conjunctivitis, like any disease that is accompanied by both chronic and acute inflammatory processes. As a rule, this form of this disease is nothing more than a consequence of acute conjunctivitis that has been suffered and not always treated.

The course of this form of inflammation is very protracted and stable, and short-term improvements are quickly replaced by sharp exacerbations. Therefore, in order not to bring the disease to a chronic form, you need to immediately seek help from a doctor at the first unpleasant symptoms indicating conjunctivitis, who will confirm the diagnosis and prescribe effective therapy.

Causes

In addition to the symptoms, the distinctive features when determining the type of conjunctivitis are the causes of the pathology.

Thus, the bacterial species occurs against the background of infection by contact: bacteria that are not part of the corresponding conjunctival microflora multiply on the mucous membrane of the eye.
The causes of the viral type are most often adenoviral actions, which are transmitted by airborne droplets, as well as contacts with already infected people. The disease can also cause influenza, measles or rubella.

To learn even more about what viral conjunctivitis is, check out the following article published on our website.

In order to clearly see the differences between viral and bacterial conjunctivitis, consider the presented photos:

Classification

The term “conjunctivitis” is not the name of the disease, but reflects only the localization of the inflammatory process - the mucous membrane of the eye. In order to obtain the full name of the disease, it is necessary to add the designation of the causative factor to the term “conjunctivitis” or indicate the nature of the inflammatory process, for example, “bacterial conjunctivitis” or “chronic conjunctivitis”, etc.

The full name of the disease, which includes the cause of inflammation or its nature, is used by doctors in medical documentation. The nature and cause of inflammation of the conjunctiva should always be clarified, since correct and effective treatment depends on this.

Currently, there are a number of classifications of conjunctivitis, each of which reflects some significant factor regarding the cause or nature of inflammation of the mucous membrane of the eye. Depending on the cause that provoked inflammation of the mucous membrane of the eye, conjunctivitis is divided into the following types:

Bacterial conjunctivitis is provoked by various pathogenic or opportunistic bacteria, such as streptococci, pneumococci, staphylococci, gonococci, diphtheria bacillus, Pseudomonas aeruginosa, etc.;
Chlamydial conjunctivitis (trachoma) is caused by chlamydia getting into the eyes;
Angular conjunctivitis (angular) is provoked by the Morax-Axenfeld diplobacillus and is characterized by a chronic course;
Viral conjunctivitis, provoked by various viruses, such as adenoviruses, herpes viruses, etc.;
Fungal conjunctivitis is provoked by various pathogenic fungi and is a particular manifestation of systemic infections, such as actinomycosis, aspergillosis, candidiasis, spirotrichelosis;
Allergic conjunctivitis develops under the influence of any allergen or factor that irritates the mucous membrane of the eye (for example, dust, wool, varnishes, paints, etc.);
Dystrophic conjunctivitis develops under the influence of various substances that cause damage to the mucous membrane of the eye (for example, reagents, paints, industrial vapors and gases, etc.).

Chlamydial and angular (angular) conjunctivitis are special cases of bacterial conjunctivitis, however, based on certain features of the clinical course and signs, they are distinguished into separate varieties.

Depending on the type of inflammatory process on the mucous membrane of the eye, conjunctivitis is divided into acute and chronic conjunctivitis. A special case of acute conjunctivitis is epidemic, provoked by the Koch-Wicks bacillus.

Depending on the nature of inflammation and morphological changes in the mucous membrane of the eye, conjunctivitis is divided into the following types:

Purulent conjunctivitis, which occurs with the formation of pus;
Catarrhal conjunctivitis, occurring without the formation of pus, but with copious mucous discharge;
Papillary conjunctivitis develops against the background of an allergic reaction to eye medications and is the formation of small grains and compactions on the mucous membrane of the eye in the upper eyelid;
Follicular conjunctivitis develops according to the first type of allergic reaction and is the formation of follicles on the mucous membrane of the eye;
Hemorrhagic conjunctivitis is characterized by numerous hemorrhages in the mucous membrane of the eye;
Membranous conjunctivitis develops in children against the background of acute viral respiratory diseases.

