Ophthalmologist "SM-Doctor" spoke about the course of conjunctivitis in children

Peculiarities

The thin mucous film lining the surface of the sclera is called the conjunctiva and is designed to moisturize the dome of the eyeball, as well as to protect the visual organ from pathogenic microflora and aggressive environmental influences. However, if the negative influence from the outside turns out to be quite strong, then the membrane becomes inflamed, revealing signs indicating a disease - conjunctivitis.

The disease can occur at any age, even in newborns when passing through the mother's birth canal if she is infected. The disease itself is not dangerous, but it has a high risk of infection and complications that arise in the absence of proper treatment.

Diagnosis of conjunctivitis

If symptoms of conjunctivitis occur, the child should be seen by a qualified ophthalmologist.

At the initial appointment, the specialist carefully listens to the complaints of the patient and his parents, studies the medical history in detail to identify the possible cause of the disease. To do this, the doctor checks whether the child has allergic reactions, previous infections, contacts with patients, etc. Then the ophthalmologist proceeds to examine the cornea and conjunctiva to detect characteristic signs of the disease. After a preliminary diagnosis has been made, the patient is referred for additional studies to confirm it and determine the nature of the disease.

The following diagnostic methods are performed at the SM-Doctor clinic for children and adolescents:

• scraping and smear from the conjunctiva of the eye for microbiological and cytological examination;
• taking a general blood test;
• carrying out allergy tests.

Other studies are prescribed according to indications.

Based on the test results, the doctor will be able to reliably assess the characteristics of the course of the disease. This is necessary to select the most optimal treatment tactics in each case.

Causes

Conjunctivitis of a child's eyes often occurs through contact with insufficiently clean hands during play, etc. All a child needs to do is rub his eyes and the first symptoms will not be long in coming. The disease can occur either in an acute form (with a sharp clinical manifestation) or in a chronic form with a gradual increase in symptoms and periods of remission. Eye conjunctivitis in adults is characterized by the same types of pathogenesis.

According to the type of primary source, pathology is:

• viral;
• bacterial;
• allergic.

These forms most often cause conjunctivitis of the eyes in a child. However, the cause of eye conjunctivitis may lie elsewhere, for example, due to injury, the use of contact lenses, infection with fungal bacteria, or chlamydia.

Viral conjunctivitis of the eyes in a child occurs when viral infections such as influenza, herpes simplex, chickenpox, measles, etc. enter the body, including the mucous membrane of the organs of vision. The same cause of conjunctivitis of the eyes contributes to damage to the mucous membrane and other organs, causing the appearance of rhinitis, pharyngitis, etc. The incubation period of the disease is from 5 to 7 days.

Conjunctivitis of the eyes of a child, provoked by bacterial microorganisms, owes its occurrence to pathogens of the coccus group, tuberculosis bacillus, etc. Normally, these and other bacteria live on the mucous membranes, but are activated when the immune system is weak. This condition, with additional infection from the outside, is the cause of bacterial conjunctivitis of the eyes. The incubation period is usually one to two weeks.

Allergies are also a common cause of eye conjunctivitis in childhood. The disease may be a reaction to any allergen, or it may be a concomitant pathology of allergic pathogenesis: atopic dermatitis, hay fever, bronchial asthma. Allergic conjunctivitis of the eyes in a child can be year-round, seasonal, papillary, or specific.

Description of the disease

Conjunctivitis is one of the most common diseases in ophthalmology, which can occur in absolutely anyone, regardless of age and gender. Conjunctivitis is often diagnosed in infants from the first weeks of life.

Pathology can be suspected by redness of the eyes, swelling of the mucous membrane and the presence of purulent or mucous discharge. There are 3 main forms of the disease, depending on the nature of its development: allergic conjunctivitis, bacterial and viral. Any form requires mandatory medical intervention, since self-medication can cause irreparable harm to the health of the child’s eyes.

Symptoms

The clinical picture of an ophthalmological disorder depends on the underlying cause that caused it. The symptoms will have features characteristic of this form of pathology.

