Conjunctivitis

Introduction

In conjunctivitis, the conjunctiva of the eye is inflamed or irritated. The inflammation is caused by an infection with bacteria or viruses (more rarely with fungi) and is highly contagious. However, conjunctivitis can also occur due to allergies or diseases such as rheumatism. In these cases, conjunctivitis is not contagious.

Conjunctivitis is one of the most common eye diseases and occurs more frequently in children. Typical symptoms of conjunctivitis are reddened, sometimes burning eyes and itching. Conjunctivitis caused by bacteria or viruses usually heals on its own. Treatment with medication is not necessarily required. Conjunctivitis can occur in one or both eyes at the same time.

Symptoms

The typical symptoms of conjunctivitis are reddened and burning eyes. The symptoms can be unilateral or affect both eyes at the same time. Other symptoms of conjunctivitis can include itching, increased tearing, a foreign body sensation or sticky eyes due to discharge.
The severity of the symptoms depends on the cause of the conjunctivitis. In the case of a bacterial or viral infection, a watery, mucous or purulent secretion of the body's substances - so-called secretions - is typical. This secretion is responsible for the eyelids becoming sticky in the morning.

In the case of conjunctivitis caused by an allergy or a disease such as rheumatism, the symptoms take the form of increasingly watery, burning and itchy eyes as well as a foreign body sensation. In these non-infectious cases, the eye does not normally secrete any secretions. However, the conjunctiva may be particularly swollen in these inflammations.

Progression

Conjunctivitis is usually mild and heals without any consequences for the eye or vision. The incubation period is five to twelve days. The infection usually subsides on its own after five to seven days; occasionally an infection lasts up to three weeks. If the infection actually lasts longer than seven days, it is advisable to seek medical advice. If conjunctivitis lasts longer, those affected should notice a daily improvement.

Cases with a severe course are rare; however, they can affect vision and the cornea. The duration of conjunctivitis varies - it can range from a few days to a few weeks. If the conjunctivitis is caused by a bacterial or fungal infection, medication can speed up the healing process.

Causes

As a rule, conjunctivitis is caused by an infection with pathogens - these can be bacteria, viruses and, in rare cases, fungi. These forms of conjunctivitis are contagious. If allergies or external stimuli (e.g. irritants) are responsible for inflammation, conjunctivitis is not contagious.

In the case of bacterial inflammation, pathogens such as pneumococci, staphylococci, gonococci, chlamydia or Haemophilus influenzae are responsible. Viral inflammation is caused by adenoviruses or herpes viruses. However, the viruses responsible for measles, chickenpox or rubella can also trigger conjunctivitis in the course of the corresponding illness.

However, conjunctivitis is often also caused by an allergy. Conjunctivitis is caused by hypersensitivity to certain substances.

Diagnosis

In principle, conjunctivitis can be easily diagnosed based on the typical symptoms and complaints (red, burning and itchy eye, foreign body sensation, increased lacrimation). For the diagnosis, it is also important for the doctor to know whether only one eye or both eyes were affected at the beginning. In the case of unilateral inflammation, an infection is more likely. Conjunctivitis can be treated well by telemedicine - especially if images are available for a diagnosis.

Treatment by a specialist is necessary if the following symptoms occur: Visual disturbances, sensitivity to light, pain in the eye, facial pain or headaches, enlarged or reduced pupil on one side as well as in the case of an already diagnosed increased intraocular pressure (glaucoma). Contact lens wearers are also more likely to develop a serious infection that can affect other parts of the eye, such as the cornea. Consultation with a specialist is therefore recommended.

Treatment & therapy

How conjunctivitis is treated depends on its cause:

Viruses: Adenoviruses are the most common cause of conjunctivitis. There is no effective medication against these viruses. However, as mild conjunctivitis usually heals on its own, no medication is necessary. Conjunctivitis is rarely caused by herpes simplex viruses (the causative agent of cold sores) or herpes zoster viruses (the causative agent of varicella and shingles). In these cases, treatment with antiviral medication is necessary to prevent secondary damage.

Bacteria: Bacterial infections also usually clear up without treatment within five to seven days (80 % of cases) - almost all infections are cured after 15 days. By taking antibiotics in the form of eye drops, however, the symptoms disappear within one to two days. In rare cases, chlamydia or gonococci are the cause of conjunctivitis. Both types of bacteria can infect the reproductive organs, trigger inflammation and damage organs. As a rule, these bacteria must be treated with antibiotics for several weeks.

Allergies: If the cause of conjunctivitis is an allergy, the allergy triggers should be identified or avoided and anti-allergic medication taken (e.g. eye drops).
Regardless of the cause of the inflammation, compresses help to relieve the burning and itching. The eyes can also be washed with boiled black tea, or diluted black tea if necessary: The ingredients in the tea have an anti-inflammatory effect and soothe the symptoms. Eye rinses with physiological saline solution can also help to alleviate symptoms, as they remove pathogens and allergens. Artificial tears in the form of eye drops or eye gels (without preservatives) can also be used. Contact lens wearers who suffer from conjunctivitis should not wear contact lenses until the infection has completely cleared up and should also sterilise or throw away the lenses.

Prevention

Conjunctivitis is highly contagious, unless the cause is an allergy or other illness. To prevent infection, people with the disease should avoid public places such as schools or nurseries as much as possible. Hygiene is also very important: both affected and healthy people should wash their hands frequently and carefully and not share towels or flannels. Sick people should also touch their eyes as little as possible.