Conjuctivitis.pptx

Conjunctivitis, commonly known as pink eye, is an inflammation of the conjunctiva, the thin, transparent tissue that covers the front surface of the eye and lines the inside of the eyelids. Conjunctivitis can be caused by various factors, including infections, allergies, and irritants, leading to different types of conjunctivitis that require specific management and therapy.
Infectious conjunctivitis is often caused by bacteria or viruses. Bacterial conjunctivitis typically presents with redness, discharge, and crusting of the eyelids. It is commonly treated with topical antibiotics to eliminate the bacterial infection. On the other hand, viral conjunctivitis is caused by a viral infection and tends to be self-limiting, with symptoms like redness, watery discharge, and sensitivity to light. Management for viral conjunctivitis involves supportive care, such as cold compresses and lubricating eye drops, to alleviate discomfort while waiting for the infection to resolve.
Allergic conjunctivitis occurs when the eyes react to allergens, such as pollen, pet dander, or dust mites. It results in itching, redness, watery discharge, and swollen eyelids. Antihistamine eye drops or oral antihistamines can help relieve symptoms by reducing the allergic response. In some cases, mast cell stabilizers or corticosteroid eye drops may be prescribed to control severe allergic reactions.
Other specific types of conjunctivitis include giant papillary conjunctivitis, which is often associated with contact lens use or ocular prosthetics, and vernal conjunctivitis, a chronic allergic condition primarily affecting young people. These types may require a combination of treatments, including avoiding the triggering factors, using lubricating eye drops, and, in severe cases, prescribed medications like mast cell stabilizers or topical steroids.
Additionally, conjunctivitis can be caused by exposure to irritating substances, such as chemicals or smoke, leading to chemical conjunctivitis. The primary management for this type involves thoroughly rinsing the eyes with clean water or saline solution to flush out the irritants.
In all cases, practicing good hygiene measures, such as frequent hand washing and avoiding touching the eyes, can help prevent the spread of infectious conjunctivitis.
It is important to consult an eye care professional for an accurate diagnosis and appropriate management of conjunctivitis. They can provide personalized recommendations and prescribe the most suitable therapy based on the type and severity of the condition, with the goal of relieving symptoms, promoting healing, and preventing complications.

1. CONJUNCTIVITIS Dr.Navaneethakrishnan PharmD ., Assistant Professor Department of Pharmacology

2. INTRODUCTION Conjunctivitis is the inflammation of the conjunctiva . The conjunctiva is a thin membrane that covers the inner surface of the eyelid and the white part of the eyeball (sclera). Inflammation of the conjunctiva is called conjunctivitis, which makes the white of the eye appear to red . When small blood vessels in the conjunctiva become inflamed, they’re more visible. This is what causes the white of the eyes to appear reddish or pink. It is also known as “PINK EYE”

3. Conjunctivitis - I nflammation of the conjunctiva

4. Risk factors Exposure to something for which the person have an allergy (allergic conjunctivitis). Exposure to someone infected with the viral or bacterial form of conjunctivitis. Using contact lenses frequently. Microbial infection (chlamydia, fungus, etc.,).

5. Causes Viral conjunctivitis : Adenovirus, HSV. Bacterial conjunctivitis : Staphylococcus aureus, Staphylococcus pneumoniae , Haemophilus influenza, Chlamydia trachomatis. Allergic conjunctivitis : Pollen, perfumes, cosmetics, smoke, dust. Chemical conjunctivitis : Acid or alkali’s.

6. Types of Conjunctivitis Viral and Bacterial conjunctivitis : Viral and Bacterial conjunctivitis may affect one or both eyes . Viral conjunctivitis usually produces a watery discharge . Bacterial conjunctivitis often produces a thicker yellow-green discharge . Both Viral and Bacterial conjunctivitis can be associated with colds or with symptoms of a respiratory infection, such as a sore throat .

7. Types of Conjunctivitis Viral Conjunctivitis Bacterial Conjunctivitis

8. Viral and Bacterial Conjunctivitis Both viral and Bacterial conjunctivitis are very contagious. They are spread through direct or indirect contact with the eye secretions of someone who’s infected. Adults and children alike can develop both of these types of pink eye. However, bacterial conjunctivitis is more common in children than it is in adults.

9. Allergic Conjunctivitis Allergic conjunctivitis affects both eyes and is a response to an allergy causing substance such as pollen . Most allergic conjunctivitis can be controlled with allergy eye drops .

10. Toxic Conjunctivitis ( Chemosis ) Toxic conjunctivitis typically occurs with constant use of topical ocular medications . The reaction may take days to years to develop. There also appears to be a dose response effect with regard to the preservative concentration and total amount of preservative containing medications used. It implies direct damage to ocular tissues from an offending agent, usually a preservative or medication.