Despite the fairly large number of varieties of conjunctivitis, any form of the disease is manifested by a set of typical symptoms, as well as a number of specific signs. The causes of conjunctivitis are the following groups of factors that can cause inflammation in the mucous membrane of the eye:

Infectious causes: pathogenic and opportunistic bacteria (staphylococci, streptococci, gonococci, meningococci, Pseudomonas aeruginosa, etc.), chlamydia, viruses (adenoviruses and herpes viruses), pathogenic fungi (actinomycetes, aspergillus, candida, spirotrichella);
Allergic causes (wearing contact lenses, atopic, drug-induced or seasonal conjunctivitis);
Other reasons (occupational hazards, dust, gases, etc.).

All of the listed causes of conjunctivitis cause the disease only if they manage to get into the mucous membrane of the eye.

As a rule, infection occurs through dirty hands with which a person rubs or touches the eyes, as well as through airborne droplets in the case of viruses, allergens or occupational hazards.

In addition, infection by pathogenic microorganisms can occur ascending from the ENT organs (nasal, oral cavity, ear, throat, etc.).

Differences in therapy for different etiologies

The prescription of medications depends on the nature of the pathogen:

bacterial conjunctivitis is treated with broad-spectrum antibiotics in the form of eye drops or ointments;
Treatment of viral conjunctivitis includes local use of antiviral drugs, specific antiviral immunotherapy and the use of general restoratives.

In addition, in case of a bacterial infection, eyelid toilet is prescribed - washing the conjunctival cavity with weak solutions of disinfectants. This helps remove purulent discharge and crusts that have formed.

REFERENCE! Bacterial conjunctivitis is more sensitive to therapy than viral conjunctivitis. Typically, treatment does not shorten the duration of viral conjunctivitis. It follows its clinical course (2 to 4 weeks), and medications only help to reduce symptoms and reduce the likelihood of the disease spreading.

Drops

Drops are an effective and easy-to-use dosage form. In addition, the liquid substance envelops the membrane of the eyeball without reducing visual acuity, such as ointments. Therefore, drops are preferable during the daytime.

For bacterial infections

An important role in the treatment of bacterial conjunctivitis is played by rinsing with antiseptic solutions:

"Okomistin"
Boric acid eye drops.

After mechanical cleansing of the eyelids and connective membrane from purulent discharge, local antibacterial drugs are used:

"Albucid" (sodium sulfacyl),
"Levomycetin" (chloramphenicol),
"Floxal" (ofloxacin),
"Neomycin"
"Ciprofloxacin."

Even if the disease affects only one eye, it is necessary to extend therapy to the second. The frequency of instillations is determined by the severity of the disease (4-6 times a day). In severe cases, drops are prescribed every hour.

For viral infections

Eye drops used in the treatment of viral conjunctivitis can be divided into the following categories:

the main drugs are antiviral agents (“Florenal”, “Aktipol”, “Oftalmoferon”);
immunostimulants (for example, “Poludan” - lyophilisate for the preparation of nasal drops);
in severe cases, especially when conjunctival edema appears, corticosteroid eye drops based on dexamethasone (Dexapos, Maxidex) are prescribed;
tear replacement therapy using “artificial tears” preparations (“Vizin”, “Hilo-Komod”, “Slezin”, etc.).

Expert opinion

Danilova Elena Fedorovna

Ophthalmologist of the highest qualification category, Doctor of Medical Sciences. Has extensive experience in diagnosing and treating eye diseases in adults and children.

The most in demand are combination drugs that have antiviral and immunostimulating effects (“Aktipol”). Eye drops "Ophthalmoferon" (based on interferon), among other things, have: anti-inflammatory, local anesthetic, antihistamine effect and antiseptic effect against secondary bacterial infection. The metacel included in the composition eliminates dryness (an “artificial tear” preparation).

Ointments

Ointment-based medications have a local effect. Their advantage over drops is their more viscous consistency, which prevents them from being washed away by tears. Thus, the contact of the drug with the surface of the eye is longer and more effective.

However, ointment placed in the conjunctival sac can create discomfort, so it is recommended for use at night.

For bacterial infections

Popular drugs:

“Tetracycline ointment” (1% or 3%) is a broad-spectrum bacteriostatic antibiotic;
Ofloxacin is an antimicrobial agent.

