An eye infection can cause visual impairment

Conjunctivitis

Conjunctivitis (Conjunctivitis): Acute or chronic inflammation of the conjunctiva, a layer of mucous membrane in the anterior part of the eye. Be differentiated infectious conjunctivitis by bacteria, viruses or fungi (= more often) from non-infectious conjunctivitis through foreign bodies, contact lenses, tobacco smoke, dust or allergies (= less often).

In addition, the course is divided into acute conjunctivitis and chronic conjunctivitis. Acute conjunctivitis heals within a few days. Doctors speak of chronic conjunctivitis if the inflammation lasts for more than 4 weeks.

Leading complaints

  • Red eye
  • Foreign body sensation, feeling of "sand in the eye", compulsion to blink
  • Sometimes unbearable itching
  • Depending on the cause, purulent, slimy or clear secretions; in the morning the lids are stuck together with whitish-yellow pus
  • Tears in the eyes, constant runny nose
  • Swollen eyelids often tightly closed
  • Photophobia, sensitivity to glare.

When to the doctor

The next day or today if

  • The mentioned main complaints occur for the first time (in the case of recurrence, a visit to the doctor is unnecessary if you are sure what to do)
  • See you worse at the same time
  • You have severe eye pain
  • Your symptoms do not get better within ten days.

Practical tip: If you cannot get a quick appointment with the ophthalmologist, see your general practitioner or internist first. They will prescribe the initial treatment - and, if necessary, refer you to the ophthalmologist.

The illness

Disease emergence

The conjunctiva is a thin, transparent layer of mucous membrane that also lines the inside of the eyelid. In the conjunctiva on both sides there are numerous accumulations of white blood cells that are supposed to prevent pathogens from entering the eye. When there is inflammation, they often swell into small blisters (follicles).

Both infectious conjunctivitis 3 forms are distinguished depending on the pathogen:

  • FrequentBacterial conjunctivitis. Bacterial conjunctivitis is usually caused by staphylococci, pneumococci, Haemophilus influenzae or Pseudomonas aeruginosa. A purulent secretion forms that sticks the eyelids - especially when sleeping. The so-called swimming pool conjunctivitis is also one of the bacterial inflammations. The pathogen here is the bacterium Chlamydia trachomatis type D-K, which is usually transmitted through bathing water or wet laundry from infected patients - but only rarely in swimming pools. The lymph follicles swell and mucous-purulent secretions form in the eye.
  • Trachoma. Although trachoma is the most common bacterial inflammation of the conjunctiva and cornea worldwide, it only occurs in tropical climates - it is extremely rare in our country. The trachoma is caused by the bacteria Chlamydia trachomatis type A – C, which are transmitted via smear infections and flies in poor hygienic conditions. The first infection usually affects childhood and leads to follicular keratoconjunctivitis. There is scarring and secondary infections of the conjunctiva, eyelids and an entropion. In the end there is blindness: around 6 million people worldwide are blind from trachoma.
  • Viral conjunctivitis. The most common viral conjunctivitis is epidemic keratoconjunctivitis. It is caused by adenoviruses and is very contagious. The patients complain of massive complaints such as watery, itchy eyes, swollen eyelids and a swollen conjunctiva.

To the non-infectious conjunctivitis counting:

  • Allergic conjunctivitis. Acute or chronic allergic conjunctivitis is an inflammatory reaction to a wide variety of substances. Very often these are pollen, dust, cosmetics and ointments. The often extremely severe itching and tearing of the eyes is particularly annoying for the patient.
  • Conjunctivitis simplex. The non-infectious, non-allergic conjunctivitis (conjunctivitis simplex) is usually caused by chemical-physical stimuli, e.g. B. by dust particles or chlorine in swimming pool water. However, it can also be the result of an ectropion (tilting the lower eyelid outwards) or missing / incorrect glasses.
  • Physiological conjunctivitis. Physiological conjunctivitis has no disease value. It occurs especially in children and adolescents when their eyes come into contact with pathogens or chemical-physical stimuli for the first time. There is no actual disease here. However, the healthy immune system reacts with the formation of small lymph follicles in the conjunctiva. These cause symptoms similar to those of real conjunctivitis.