11. Conjunctivitis - Pathophysiology Microbes enter into the eye on contact with infected objects Inflammation of the eye Dilation of the blood vessels in eye Swelling, Redness, exudates and discharge

12. Signs and Symptoms Tenderness of the eye, pain, Swelling, Itchiness, Body aches, Photophobia, Fever, Sore throat, Runny nose. Redness of the eye or inner eyelids (hyperemia). Discharge and tear ( epiphora ). Drooping of upper eyelid. Infection usually begins with one eye, but can quickly spread to other eye in cases of viral or bacterial conjunctivitis.

13. Diagnostic tests History collection Physical examination Culture of secretions Conjunctival incisional biopsy . Conjunctival scrapes for cytology (rarely done) – detecting chlamydia and fungal infections.

14. Treatment The management of conjunctivitis depends on the type . Most types of mild and viral conjunctivitis are self-limiting, benign conditions that may not require treatment and laboratory procedures.

15. Bacterial conjunctivitis If the infection is bacterial, the doctor may prescribe antibiotic eye drops as pink eye treatment, and the infection should go away within several days. Antibiotic eye ointment , in place of eye drops, is sometimes prescribed for treating bacterial pink eye in children. An ointment is often easier to administer to an infant or young child than are eye drops, though the ointment may blur vision for up to 20 minutes after application.

16. Bacterial conjunctivitis With either form of medication, expect signs and symptoms to start getting better in a few days. Topical antibiotics Fluoroquinolones, sodium sulfacetamide or trimethoprim for 7 to 10 days.

17. Viral conjunctivitis There is no treatment for most cases of viral conjunctivitis. Instead, the virus need time to run its course – up to two or three weeks. Viral conjunctivitis often begins in one eye and then infects the other eye within a few days. The signs and symptoms should gradually clear on their own . Antiviral medications may be an option if the doctor determines that the viral conjunctivitis is caused by the Herpes Simplex Virus ( HSV ).

18. Allergic conjunctivitis If the irritation is allergic conjunctivitis, the doctor may prescribe on of many different types of eye drops for people with allergies. These may include medications that help control allergic reactions, such as antihistamines or drugs that help control inflammation, such as steroids and anti inflammatory drops. The patient may also reduce the severity of allergic conjunctivitis symptoms by avoiding whatever causes the allergies when possible.

19. According to Indian Standard Treatment Guidelines Ophthalmology Type Management Viral conjunctivitis Advice the patient to clean the eye by washing with normal saline frequently. Cold compression. Topical anti- histaminics Frequent application of preservative free artificial tears. Topical antibiotics in cases of suspected secondary bacterial infection. Severe inflammation, presence of sub-epithelial infiltrate, presence of membranes and pseudo membranes may necessitate a short course of topical steroids. Herpetic conjunctivitis to be treated with topical acyclovir eye ointment.

20. Type Management Bacteri al conjunctivitis Chloramphenicol 0.5%eye drops Ciprofloxacin 0.3%eye drops Intensive instillation every 15 to 30 min until symptoms and signs are reduced and gradually tapered. Allergic conjunctivitis Cold compression and ocular lubricants. Topical and systemic anti- histaminics . Topical mast-stabilizer Topical NSAIDs Topical steroids in short pulses Chemical conjunctivitis Stop instilling the substances that has caused the reaction. Lubricant ointment can be soothening . Mild topical antibiotics like chloramphenicol will prevent secondary bacterial infection.

21. Type Management Chlamydial conjunctivitis In Neonates Topical tetracycline1% or erythromycin ointment twice daily for 2 months. Oral tetracycline1.5-2gm daily in divided doses for 2 weeks or oral azithromycin single dose or erythromycin50mg/kg in four divided doses for 2weeks In Adults Oral azithromycin 1g single dose or doxycycline100mgBD for 7 days or tetracycline250mgqid for 7days or erythromycin 500mg qid for 7 days. Gonococcal conjunctivitis In Neonates I M Ceftriaxone 25-50mg/kg single dose In Adults I M Ceftriaxone 1g single dose. I M Spectinomycin 2g single dose. Chloramphenicol 1%eye ointment Use normal saline or cooled boiled water. Initially continuous irrigation will be needed.

22. Lifestyle modifications Apply a hot compress to the eyes. Stop wearing contact lenses. Reduce exposure to light. Prevent rubbing of the eye. Clean the eye using sterile water and cotton swabs, from inner canthus to outer canthus. Use of dark sunglasses is advised, in presence of photophobia.

23. Prevention Don’t touch your eyes with your hands. Wash your hands often. Use a clean towel and wash cloth daily. Don’t share towels or washcloths. Change your pillow cases often. Don’t use eye cosmetics. Don’t share eye cosmetics or personal eye care items.

24. Thank you 