Among the combined antibacterial ointments are:

"Alfatex" (Eubetal Antibiotic) - tetracycline, betamethasone, chloramphenicol, sodium colistimethate,
"Colbiocin" - tetracycline, chloramphenicol and colistin.

With a viral form

Viral forms of conjunctivitis require the use of viruscidal and virusostatic agents based on:

acyclovir (Zovirax, Virolex),
oxolina,
tebrofen,
bonaftone (bromonaphthoquinone).

To prevent the addition of a bacterial infection, treatment can be supplemented with antimicrobial drugs.

Similar to the treatment of severe forms of the disease with eye drops, it is possible to use glucorticosteroid ointments (Hydrocortisone, Dex-Gentamicin).

Folk remedies

For inflammation of the mucous membrane of the eyes, adherents of herbal medicine advise using decoctions:

chamomile flowers,
calendula,
cornflower,
dill greens,
bay leaf,
fennel seeds,
rosehip.

These plants have excellent antiseptic properties and relieve swelling. Decoctions are used for external washing of the eyes or as compresses to facilitate the outflow of pus. To do this, soak a clean cotton pad with liquid and apply it to the affected eyelid for 5-20 minutes.

Compresses can also be prepared from:

ground aloe leaves,
grated potatoes and egg white.

REFERENCE! The most popular remedy for conjunctivitis, firmly entrenched in the minds of compatriots, is fresh tea leaves. Both black and green tea are used. Rub the eyes with warm liquid so that the pus that has dried after sleep can be easily separated.

Causes of the disease

Source: zrenie.online
The microflora of the mucous membrane of the eye, the back walls of the eyelids and the arches of the eye folds always includes various bacteria and microbes, and they can be found even in completely healthy people. If the adnexal apparatus of the organ of vision does not have pathological changes, then its lacrimal glands function normally.

How the disease is formed

The lacrimal glands constantly secrete a secretion that, during blinking movements of the eyelids, moisturizes the conjunctiva of the eye and removes all pathogens from its surface. But with the confluence of both external and internal factors, certain conditions are created that lead to a malfunction of the appendage apparatus of the eye, as a result of which a person develops conjunctivitis.

External factors that influence the development of the disease can be divided into infectious and non-infectious types. Infectious pathogens include:

viruses – influenza, herpes, measles, a strain of adenovirus infection;
bacteria - staphylococcus, streptococcus, pneumococcus, gonococcus, as well as bacilli: Pseudomonas aeruginosa, Escherichia coli, Haemophilus influenzae, diphtheria and Koch-Wicks;
fungi: candida, actinomycota, aspirgillus, rhinosporidia and sporotrichia.

It is important to remember that all infectious conjunctivitis is contagious, which means it can be transmitted from a sick person to a healthy person. Therefore, it is necessary to always observe the rules of personal hygiene and, if possible, limit contact with a person suffering from this infectious disease.

But the development of non-infectious inflammation of the mucous membrane of the organ of vision is provoked by the following factors:

allergic - plant pollen, ultraviolet rays, eye exposure to dust, smoke, contact lenses, toxic and chemical irritants;
medicinal - antibiotics or antiseptics in the form of ointments and drops;
autoimmune - morphological changes in the conjunctiva occur under the influence of cells of the own immune system.

In rare but very severe cases, acute conjunctivitis can be provoked by several types of infections at once, for example, a fungus and a virus, or a bacterium, a virus and a fungus. The situation is even worse when a bacterial or viral infection is superimposed on allergic conjunctivitis. A disease of this combinatorial type is very difficult and long to treat.

If an infection, allergen or other causative agent of conjunctivitis enters the body or eyes, this does not mean at all that the person will definitely get sick. For this, there must also be risk factors that will create favorable conditions for the development of the inflammatory process.

The main ones include:

weakened immune system;
long-term chronic and inflammatory general diseases;
hypothermia or overheating of the whole body;
vitamin A deficiency;
skin diseases;
injuries and mechanical damage to the conjunctiva of the eye;
frequent bronchitis, otitis, tonsillitis and sinusitis;
pathologies of the endocrine system;
blepharitis and disruption of the lacrimal glands;
vision refractive problems;
violation of personal hygiene rules.