Conjunctivitis of the eyes in a child, caused by viruses, is accompanied by swelling and redness of the conjunctiva, eyelids, dryness, and the appearance of follicles on the mucous membrane. Cough, runny nose, and hyperemia are often observed, which is typical for viral infections.

If the cause of eye conjunctivitis is bacterial pathogens, then the appearance of purulent discharge of a yellowish or greenish tint is inevitable. These discharges cause a lot of trouble for the baby especially in the mornings, when he cannot open his eyes due to gluing of eyelashes and eyelids.

Allergic conjunctivitis of the eyes in a child manifests itself quickly. The baby begins to intensively scratch his eyes, redness, pain, and copious secretion of tear secretion occur.

Against the background of a viral course of the disease, a bacterial complication often occurs, then the symptoms become mixed. Treatment of eye conjunctivitis in this case will be more extensive.

Symptoms of conjunctivitis in a child. Its types

In addition to the general signs of conjunctivitis in children - hyperemia of the protein, lacrimation, swelling of the eyelids, itching, burning, pain in the eyes, there are also features characteristic of each type of disease.

Bacterial conjunctivitis in children

Characterized by the presence of cloudy gray, gray-yellow or yellow discharge from the eyes. There is so much discharge that when the child wakes up in the morning, he cannot open his eyes: the eyelashes and eyelids are stuck together with dried pus and mucus. In addition, with purulent conjunctivitis, a general deterioration in health is often observed: headache, fever, fatigue, lethargy - all signs that usually accompany the course of a bacterial infection.

Bacterial conjunctivitis easily spreads in children's groups: nursery and kindergarten groups, classes.

Viral conjunctivitis in children

It has a long course. Based on the symptoms, it is possible to distinguish herpetic conjunctivitis from adenoviral conjunctivitis: in the first case, the inflammatory process is often unilateral, in the second - bilateral, with enlargement of the cervical lymph nodes and an increase in temperature. Herpetic conjunctivitis often leads to complications, since with it the damage spreads to deeper parts. Adenoviral infections are characterized by a combination of eye inflammation with otitis media, pharyngitis, and rhinitis.

Allergic conjunctivitis in children

The proportion of allergic conjunctivitis increases with the overall increase in the incidence of allergies. They generally affect both eyes and last at least a month, often longer. The main complaint is painful constant itching. A child suffering from allergic conjunctivitis constantly rubs his eyes, which leads to the appearance of eyelid dermatitis. Unpleasant sensations include cracks, abrasions, and rashes around the eyes. Characterized by severe lacrimation. The discharge is usually mucous or purulent-mucous.

Allergic conjunctivitis can be caused by plant pollen, pet secretions, food, and even helminthic infestations. Unlike infectious conjunctivitis, it is not contagious and does not lead to epidemic outbreaks in groups.

Contact conjunctivitis in children

Its main difference is that only one eye is affected. This is because the disease is directly related to contact of the organ of vision with an irritating element - a speck, grain of sand, eyelash, or microtrauma.

Treatment of viral conjunctivitis in children

To eliminate the symptoms of viral pathologies, drugs with interferon are used. They fight viruses, alleviate the symptoms of the disease and improve their general condition. Antiviral ointments complement the main course of therapy well. It is important that the prescribed drug affects exactly the pathogen that provoked the disease. In this case, the choice of medications depends on the age of the child. The standard method of treating conjunctivitis of viral etiology is drops and ointments. To eliminate symptoms, the drugs “Actipol”, “Oftan Idu”, “Oftalmoferon”, “Oftan”, “Sodium Sulfacyl”, “Vitabakt”, “Levomycetin”, “Tobrex”, “Floxal” and others can be prescribed. For the herpetic form of the disease, Florenal, Zovirax, Virolex and others drops are used.

If the virus has also affected the skin around the eyes, then Acyclovir and Valtrex ointments may be additionally prescribed. To avoid the addition of a bacterial infection, tetracycline or erythromycin ointments and antibiotic eye drops are additionally used.