Risk factors

Conjunctivitis is particularly common in people who

  • Wear contact lenses
  • Not taking good care of your contact lenses
  • Tend to allergies or suffer from neurodermatitis, hay fever or asthma
  • Frequently expose your eyes to smoke, dust, drafts or chlorine in swimming pools
  • Suffer from a lack of tear fluid - which can be the result of frequent intake of "whitening" eye drops, i.e. vasoconstricting agents that can be used to treat red eyes
  • Too little sleep.

Diagnostic assurance

Even if conjunctivitis is usually harmless, the ophthalmologist will first rule out a serious illness that can cause similar symptoms, e.g. B. corneal injuries, corneal inflammation or a sudden increase in intraocular pressure (glaucoma attack).

The ophthalmologist also determines the underlying cause and adjusts the therapy accordingly. The combination and characteristics of the findings provide the doctor with information about the cause.

The ophthalmologist uses the slit lamp to assess the vessels, the type of secretion and the conjunctival swelling. The conjunctiva of the eyeball is directly visible in the eyelid, with conjunctivitis there are typically bulging vessels in brick-red color (injection).

In the outpatient practice, pathogen detection and resistance determination are carried out if an infectious conjunctivitis is suspected Conjunctival swab.

Complications

Occasionally, untreated conjunctivitis spreads to the cornea. The resulting corneal inflammation (keratitis) also leads to visual disturbances. Contact lens wearers are particularly at risk from this complication.

Differential diagnoses

The symptoms of conjunctivitis are often associated with other inflammatory changes in the eye, such as: B. in iris inflammation or corneal inflammation. Sometimes foreign bodies that have penetrated the eye are also behind burning, reddening and itching of the eyes.

Your pharmacy recommends

What can you do yourself?

Hygiene. Tears and eye secretions are very contagious! Always wash your hands after touching eye or nasal secretions. Be sure to use paper tissues or sanitary paper instead of wax slippers or towels to wipe or dry your eyes after getting up in the morning.

Cool. Cooling eye pads, e.g. B. cotton balls soaked in cold water have a pain-relieving and itch-relieving effect.

Prevention

If you are prone to conjunctival irritation: Avoid drafts, smoky rooms and a lot of dust. Be careful not to get soap, shampoo, or bath products in your eyes. The same applies to chlorinated water: wear protective goggles when swimming. In order not to spread the pathogen, you should avoid wearing contact lenses during the inflammation.

Note: If you wear contact lenses, have them checked by an optician. Scratched or dirty contact lenses are a common cause of conjunctivitis and irritation.

Avoid allergens. As an allergy sufferer, you should avoid the triggering substances as much as possible. If you wear contact lenses, change the detergent and storage solution if necessary, and change brands for disposable lenses.

Eye protection. Protect your eyes from sunlight and wind, e.g. B. with tinted glasses and with sports glasses that close at the sides of the temples.

Appropriate medication

Use of eye drops and ointments. Eye drops are rinsed out of the eye faster, so they have a shorter duration of action than eye ointments. The ointments form a protective film that covers and wets the eye a little longer. Always use eye drops before an eye ointment. Before putting any drops or ointment in your eyes, take out your contact lenses and wash your hands thoroughly. Some eye drops need to be stored in the refrigerator. To reduce the uncomfortable feeling of cool drops in the eye, warm the eye drops before use by keeping them in your pocket for a few minutes. A single drop is sufficient for each eye and application. Since eye ointments obscure the view, you should only apply eye ointments in the evening or before a nap.

Note: Contact lenses make conjunctivitis more difficult to heal. Therefore, wear glasses consistently until you are free of symptoms and no more eye drops need to be taken.

Whitening eye drops. An application of eye drops, which make the annoying red veins on the eyeball disappear, is absolutely fine at the wedding or passport photo appointment. Otherwise, caution is advised - the healing of bacterial conjunctivitis is delayed by these drops! In addition, prolonged use threatens the tear glands to permanently reduce their tear production, which makes future conjunctivitis all the more likely!

Complementary medicine

Acupuncture. According to the WHO, acupuncture is suitable as a therapy for non-infectious conjunctivitis.