As a rule, a risk factor alone does not lead to the development of pathology. But thanks to it and in the presence of external pathogens, the likelihood that acute conjunctivitis will develop increases significantly.

Features of the course of bacterial conjunctivitis

The course of bacterial conjunctivitis has its own differences.
Its causative agents are pyogenic, that is, pus-producing bacteria. These are staphylococci, streptococci, pneumococci, E. coli. There are factors that increase susceptibility to developing the disease:

long-term wearing of contact lenses and violation of the rules for their storage;
decreased immunity;
hypothermia of the body;
mechanical eye injuries;
infectious skin diseases.

Symptoms of bacterial conjunctivitis:

redness and swelling of the eyelids;
Sensation of a foreign body in the eyes;
The appearance of purulent discharge;

It is the presence of purulent discharge that is the main difference between bacterial conjunctivitis and viral conjunctivitis. Sometimes they are so abundant that after a night's sleep a person has difficulty opening his eyes, because the purulent discharge sticks the eyelashes together and dries out.

Bacterial conjunctivitis is discussed in detail in this article.

How to determine viral or bacterial conjunctivitis: the main differences

Source: ofthalm.ru
Based on statistical data, about 79% of the population (who are faced with an eye disease such as conjunctivitis) are infected with the viral variety.

Often, if the diagnosis is incorrect and as a result of ineffective therapy, bacteria also join the virus. That is why it is very important to correctly determine the nature of the disease and begin timely treatment.

If we take the viral and bacterial nature, each of them has its own similarities and differences. Here are the most basic of them:

The disease, which occurs due to the ingress of bacteria, manifests itself in the shortest possible time. At first, the inflammation may be very similar to the viral type of conjunctivitis (itching, swelling, redness, tearing). But soon, within about 24 hours, the bacterial form promotes the release of purulent fluid in large quantities.
When viral bacteria get into the eyes, the discharge is mucous in nature. With viral inflammation, the eyelids calmly open after sleep, which cannot be said with bacterial etiology. Small discharges of pus may appear only a few days after infection.
This indicates that bacteria have also joined the viral microbes. Bacterial conjunctivitis occurs more calmly.
Discharge from the mucous membrane of infected eyes during a viral disease, even if it contains pus, comes out in small quantities. The liquid will be clear in color and contain some pus. With conjunctivitis, which is caused by bacteria, the discharge is strong.
A bacterial disease instantly infects the mucous membrane of both eyes. Viral conjunctivitis is characterized by an inflammatory process in one visual organ, which over time can spread to another.
With a viral disease, the mucous membrane of the eye becomes very red. This does not occur with bacterial conjunctivitis.

Before prescribing the necessary therapy, a qualified specialist must establish the nature of conjunctivitis. To do this, the attending physician collects an anamnesis of the disease, conducts a full examination of the visual organs and the source of inflammation through a medical slit lamp. This is a necessary action to determine the rash of a specific nature, the etiology of tearing and the stage of the disease.

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.

Symptoms of different types of conjunctivitis

With any type of conjunctivitis, a person develops certain nonspecific symptoms, such as:

Swelling of the eyelids;
Swelling of the mucous membrane of the eye;
Redness of the conjunctiva and eyelids;
Photophobia;
lacrimation;
Pain in the eyes;
Feeling of a foreign body in the eye;
Discharge of mucous, purulent or mucopurulent nature.

Nonspecific signs

The symptoms listed above develop with any type of conjunctivitis and are therefore called nonspecific. Often, the symptoms of conjunctivitis are combined with symptoms of catarrh of the upper respiratory tract due to various respiratory infections, and a rise in temperature, headache and other indicators of intoxication (muscle pain, weakness, fatigue, etc.).

But in addition to nonspecific symptoms, different types of conjunctivitis are characterized by the appearance of specific indicators, which are determined by the properties of the factor that is a circumstance of the inflammatory process.

It is the specific symptoms that make it possible to differentiate different types of conjunctivitis on the basis of the clinical picture without special laboratory tests. Let us consider in detail what nonspecific and specific symptoms manifest different types of conjunctivitis.

Viral

This form of the disease can be suspected by the frequent occurrence of profuse lacrimation, accompanied by severe itching, which manifests itself against the background of cold symptoms and other lesions of the upper respiratory system caused by viruses, for example: adenoviruses, herpes, influenza. In this case, the disease is always accompanied by a sore throat, runny nose, and general malaise.