Types of conjunctivitis

Types of pathology in newborns:

• Chemical. A rare condition caused by irritation from eye drops given to newborns to prevent bacterial infection. The mucous membrane is red, inflamed. The reaction begins a few hours after taking the medication. Symptoms last about 2–4 days. This type of conjunctivitis often does not require therapy.
• Gonococcal (GK) is caused by bacteria. A newborn becomes infected from the mother during childbirth. Severe conjunctivitis is prevented by the use of eye drops. Symptoms appear approximately 2–5 days after birth. Treatment is intravenous antibiotics.
• Bacterial (BC). CD accounts for 18-57% of all cases. Infection occurs through contact with certain bacteria. The eyes become red and swollen. The therapeutic course depends on the type of bacteria that caused the infection.
• Allergic (AK) type of pathology is not contagious. Other signs of hay fever will appear if the illness is the result of an allergy. The cause is different types of allergens. For example, pollen, dust, washing powder, household chemicals, food.
• Viral (VK). The disease occurs as a symptom of ARVI. Adenoviral inflammation of the mucous membrane is more common and occurs against the background of pharyngitis.

There are chronic and acute conjunctivitis.

The dangers of viral and bacterial conjunctivitis

These types of eye pathologies pose the greatest danger to the child’s health. They tend to take an epidemic course, quickly spreading in children's groups through the air and household contacts: shared toys, hygiene items, dishes, etc. In the event of an epidemic of conjunctivitis, quarantine is declared for a period of 10-14 days. At the same time, if possible, it is better to limit visits to kindergarten so as not to expose the child to infection. Inside the premises of the child care facility, a complete sanitary and hygienic treatment is carried out to ensure that all surfaces are as safe as possible. Some types of viruses can survive on them for up to 7-10 days.

Treatment of conjunctivitis

Treatment of conjunctivitis in children depends on the cause and form of the disease (viral, bacterial or allergic), the severity of specific symptoms, age and individual characteristics of the child. When prescribing therapy, the specialist sets several goals: to relieve the inflammatory process, eliminate unpleasant symptoms and prevent the development of complications and relapses.

• Application of local anti-inflammatory and antipruritic drugs in the form of drops, ointments and gels.
• Removing the crusts that have formed and washing the eye mucosa with medicinal solutions.
• Injections of medications using a special syringe.
• Antibiotic therapy (for bacterial infection).
• Taking antihistamines (for allergic conjunctivitis).
• Using tear drops to relieve dryness and discomfort in the eyes.

During treatment, a child with infectious (non-allergic) conjunctivitis should be isolated from healthy people. With proper treatment, complete recovery occurs after 7-14 days.

Is conjunctivitis dangerous for children?

Although the disease is contagious, it is quite easy to treat if you pay attention to the accompanying symptoms in time and do not delay contacting a pediatric ophthalmologist.

Complications after an infection are rare, but they are still possible.

For example, the transition of a disease to the chronic stage occurs in the absence of adequate treatment or non-compliance with doctor’s recommendations. In this case, possible relapses of the disease (quite frequent) as a response to a decrease in immunity caused by various factors. With a cold or any other infectious disease, a child may also develop conjunctivitis.

Permanent damage to the conjunctiva can affect the quality of vision and even lead to disability.

When should you see a doctor?

Not all parents are seriously concerned about the appearance of conjunctivitis and prefer to treat it using “grandmother’s” recipes. Treatment with folk remedies is quite acceptable and in some cases turns out to be very effective, but it can only be used after consulting a pediatrician about the possibility of using a specific method and the absence of contraindications for this.

You should urgently visit an ophthalmologist if your child:

• has not reached one year of age;
• complains of pain and severe burning in the eye area;
• notes blurred vision;
• there is profuse lacrimation;
• I began to feel worse (a temperature appeared, my eyes turned red and watery).

The reason for going to the doctor is the formation of pustules, bumps and blisters on the surface of the eyelid or on the mucous membranes of the eyes.

Herpetic conjunctivitis

The herpes simplex virus is also a common cause of inflammation of the conjunctiva. It can provoke various types of herpetic conjunctivitis:

• catarrhal, which is characterized by mucous or purulent discharge from the eyes;
• follicular, in which vesicles with liquid content appear on the conjunctiva and eyelids - follicles;
• The vesicular-ulcerative type of the disease occurs with the formation of erosions or ulcers covered with films, often accompanied by the formation of dense nodules.

