Bacterial Conjunctivitis

Symptoms

Bacterial conjunctivitis usually begins first in one eye and may spread to the second. Whitish-yellow smeary purulent secretions are discharged, causing conglutination and crusting, especially in the morning after sleep. The conjunctiva is reddened and blood may accumulate due to increased blood flow. A foreign body sensation and itching often occur. Other possible symptoms include swelling of the eyelid, eye tearing, pain, swelling of the conjunctiva and impaired visual acuity. Depending on the course, a distinction is made between hyperacute, acute and chronic (recurrent) conjunctivitis. Depending on the pathogen and the immune status of the patient, rare complications such as inflammation of the cornea or lacrimal sac, middle ear infection, meningitis, blood poisoning, and, in the worst cases, even blindness are possible.

Causes

It is a bacterial infection. Numerous pathogens are possible triggers, for example, pneumococci, streptococci, staphylococci, , gonococci, chlamydia, pseudomonas, Corynebacterium diphtheria, and neisseria.

Transfer

Most commonly, bacterial conjunctivitis is transmitted as a droplet or smear infection via contaminated hands or objects. Sexual transmission is also possible, depending on the pathogen (eg, ). A special case is neonatal conjunctivitis, which is transmitted from mother to child at birth and occurs about a week after birth (gonorrhea, genital chlamydial infection).

Diagnosis

Diagnosis is made on the basis of the patient’s history, clinical presentation, or by pathogen detection during medical treatment, preferably by an ophthalmologist. Differentiation between bacterial and viral conjunctivitis based on symptoms is difficult because the symptoms overlap considerably. Viral infections are often said to result in watery rather than purulent secretions. Other causes of red eye such as allergy, glaucoma, foreign bodies, lid margin inflammation, dry eye, keratitis, or nonspecific irritation must also be ruled out. See also under the article conjunctivitis.

Nonpharmacologic treatment

In most cases, the disease is self-limiting, meaning that it disappears on its own within one to two weeks. Therefore, drug therapy is not mandatory in every case. The nasolacrimal duct can be lightly massaged in case of congestion. Light cooling and room darkening can symptomatically relieve the discomfort. Contact lenses must not be worn during the disease! Prevention: Both the patient and the persons in contact with him/her should wash their hands frequently or, if necessary, disinfect them (including surfaces). Own towels and washcloths, as well as disposable handkerchiefs should be used, so that the infection is not transmitted.

Drug treatment

Antibiotic eye drops:

  • Antibiotic eye drops are the first-line drug treatment. They are effective against the causative agents of the disease, shorten the duration, reduce the occurrence of complications and transmission. Disadvantages include possible adverse effects. Antibiotics are also combined with ocular glucocorticoids, which have an anti-inflammatory effect. The glucocorticoids can increase intraocular pressure and should only be used short-term for a maximum of 10 days, as they can cause glaucoma or cataracts with long-term use. Their use is controversial because of the possible side effects on the eye. Internally administered antibiotics are used for infection with chlamydia.

Disinfectant eye drops:

Tear substitutes:

  • Tear substitutes are eye drops or eye gels that replace or supplement the tear film of the eye. They form a lubricating and protective film on the conjunctiva and cornea and can symptomatically relieve symptoms. Monodoses without preservatives should be preferred, because the preservatives can cause adverse effects on the eye.

Vasoconstrictor agents:

Eyebright:

Chamomile or black tea:

  • Chamomile and black tea bags or corresponding preparations are used in folk medicine. They have antibacterial and anti-inflammatory properties. Chamomile can cause allergic reactions and should be used with caution or not at all. Both medicines are usually not sterile.

Sterile saline:

  • For rinsing the eyes (0.9% NaCl solution).