If conjunctivitis is caused by the penetration of an adenovirus, then at the very beginning of the disease, in addition to significant damage to the respiratory system, expressed in severe sore throat, nasal congestion, swelling of the mucous membranes of the oropharynx, the temperature rises, and the pre-auricular lymph nodes also noticeably enlarge.

Sometimes a spastic condition of the eyelids can be observed, which does not allow the eyes to open completely, while the eyelids are constantly practically closed. This condition may be accompanied by the appearance of a scanty amount of discharge, which, as a rule, does not contain pus.

Bacterial

In most cases, a disease of this type occurs when streptococci or staphylococci enter the body, entering the eyes along with dust, particles of dirt from the air, or when swimming in bodies of water with contaminated water.

Bacterial conjunctivitis is characterized by the formation of copious discharge from the eyes, which has a purulent structure. Often this form of the disease can become epidemic, for example, in child care institutions (preschool, sports, school), where your child is constantly in contact with other children.

If conjunctivitis is caused by pneumococci, this can be seen in the condition of the sclera. In this case, the white of the eyes is covered with small, pinpoint hemorrhages, and thin whitish-gray films are formed on its surface, which can be easily removed with a regular cotton swab.

When such films are removed from the surface of the eye, a reddened and rather loose conjunctiva without blood discharge is observed. In this case, the cornea may also be involved in the inflammation process, and small foci of inflammation, called infiltrates, are noted on it, which disappear after the disease is eliminated. Bacterial conjunctivitis is also epidemic in nature.

How to distinguish viral conjunctivitis from allergic?

The most common form of the disease is viral conjunctivitis. Therefore, if this disease is suspected, many people think that they have contracted conjunctivitis of viral origin. Distinguishing between allergic and viral conjunctivitis is actually not that difficult.

One of the features of the viral form of conjunctivitis is minimal swelling of the eyelids, while the allergic form is characterized by rather severe swelling. This sign of the disease is considered one of the main differences between different types of disease. Both allergic and viral conjunctivitis are characterized by discharge from the eyes. In both forms of the disease, the discharged contents are light in color. In the first case, the consistency of the discharge resembles viscous mucus. If you conduct a laboratory analysis, you can find eosinophils in it - a type of granulocytic leukocytes in the blood. When conducting a study, viral conjunctivitis can be distinguished by the presence of mononuclear cells in the discharged contents. The presence of mononuclear cells in a general blood test indicates an infectious disease of the body. Viral conjunctivitis has one characteristic difference. Only with this form of the disease do the patient’s lymph nodes become inflamed. Another symptom is a severe sore throat. Often the disease is accompanied by an increase in temperature, which is the body’s reaction to inflammatory processes occurring in the upper respiratory tract. For allergic conjunctivitis, such symptoms are unusual. Conjunctivitis of allergic origin differs from the viral form by severe itching, which persists throughout the entire duration of the disease.

A person’s desire to rub their eyes is associated with exposure to allergens that provoke irritation. By the way, itching is characteristic only of allergic conjunctivitis. With a viral infection, as with a bacterial infection, this symptom is not observed.

Diagnostic methods

Source: umedp.ru
To know how to cure conjunctivitis, it is necessary to conduct a thorough diagnosis of the disease, because each type requires a specific treatment method. Using diagnostics, the doctor determines the cause of the disease. The main diagnostic methods are:

Determination of causative microorganisms (bacteriological examination). By assessing the sensitivity of microbes to a number of antibiotics, it is possible to determine which bacteria and viruses are the causative agents of conjunctivitis.
This method is often used both before and after therapy if it does not give the desired result (which is possible when bacteria develop immunity to this type of antibiotic).
Setting up a polymerase chain reaction. As a result, DNA and RNA sequences characteristic of certain microbes that are pathogenic agents are determined.
Immunogram. Used for allergic reactions. Thanks to it, it is possible to determine the allergen, as well as the presence of certain immune disorders.

Diagnostics

To decide on treatment tactics, you need to make a correct diagnosis. This is done by an ophthalmologist; first he listens and records the patient’s complaints and collects anamnesis.