The herpes virus, once entering the body, is integrated into the DNA of the trigeminal ganglion, and a person lives with it all his life. From 60 to 90% of all people are carriers of the herpes simplex virus. However, in the normal state of the body, it does not bother the owner. But in certain situations, for example, a weakened immune system, hypothermia, vitamin deficiency, or after previous infections, the herpes virus is activated, provoking the development of inflammatory diseases: the well-known “cold” on the lips or conjunctivitis.

Prevention of conjunctivitis

In order to reduce the likelihood of recurrence of conjunctivitis, it is necessary to adhere to preventive measures:

• Follow the rules of personal hygiene - regularly wash your hands with soap after visiting the toilet, contacting animals, visiting public places; try not to touch your eyes with dirty hands.
• Avoid contact with sick people.
• Strengthen the immune system - provide the child with a balanced diet, exercise, and take daily walks in the fresh air.
• Treat infectious diseases in a timely manner, do not self-medicate.
• Avoid contact of skin and mucous membranes with allergens and external irritants.

If the disease does occur, it is necessary to promptly seek medical help from an experienced ophthalmologist. SM-Doctor specialists will help diagnose and eliminate eye diseases of any nature. Contact an ophthalmologist when the first suspicious signs appear!

Causes of conjunctivitis

Conjunctivitis in children occurs when the eye mucosa comes into direct contact with a bacterial infection (staphylococci, streptococci, gonococci, etc.), intracellular parasites (ureaplasma, mycoplasma, legionella, chlamydia), viruses, fungal pathogens, or when microflora is introduced hematogenously in various infectious diseases ( ARVI, measles, chicken pox). Inflammation of the conjunctiva can be caused by individual pathogenic microorganisms or their various combinations. There is also allergic conjunctivitis, which develops in response to the action of an allergen (pollen, fluff, animal hair, etc.). Inflammation of the conjunctiva can result from:

• prolonged exposure to smoke, dust, chemicals;
• influence of ultraviolet radiation;
• violation of the rules for using soft contact lenses;
• eye fatigue;
• avitaminosis;
• metabolic pathology;
• chronic diseases of the nose, its paranasal sinuses and lacrimal ducts;
• congenital and acquired refractive errors in children.

In infants, staphylococcal conjunctivitis most often develops against the background of purulent-septic diseases of newborns (omphalitis, pyoderma, otitis, etc.). More often these are premature babies with reduced immunity or children born to mothers at risk for intrauterine infection. Also an important factor in the appearance and prevalence of purulent conjunctivitis is the violation of the sanitary and hygienic regime in the obstetric hospital.

In recent years, there has been a significant increase in the frequency of conjunctivitis caused by Staphylococcus epidermidis, Streptococcus, Pseudomonas aeruginosa, Escherichia coli, and gonococcus. Chlamydial conjunctivitis is currently a serious problem.

Viral conjunctivitis

This type of disease develops when various viruses enter the child’s body. The most common of them are adenoviruses, which are the causative agents of many ailments: influenza, ARVI, acute respiratory infections and others. When infected with adenoviruses 3, 4 and 7 serotypes, acute pharyngoconjunctivitis develops. Viruses 8 and 10 serotypes cause epidemic keratoconjunctivitis. Many adenoviruses cause the development of upper respiratory tract infections: tonsillitis, pharyngitis, rhinitis and other diseases. Adenoviruses are very tenacious. They can remain active on various surfaces for up to 7-10 days. As soon as a child picks up a dusty or dirty object and then touches the mucous membrane, the virus enters the body, provoking the development of the disease. Children under 6-7 years of age are especially susceptible to the effects of adenoviruses. Their immune system is still very weak and cannot resist infections to the same extent as an adult body. According to statistics, adenovirus infection in children under six years of age accounts for up to 30% of cases of all viral illnesses.

Viral conjunctivitis in a child can occur as an independent pathology or develop against the background of illnesses caused by viruses: influenza, acute respiratory viral infections, acute respiratory infections, nasopharyngitis and other diseases of the upper respiratory tract. In such cases, complex treatment is prescribed.