Thursday, July 19, 2012

Conjunctivitis, a monsoon malady


Monsoon is here, and so is conjunctivitis. Experts tell Zeenia F Baria how to combat this illness

Cornea, cataract and lasik surgeon Dr Kavita Rao says that conjunctivitis is an inflammation or infection of the conjunctiva, the thin transparent layer of tissue that lines the inner surface of the eyelid and covers the white part of the eye. "It is is a common eye disease and may affect one or both eyes. Some forms of conjunctivitis can be highly contagious and easily spread. While it is usually a minor eye infection, sometimes it can develop into a more serious problem. It may be caused by a viral or bacterial infection, and can also occur due to an allergic reaction to irritants in the air like pollen and smoke, chlorine in swimming pools, and ingredients in cosmetics or other products that come in contact with the eyes."

Consultant ophthalmologist Dr Keiki R Mehta has warned that conjunctivitis could assume epidemic proportions since it is spreading quickly across the state. "The last two weeks have witnessed an increase in the number of conjunctivitis cases in Mumbai. While cases are reported during the rainy season every year, this year, the occurrence is manifold.

Conjunctivitis is highly contagious and spreads if a non-infected individual comes in contact with a person suffering from conjunctivitis or touches an object that has been touched by such a person after wiping his eyes. Wearing a pair of goggles helps as it acts as a barrier in rubbing the eyes and makes the patient more tolerant," says Dr Mehta.

What causes conjunctivitis
The cause varies depending on the offending agent...

Allergic conjunctivitis
This occurs commonly among people, who already have seasonal allergies. At some point they come in contact with a substance that triggers an allergic reaction in their eyes. Giant Papillary Conjunctivitis is a type of allergic conjunctivitis caused by the chronic presence of a foreign body in the eye. This condition occurs pre-dominantly with people who wear soft contact lenses that are not replaced frequently.

Bacterial conjunctivitis
This is an infection often caused by staphylococcal or streptococcal bacteria from your own skin or respiratory system. Infection can also occur by transmittal from insects, physical contact with other people, poor hygiene (touching eyes with unclean hands) or by use of contaminated eye make up and facial lotions.

Viral conjunctivitis
This is most commonly caused by contagious viruses associated with the common cold. The primary means of contracting this is through exposure to coughing or sneezing by persons with upper respiratory tract infections. It can also occur as the virus spreads along the body's own mucous membranes connecting lungs, throat, nose, tear ducts, and conjunctiva.

Chemical conjunctivitis
This can be caused by irritants like air pollution, chlorine in swimming pools, and exposure to noxious chemicals.

Usually, conjunctivitis starts from one eye. Although it is not life threatening, patients should not be allowed to attend school or office, as they may pass on the infection to others. "Self-medication should never be attempted. People should consult an eye specialist instead of buying medicine off the counter. The treatment includes use of antibiotics and astringent eye drops," adds Dr Mehta. Steroid eye drops available off the counter are commonly used to treat conjunctivitis. "These can lead to corneal ulcers and blindness and should never be used in this infection. Conjunctivitis is caused either by entero virus or adeno virus. While the adeno virus causes haemmorhagic conjunctivitis, which we are seeing in 10 to 20 per cent of the cases, the entero virus causes pharyngo conjunctival fever, which includes sore throat, fever and conjunctivitis," he says.
Dr Rao adds that treatment of conjunctivitis has three main goals — to increase patient comfort, to reduce or lessen the course of the infection or inflammation and to prevent the spread of the infection in contagious forms of conjunctivitis. "Contact lens wearers may need to discontinue wearing lenses while the condition is active. Your doctor can advise you on the need for temporary restrictions on contact lens wear. If conjunctivitis developed due to wearing contact lenses, your eye doctor may recommend that you switch to a different type of lens or disinfection solution," she says.

Symptoms
- A gritty feeling in one or both eyes
- Itching, redness or burning sensation in one or both eyes
- Excessive tearing
- Discharge from one or both eyes
- Swollen eyelids
- Pink discolouration to the whites of one or both eyes
- Increased sensitivity to light
- Irritation and heaviness of eyes, and sensitivity to light.

What to do
- Isolate personal belongings such as tissues, soap, towel and pillow cases.
- Use disposable tissues instead of handkerchiefs or towels to dab eyes.
- Wash your hands thoroughly and frequently.
- Gently dab tears at eye corners to prevent hemorrhages or red spots.
- Avoid touching your eyes with your hands and don't use eye cosmetics.
- Soothe discomfort of viral or bacterial conjunctivitis by applying warm compresses to the affected eye. To make the compress, soak a clean cloth in warm water and wring it out before applying it gently to your closed eyelids.
- For allergic conjunctivitis, avoid rubbing your eyes. Instead of warm compresses, use cool compresses to soothe your eyes.
- See your ophthalmologist to help diagnose the cause and the proper course of action. Do not self medicate.