The doctor examines the patient's eyes using a special ophthalmological device - a slit lamp. He may also prescribe a cytological examination of a smear from the conjunctiva of the eye. It will show whether a virus or bacteria is the cause of the disease.

Another informative analysis is a bacteriological examination of a smear. It allows you to identify the presence of pathogenic flora. If one is detected, it is necessary to check how sensitive the patient is to different types of antibiotics.

General principles of treatment

Treatment depends on the cause of the disease. However, there are general principles of therapy that must be followed under all conditions. First of all, you need to seek medical help, because only a doctor can determine the cause of the disease and prescribe the necessary treatment. By self-medicating, you can not only fail to achieve recovery, but also transform the disease into a chronic form.

For severe pain

For severe pain, anesthetics are used - lidocaine, Trimecaine or Pirocaine drops. After this, the eyelids and eyelashes are treated with antiseptic solutions in order to clean them; Dimexide, Furacilin, etc. are used for this.

Conjunctivitis should be treated strictly in accordance with the doctor’s recommendations. Do not stop taking medications as soon as the symptoms of the disease subside. This can cause a sharp deterioration in the condition. This is the only way to reliably get rid of conjunctivitis and prevent unpleasant consequences.

Treatment for conjunctivitis includes regular eye rinsing. This can be done using a weak solution of potassium permanganate or tea leaves. Under no circumstances should you apply compresses or bandages on top. After all, this creates favorable conditions for the further proliferation of viruses and bacteria. The negative consequences do not end there; the inflammatory process can even spread to the cornea.

When taking the necessary treatment, you must strictly adhere to the recommended time intervals between using drops, applying ointment and rinsing. This is necessary to ensure that drops and other drugs do not interact with each other and reduce their therapeutic effectiveness.

Under no circumstances should you use just one eye tissue, especially if the conjunctivitis is unilateral. It's better to switch to disposable napkins. If the inflammatory process affects both eyes, when instilling the medicine, you need to use a separate pipette for each.

Drops for bacterial infections

Source: armoravto.spb.ru

Tobrex. Its eye drops contain the antibiotic tobramycin, which has a wide spectrum of antibacterial action. Active against Klebsiella, streptococcus, staphylococcus, diphtheria and Escherichia coli. In some cases, it can cause adverse reactions such as pain in the eyes, swelling and redness of the mucous membrane.
Dancil. The drops contain an antibiotic from the fluoroquinolone group - ofloxacin, which has a wide spectrum of action. The drug Dancil has the strongest antimicrobial effect on Haemophilus influenzae, Chlamydia, Proteus, Enterobacteriaceae, Pseudomonas, Streptococcus and Staphylococcus. Possible adverse reactions: photophobia, dry eyes, blurred vision.
Levomycetin. This is a broad-spectrum antimicrobial drug. May sometimes cause allergic reactions. If chloramphenicol for the eyes is taken for a long time, a failure of the hematopoietic function may occur with the development of leukopenia and thrombocytopenia (decrease in the number of leukocytes and platelets in the serum).
Phloxal. Belongs to the group of fluoroquinolones. One of the most popular drugs in ophthalmic practice. It helps well in the treatment of conjunctivitis caused by Escherichia coli, spirochete pallidum, chlamydia, streptococci, Klebsiella, etc. It acts quickly. After instillation, the effect develops within 10-15 minutes. Lasts up to 6 hours.
Oftaquix. The active component of this drug is the antibiotic levofloxacin from the fluoroquinolone group. Characterized by a wide spectrum of activity. In case of individual intolerance, it can cause contact eczema and an allergic reaction with photophobia, burning, itching and lacrimation. Rarely, may cause eye pain and decreased visual acuity.
Albucid. The basis of the drug is sulfacetamide, an antimicrobial drug from the sulfonamide group. It has a bacteriostatic effect (that is, it does not kill microorganisms, but suppresses their growth and reproduction). Can be used as an ambulance for conjunctivitis. Possible side effects: swelling of the eyelids, burning or itching in the eyes.

Differences between viral and bacterial conjunctivitis

Treatment of any type of eye disease is carried out after confirmation of the correct diagnosis. Due to the similarity of symptoms, the bacterial form is often confused with infectious conjunctivitis

Therefore, for the correct prescription of medications, it is important to accurately determine the type of infectious agent. This can be done by analyzing indirect signs.

