1 Causes of the development of the disease
Chronic conjunctivitis is an urgent problem of modern ophthalmology, it is the main reason for patients' treatment to the ophthalmologist. Unlike acute inflammatory processes, which are usually diagnosed in children, chronic infections most often occur in people of mature and advanced age. Often, the disease is combined with blepharitis, keratitis, dry eyes. By origin, the inflammatory processes in the conjunctiva are divided into septic and aseptic, exogenous and endogenous.
Non-infectious forms of the disease are caused by prolonged exposure to irritating factors: chemicals, smoke, dust, cosmetics. Possible development of chronic conjunctivitis on the background of long work at the computer, reading in a poorly lit room. The risk group includes people working in the coal, bakery, cement or paper industries, foundries, chemical plants. Chronic conjunctivitis can develop against a background of prolonged mechanical exposure of foreign bodies: improperly growing or artificial eyelashes, sand, particles of granular substances.
The causes of endogenous non-infectious forms of the disease can contribute to pathologies that contribute to visual impairment:
- dry eye syndrome;
The role of internal provoking factors is played by helminthiases, the presence of subcutaneous parasites, seborrhea, chronic pathologies of the digestive system( gastritis, gastroenteritis, cholecystitis), anemia, vitamin deficiency, metabolic disorders. Sluggish character can also take allergic conjunctivitis. In this case, the symptoms from the eyes are combined with signs of rhinitis, bronchial asthma, skin rashes. The disease is characterized by seasonal exacerbations.
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Infectious chronic conjunctivitis of the eye can occur against the background of inflammatory processes in the eyes, upper respiratory tract and maxillary sinuses. The transition of the disease into a chronic form results in improper treatment of acute types of conjunctivitis. With microscopic and bacteriological studies of secretions streptococci, staphylococci, enterobacteria, adenoviruses, chlamydia and other pathogenic microorganisms are found.
2 Clinical picture of
The pathological process develops in several stages, each of which has typical symptoms. Initially, the patient experiences a burning sensation and heaviness in the eyelids, the contamination of the eye. In the future, tearing, increased eye fatigue, photophobia develop. All the symptoms of chronic conjunctivitis are most pronounced in the evening and when they are in a room with artificial light. Depending on the origin of the disease, the secretions may be abundant or scarce. They can consist of mucus or pus. When examining the eye, there is a slight reddening of the conjunctiva, irregularity of the mucous membranes.
Chronic allergic forms of the disease are characterized by the appearance of follicles or outgrowths on the conjunctiva, this process may be accompanied by inflammation of the cornea, deterioration of vision and itching. Symptoms of allergic conjunctivitis can be combined with signs of dermatitis of the eyelids, blepharitis and neuritis. The disease takes a persistent character, discomfort can torment the patient for several years.
3 Detection and treatment of chronic conjunctivitis
A distinctive characteristic of this disease is the inconsistency of the symptoms with pathological changes. This makes it difficult to make a final diagnosis. It is possible to detect the disease only after an ophthalmologic examination, an analysis of the symptoms present in a person, the diagnosis of accompanying pathologies, the conduct of laboratory and apparatus studies. With visometry, a decrease in visual acuity is revealed. In certain cases, this indicator may remain within normal limits. Microscopic examination of the mucous membranes of the eye can detect the following changes: redness, looseness, unevenness of the surface, outgrowths.
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For the elimination of visual impairment, refractometry and skiascopia are prescribed. In the diagnosis of dry eye syndrome, samples are taken to stimulate the development of tears: the Norn test, the Schirmer test. Bacteriological analysis of the smear can detect the causative agent of the infection and determine its sensitivity to antibacterial drugs. In the presence of accompanying pathologies, consultations of narrow specialists may be required: a dermatologist, an otolaryngologist, a gastroenterologist. Additional diagnostic procedures are: x-ray examination of maxillary sinuses, examination of a nasopharyngeal smear, a blood test for chlamydia and a sugar content. Allergic tests are carried out, eyelashes are examined for the presence of subcutaneous mites.
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In chronic conjunctivitis, treatment is effective only if the cause of the disease is identified and eliminated. If a decrease in visual acuity is detected, a correction tool is selected. Laser correction of ametropia is shown. With prolonged mechanical irritation of the mucous membranes and the eyeball, it is necessary to extract the foreign object from the conjunctival arch, to eliminate the incorrectly arranged eyelashes. Be sure to treat associated diseases and be under the supervision of a specialist.
For external use in chronic conjunctivitis, cold compresses are used from decoctions of herbs that have antiseptic and anti-inflammatory effects: chamomile, oak, and oak bark. In the conjunctival cavity antibacterial, moisturizing, anti-inflammatory drops, hormonal creams, tear replacements are introduced. At night, a bandage with antibacterial ointments is applied. Treatment of recurrent conjunctivitis is a long process, periodic change of medicines avoids addiction.
The chronic form of the disease is difficult to treat, in most cases it occurs repeatedly. The success of treatment is determined by the ability to detect and eliminate the cause of the pathology. A prolonged course of the pathological process can contribute to the loss of ability to work and the restriction of occupational fitness. Prevention of the disease implies the exclusion of the influence of provoking factors. When working in dusty areas, it is recommended to use personal protective equipment. It is necessary to eliminate refractive visual impairments, chronic infections of the upper respiratory tract, pathology of the digestive system in a timely manner.