Phytotherapy. Various herbs promote the healing of conjunctivitis. Locally with warm or cold tea infusions with which eye compresses are soaked, eyebright, black tea and oak bark are particularly suitable.

Homeopathy. In the case of chronic, non-infectious conjunctivitis, an individually tailored constitutional treatment is worth considering.

Anthroposophy. Appropriate preparations, e.g. B. with Euphrasia, are suitable for chronic, non-infectious conjunctivitis.

treatment

In most cases, the inflammation will go away without medical attention. In the case of inflammation requiring treatment, the therapy depends on the cause.

Conjunctivitis simplex. This uncomplicated conjunctivitis, often referred to as eye irritation, does not require drug therapy. The cause of the inflammation should be eliminated, e.g. B. by avoiding chemical-physical stimuli (wind, indoor pool water containing chlorine, strong sunlight) or correcting the visual defect (e.g. new glasses).

Bacterial conjunctivitis. Uncomplicated bacterial conjunctivitis usually heals within 10 days, even without treatment. In the case of persistent or widespread acute bacterial conjunctivitis, the ophthalmologist will prescribe eye ointments or eye drops containing antibiotics. In the hospital, the respective active ingredient depends on the pathogen, which is determined by the ophthalmologist. Outpatients are often treated with a standard antibiotic, e.g. B. Gentamycin 1 drop per eye 4 times a day for a week.

Viral conjunctivitis. The course of the viral conjunctivitis can be positively influenced by treatment with antiviral eye drops or eye ointments (e.g. acyclovir, ganciclovir or bromovinyl deoxyurides (BVDU = brivudine). It is administered 5 times a day for 2–3 weeks. With or without antiviral eye drops or eye ointments, also the viral conjunctivitis heals after 2-4 weeks.

Allergic conjunctivitis. Eye drops with antihistamines, mast cell stabilizers and / or cortisone are used therapeutically for allergic conjunctivitis.

  • Antihistamines show a quick but rather short-term effect
  • Mast cell stabilizers are suitable for long-term therapy
  • Eye drops containing cortisone are reserved for more severe cases because of the threat of side effects such as an increase in internal pressure and accelerated development of cataracts.

Note: Certain eye diseases get worse with cortisone treatment. If it worsens, stop using cortisone on the eye and consult the ophthalmologist (again).

General measures

Artificial tears. If the focus is on irritation and dryness of the eyes, irrespective of the cause, artificial tears will help to alleviate the discomfort - but not to combat the inflammation.

When it comes to artificial tears, a distinction is made between eye drops and eye gels. Both form a lubricating and protective film on the connective and cornea, thereby alleviating the sensation of foreign bodies and chafing in the eye. Artificial tears contain - just like the natural tear film - mucus, water and fats. Artificial polymers, hyaluronic acid and cellulose derivatives, some of which are combined with fat components, are added to the preparations as cross-linking agents that stabilize the tear film. Their use is harmless, they can be dripped as often as desired.

Eye gels stay in the eye longer than eye drops. On the other hand, it takes longer after the application until they have spread over the eyeball and you have a clear view again. Contact lens wearers and people who are hypersensitive to preservatives should use artificial tears without preservatives. When using it, care should be taken that the dropper tip does not touch the eye in order to avoid contamination with pathogens.

Further information

  • augeninfo.de - Professional Association of Ophthalmologists in Germany V .: Guideline "Bacterial Conjunctivitis"
  • augeninfo.de - Professional Association of Ophthalmologists in Germany V .: Patient brochure conjunctivitis
  • www.gesundheitsinformation.de - Information portal of the Institute for Quality and Efficiency in Health Care

Authors

Dr. Katharina Munk, Dr. med. Arne Schäffler in: Gesundheit heute, edited by Dr. med. Arne Schäffler. Trias, Stuttgart, 3rd edition (2014). Revision and update of the sections "The disease", "Treatment" and "Your pharmacy recommends": Dr. med. Arne Schäffler, Sandra Göbel. | last changed on at 10:00 o'clock


Important note: This article has been written according to scientific standards and has been checked by medical professionals. The information communicated in this article can in no way replace professional advice in your pharmacy. The content cannot and must not be used to make independent diagnoses or to start therapy.