Viral pathology of the organs of vision	Bacterial type of inflammation
The causative agent of infection is viruses	The culprit of the problem is bacteria
The inflammation process usually develops gradually and affects the conjunctiva of only one eye	Signs of damage to the mucous membrane start in one eye with a rapid transition to the other
The disease begins with an increase in redness of the eye shell, accompanied by tearing	Symptoms of redness and tearing are minimal. A striking manifestation is an abundance of purulent discharge
Exudate from the eyes is transparent, although it may cause eyelashes to stick together.	Opaque mucus with an abundance of purulent secretion leads to sour eyes after sleep

Medical statistics report that almost 80% of inflammations of the eye membrane are of the viral type of ophthalmia. Delayed or inadequate treatment of viral conjunctivitis leads to the development of a bacterial form of inflammation.

Drops for viral infections

Oftalmoferon - simultaneously has both antiviral and antibacterial activity. Thus, it can be used to prevent secondary bacterial infection of the eye. It has a pronounced immunomodulatory and anti-inflammatory effect.

Its ability to stimulate the regeneration of eye tissue has been identified. In addition, it has a mild anesthetic property, which helps eliminate pain, burning and other symptoms of conjunctivitis. As for side effects, sometimes a short-term burning sensation may occur immediately after instillation.

Poludan is especially effective for the treatment of herpetic and adenoviral conjunctivitis. The mechanism of action is based on the induction of immune defense factors in the tear fluid. After instillation, it is quickly and evenly distributed in tissues.

It can cause a number of adverse reactions: itching, burning, congestion of the scleral vessels. In some cases, it can cause increased intraocular pressure and minor hemorrhages. However, all unwanted reactions disappear within a couple of days.

Okoferon is one of the most powerful antiviral and immunomodulatory drugs. Quickly and effectively eliminates the main symptoms of conjunctivitis.

Actipol induces the production of interferon (an immune defense factor). It has an immunomodulatory, antioxidant and radioprotective effect, accelerates the healing process of the cornea. Sometimes it can cause redness of the conjunctiva.

Symptoms of viral conjunctivitis

a large amount of tear fluid;
photosensitivity, fear of bright light;
purulent discharge;
swelling of the eyelid;
severe burning and itching;
clouding of the lens of the eye;
the infection usually spreads to only one eye (in rare cases, both).

The viral type is less dangerous and less common. If such a diagnosis was made during the examination, you should not worry too much and panic. It can be treated quite simply and quickly with Actipol or Poludan eye drops. But it is more difficult to diagnose. A PCR reaction can be performed to detect the DNA of the virus.

Drops for allergic reactions

Allergodil. The drug has a powerful and long-lasting antiallergic effect. Quickly relieves the condition, eliminating such unpleasant symptoms as itching, lacrimation and burning in the eyes. Well tolerated. Immediately after administration, it may cause a short-term increase in symptoms of the disease. However, after a few minutes everything goes away. Adverse reactions are rare.
Lecrolin. Designed to relieve symptoms of allergic inflammation of the conjunctiva. Suitable for long-term use, which is important for people suffering from a chronic form of the disease. Allows you to avoid the prescription of corticosteroid drugs. Immediately after instillation, short-term eye irritation may occur, which will manifest itself as tingling or burning.
Cromohexal. It has a pronounced anti-edematous effect and also eliminates dryness and itching. The maximum therapeutic effect occurs a few days after the start of use. Can be used as a means of preventing exacerbations of chronic allergic conjunctivitis. After instillation, a short-term deterioration in vision may occur.
Opatanol. An antihistamine, which can be used without consequences for a long time, perfectly and quickly eliminates swelling of the conjunctiva, itching, lacrimation and other unpleasant symptoms. Among the adverse reactions, it is worth highlighting dizziness, dry mucous membranes, headache, and a short-term increase in the symptoms of conjunctivitis.

