6 November 2017

Rwanda: Understanding Conjunctivitis

Conjunctivitis, also called "pinkeye", is defined as an inflammation of the conjunctiva. The conjunctiva is the thin membrane that lines the inner surface of the eyelids and the whites of the eyes. Conjunctivitis can affect children and adults. The most common symptoms of conjunctivitis include a red eye and discharge.

There are many potential causes of conjunctivitis, including bacterial or viral infections, allergies, or a non-specific condition (e.g., a foreign body in the eye). All types of conjunctivitis cause a red eye, although not everyone with a red eye has conjunctivitis.

Conjunctivitis can be of viral, bacterial, allergic, or non-specific causes. Most cases of infectious conjunctivitis are viral in adults and children. However, bacterial conjunctivitis is more common in children than in adults.

Viral conjunctivitis is typically caused by a virus that can also cause the common cold. A person may have symptoms of conjunctivitis alone, or as part of a general cold syndrome, with swollen lymph nodes (glands), fever, a sore throat, and runny nose.

Both bacterial and viral conjunctivitis are highly contagious. It is spread by contact, usually with objects which have come into contact with the infected person's eye secretions. As examples, the virus or bacteria can be transmitted when an infected person touches their eye and then touches another surface (eg, door handle) or shares an object that has touched their eye (eg, a towel or pillow case).

Allergic conjunctivitis is caused by airborne allergens ( a substance that causes an allergy to someone) that come in contact with the eye. Symptoms (most commonly redness, watery discharge, and itching of both eyes) may be sudden in onset (acute), seasonal, or present year-round (perennial), depending upon the allergen.

The diagnosis of conjunctivitis most often requires an examination by a healthcare provider or eye care specialist because many conditions can cause eye redness some of which may be more threatening one one's eye.

The treatment of conjunctivitis depends upon the cause one should visit an eye specialist or seek proper medical care before treatment.

Various eye drops may help to relieve the irritation of viral conjunctivitis. These drops are available without a prescription in most pharmacies. However, particular care must be taken to avoid spreading viral infections from one eye to the other. Apply drops only to affected eye and wash hands thoroughly after application. Similar to cold medicines, this treatment may reduce the symptoms but does not shorten the course of the infection. Another option is to use warm or cool compresses, as needed.

The irritation and discharge may get worse for three to five days before getting better, and symptoms can persist for two to three weeks.

Bacterial conjunctivitis is usually treated with an antibiotic eye drop or ointment. When started early, treatment helps to shorten the duration of symptoms, although most cases do resolve spontaneously if no treatment is used.

Bacterial and viral conjunctivitis are both highly contagious and spread by direct contact with secretions or contact with contaminated objects. Simple hygiene measures can help minimize transmission to others.

Adults or children with bacterial or viral conjunctivitis should not share handkerchiefs, tissues, towels, cosmetics, or bed sheets/pillows with uninfected family or friends. Hand washing is an essential and highly effective way to prevent the spread of infection. Hands should be wet with water and plain soap, and rubbed together for 15 to 30 seconds. It is not necessary to use antibacterial hand soap. Teach children to wash their hands before and after eating and after touching the eyes, coughing, or sneezing.

Alcohol-based hand rubs are a good alternative for disinfecting hands if a sink is not available. Hand rubs should be spread over the entire surface of hands, fingers, and wrists until dry, and may be used several times. These rubs can be used repeatedly without skin irritation or loss of effectiveness.

Dr. Ian Shyaka is a General Practitioner at Rwanda Military Hospital

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