CONJUNCTIVITIS

• Inflammation of the conjunctiva (conjunctivitis) is classically defined as conjunctival hyperaemia associated with a discharge which may be watery, mucoid, mucopurulent or purulent. It is most commonly caused by viruses or bacteria but can also have non infectious (allergic) causes
• A person experiencing the following features can be suggestive of conjunctivitis (pink eye)
  • A gritty feeling in one or both eyes
  • Itching or burning sensation
  • Excessive tearing
  • Discharge
  • Swollen eyelids
  • Pink discolouration to the whites of one or both eyes
  • Increased sensitivity to light

• Bacteria- Caused by diplococcus pneumonia or staphylococcus aureus
• Viruses - Adenovirus conjunctivitis, Herpes simplex conjunctivitis
• Allergy- Caused by sensitivity to pollens, drugs or cosmetics
• Toxic substances

Types of Conjunctivitis

Common types of conjunctivitis include:

Infective conjunctivitis

Bacterial conjunctivitis

• Acute bacterial conjunctivitis
• Chronic bacterial conjunctivitis
• Angular bacterial conjunctivitis

Chlamydial conjunctivitis

• Trachoma

Viral conjunctivitis

• Adenovirus conjunctivitis
• Herpes simplex conjunctivitis

Ophthalmia neonatorum(A separate entity)

Granulomatous conjunctivitis

Allergic Conjunctivitis

• Simplex allergic conjunctivitis
• Vernal keratoconjunctivitis(VKC)
• Atopic keratoconjunctivitis
• Giant papillary conjunctivitis (GPC)
• Phlyctenular conjunctivitis (PKC)
• Contact dermoconjunctivitis(drop conjunctivitis)

Cicatricial conjunctivitis.

Toxic conjunctivitis

Bacterial Conjunctivitis

• The predominant sign is a yellow mucus discharge
• No pain or blurring of vision
• If untreated, it usually lasts about two weeks
• Antibiotic drops or ointment - clear the infection in 2 or 3 days

Viral Conjunctivitis

• May or may not be associated with a cold
• Can cause tearing, but not much yellow mucus
• Infection usually passes in about 10 days

Allergic Conjunctivitis

• Commonly associated with hay fever
• Symptoms include itching, tearing and redness and can last as long as the allergen is present
• Symptoms are seasonal or year-round

• History and Eye examination - This should include staining the eyes, testing acuity, checking the anterior chamber for clarity (with an ophthalmoscope) and everting the lids to look for foreign bodies
• Swabs for bacterial culture - if the history and signs suggest bacterial conjunctivitis
• A viral culture may be appropriate in epidemic case clusters
• Patch test -in allergic conjunctivitis to identify the causative allergen
• Conjunctiva scrapes for Cytology -Chlamydial and Fungal infections, Allergy, and Dysplasia
• Conjunctival Incisional Biopsy- Occasionally done when granulomatous diseases (e.g., sarcoidosis) or dysplasia are suspected

• Topical antibiotics -positive bacterial culture results, those with mucopurulent discharge and eye pain, suspected cases of chlamydial and gonococcal conjunctivitis
• Allergic conjunctivitis- Antihistamines, mast cell inhibitors, topical steroids (in selected cases)
• Steroids

Ayurvedic Treatment

• Special attention to visual acuity
• Advice to avoid a head bath, sour and spicy foods

Internal medicines

• Guduchyadi Kashaya
• Panchatikthaka kashaya
• Avipathi Choorna - with hot water/honey HS
• Kaisora guggulu
• Indukantha gritha – in Allergic Conjunctivitis
• Rajanyadi choornam – in Allergic Conjunctivitis
• Haridra khandam – in Allergic Conjunctivitis
• Dooshivishari gutika - – in Allergic Conjunctivitis

Procedures

• Purambada - Mukkadigulika + milk in redness and swelling
• Netraseka - Darvi/ Yasti/ Triphala kashaya , Mridveekadi kashaya
• Aschotana - Chandanadi varti , Mridveekadi kashaya
• Jaloukavacharana- forehead
• Clean the eyes with cotton soaked in Triphala kashaya – in Discharge