Ointments for conjunctivitis

Source: linza.guru
The number of drugs, as well as the order and time intervals for using drugs, is individually prescribed by the doctor, depending on the degree of development of the pathological process. Conjunctivitis of bacterial origin is recommended to be treated:

Tetracycline ointment. When used locally, the effect occurs directly on the site of the disease, which is the safest and most effective when used for a child under 8 years of age.
A common remedy for conjunctivitis is Erythromycin ointment, which copes well with microbial lesions of the mucous membrane of the eyes. This is an antibiotic from the macrolide group and can be used in children from birth.
Torbex is a broad-spectrum antibiotic and is used not only for infectious conjunctivitis, but also for other eye diseases.
The combined ointment Eubetal acts comprehensively in several directions and has antiallergic, anti-inflammatory and antibacterial effects.
Colbiocin is also a combination drug that has a therapeutic effect simultaneously for several causes of the pathological process.

With a viral form

Before using ointments for viral conjunctivitis, it is recommended to visit a doctor and clarify the origin of the inflammatory process so that the doctor can prescribe the correct course of treatment.

Before applying any product to the mucous membrane, you should rinse your eyes with a chamomile decoction or an infusion of black tea without additives, drip Albucid or other prescribed drops. After 20-30 minutes you can apply the ointment.

Tebrofen ointment helps with a variety of viral infections of the conjunctiva; it is available in 10 gram tubes.
Florenal - used for viral lesions of adenoviral and herpetic origin.
Bonafton is also an antiviral eye ointment, effective against the herpes virus and adenovirus.

In combination with antiviral ointments, antibacterial agents (Erythromycin or Tetracycline) can be prescribed to prevent secondary infection, as well as antiallergic drugs in the form of drops. In some cases of herpetic conjunctivitis, additional medications may be prescribed: Virolex, Zovirax, Acyclovir.

For allergic form

All ointments for the treatment of allergic conjunctivitis are hormonal with the addition of antiallergic or antibacterial agents:

Maxidex is used for non-purulent allergic conjunctivitis, it contains Dexamethasone. This drug is contraindicated for treatment in children.
Tobradex is an effective anti-inflammatory and antiallergic agent. The ointment contains antihistamines, antibacterial and hormonal drugs. Do not use during pregnancy, breastfeeding or children of any age.
Dexa-Gentamicin is a combination drug. It is contraindicated in children under 18 years of age, with tuberculosis and fungal eye infections.
Garazon and Cortineff are hormonal drugs and have a deep anti-inflammatory effect in acute processes.

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.

Folk remedies

Lotions made from chamomile decoction will be effective in the treatment of infectious diseases: three tablespoons of flowers are brewed in a glass of boiling water, left to infuse for an hour. Apply a cloth soaked in the infusion to the inflamed eyelids.

Propolis ointment

Propolis, from which an ointment is prepared, actively fights viruses by mixing 6 g of crushed product with 100 g of petroleum jelly. Keep in a water bath for some time for better dissolution. The finished ointment should have a resin-like consistency. It is applied to the edge of the diseased eyelid and the remains are removed after 6 hours. You can re-use the product after the eyelids have rested overnight.

Sawdust from old pine resinous stumps is poured into a chintz bag and placed near the pillow. The benefits of inhaling pine resin are great: symptoms of inflammation will decrease, itching and burning in the affected area will calm down, and lacrimation will stop.

An infused and strained decoction of millet cereal, a tablespoon of which is boiled in a glass of water for fifteen minutes, is used to wash the eyes in the morning. This remedy is recommended for young children when there is an exacerbation of the bacterial inflammatory process on the eyelids.

Consequences

Source: glazam.info
Most forms of conjunctivitis, after eliminating the cause, go away on their own within a few days or weeks. The disease is critical in newborns. With gonococcal infection, which is very rare in our time, the newborn's vision may be lost without treatment.

Conjunctivitis caused by chlamydia is characterized by very slow progress. If left untreated, long-term effects may occur on the cornea and the inside of the upper eyelid.

Diagnosis of conjunctivitis based only on redness of the eyes may be erroneous: the main cause may be inflammation of other parts of the eyes (iris, cornea, eye muscles, eyelids, etc.).

Redness also occurs due to injury to the cornea. In the case of acute onset of glaucoma, due to a sudden increase in pressure inside the eye, redness occurs, accompanied by pain, blurred vision, nausea and vomiting. A misdiagnosis can be fatal: in the absence of urgent therapeutic measures, blindness can develop within a few hours.