Conjunctivitis (inflammation of the conjunctiva): symptoms, causes, and treatment
The human eye is exposed to aggressive environmental influences every day. Dust, bacteria, viruses, allergens, dry air, and poor-quality cosmetics can trigger a protective reaction in the mucous membrane.
In our practice, complaints of eye redness and discomfort are among the most common. These symptoms often mask conjunctivitis, an inflammatory process affecting the thin, transparent tissue lining the inner surface of the eyelids and the sclera.
At the K31 Clinic, we help patients diagnose this problem promptly and select safe treatment every day.
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Types of conjunctivitis
Understanding the origin of the inflammatory process is critical to selecting effective therapy. Ophthalmologists distinguish several main types of the disease, each requiring a fundamentally different approach.
Bacterial conjunctivitis
This occurs when pathogenic or opportunistic microorganisms, such as staphylococci, streptococci, or Pseudomonas aeruginosa, enter the mucous membrane. Bacterial conjunctivitis often develops due to a weakened immune system, after colds, or due to poor personal hygiene. A characteristic feature is the rapid appearance of discharge and the involvement of first one eye, and then, if proper care is not provided, the other.
Viral conjunctivitis
This type of inflammation is most often caused by adenoviruses, herpes viruses, or enteroviruses. Viral conjunctivitis often accompanies acute upper respiratory infections and is transmitted by airborne droplets or direct contact.
Allergic conjunctivitis
This is the body's local immune response to contact with a specific irritant. Allergens can include pollen, pet dander, house dust, and components of cosmetics or household chemicals. Allergic conjunctivitis almost always affects both eyes simultaneously and is often associated with allergic rhinitis, nasal congestion, and sneezing. Symptoms can be seasonal or year-round.
Irritant conjunctivitis and contact lens reactions
Sometimes the mucous membrane becomes inflamed without the involvement of microorganisms or allergens. Chronic mechanical or chemical exposure is the cause. This group includes reactions to smog, tobacco smoke, and chlorinated pool water. In our practice, we also specialize in treating patients whose irritation is caused by contact lenses.
Symptoms of conjunctivitis: how to recognize the problem
Despite their different origins, all forms of the disease have a number of similar manifestations, which are caused by the development of an inflammatory reaction in the vascular network.
Typical signs in adults
When conjunctivitis develops in adults, the first symptoms are severe redness of the eyes and a foreign body sensation.
Later, the following symptoms develop:
- Constant or intermittent lacrimation
- Intrusive itching of the eyes and a sensation of warmth in the eyelids
- Painful burning in the eyes and a stinging sensation when looking at light sources
- Swelling of the mucous membrane and the eyelids themselves
The nature of the discharge depends on the cause. With a bacterial infection, copious purulent discharge of a yellowish or greenish tint appears, which sticks the eyelashes together in the morning. With a viral or allergic form, the discharge is usually clear, serous, or mucous.
Characteristics in children
In childhood, the disease progresses more rapidly. Developing conjunctivitis in children is often accompanied by changes in general behavior. The child becomes cranky, whiny, and constantly rubs their eyelids with their fists, which only aggravates mechanical irritation and promotes the spread of infection. In the morning, children may have difficulty opening their eyes due to crusty, dried eyelashes.
How to distinguish conjunctivitis from other eye diseases
It's impossible to make an accurate diagnosis on your own, as many eye conditions have similar clinical presentations. For example, eye redness and lacrimation can accompany dry eye syndrome, computer vision syndrome, or blepharitis. However, there are important differences. With conjunctivitis, the inflammatory process is localized primarily in the conjunctiva, sparing the deeper structures.
If redness is accompanied by severe, piercing pain inside the eyeball, or if the person experiences progressively decreased visual acuity, this may indicate the development of keratitis or uveitis.
| Type of conjunctivitis | Main symptoms | Nature of discharge | Contagiousness | Treatment approach | When to see a doctor urgently |
|---|---|---|---|---|---|
| Bacterial | Redness, stinging, sticking of the eyelids in the morning | Abundant purulent, thick, yellow-green discharge | High with poor hygiene | Antibacterial drops and ointments | For severe swelling and pain |
| Viral | Sudden onset, itching, swelling of the eyelids, lacrimation | Scant mucous or clear watery | Very high, easily transmitted | Antiviral, tear substitutes | With decreased vision and photophobia |
| Allergic | Intolerable itching, swelling, redness of both eyes | Clear, watery or thread-like mucous | Not contagious | Antihistamines, drops | If treatment is ineffective |
| Irritating | Sensation of sand, burning after external factors | Clear, watery, or absent | Not contagious | Eliminate the irritant, moisturize | If complaints persist for more than 2 days |
There are certain clinical signs that indicate a severe course of the process or involvement of the deep layers of the eye.
Worrying symptoms that require an eye examination
You need an urgent consultation with an ophthalmologist if the following complaints appear against the background of inflammation of the mucous membrane:
- Severe photophobia, when even dim light causes squinting
- Sharp, pressing, or throbbing pain in the eyeball itself
- Noticeable deterioration in vision, the appearance of fog or veil that does not resolve with blinking or rinsing
- Severe, progressive swelling of the eyelids, causing the palpebral fissure to completely close
- The appearance of dense gray or whitish films on the mucous membrane
- If symptoms developed after mechanical trauma or exposure to a chemical substance
Diagnosis of conjunctivitis in our practice
At K31 Clinic, we approach each patient's examination with the utmost care. Successful treatment of conjunctivitis directly depends on accurately determining the cause of the condition, so we don't limit ourselves to a cursory examination.
Examination and complaints collection
The first step is always a detailed discussion with the doctor. To help the specialist quickly understand the situation, we recommend that patients be prepared.
What to tell your ophthalmologist at your appointment:
- When did the first symptoms of inflammation appear?
- Is there any discharge from the eye and what is its nature?
- Do you wear contact lenses in your daily life?
- Have you recently been in contact with sick people?
- Are you prone to allergic reactions?
- Does the eye itself hurt or has vision deteriorated?
After collecting the medical history, a biomicroscopy is performed—an examination of the anterior segment of the eye using a slit lamp under magnification.
When are smears, cultures, or additional tests needed?
In most standard cases, the clinical picture is sufficient to prescribe treatment. However, if the condition is protracted, there is no response to treatment, or a specific infection is suspected, an extended diagnosis of conjunctivitis is performed. We take a conjunctival smear for cytological examination and also culture the discharge on nutrient media to determine the specific pathogen and its sensitivity to antibiotics.
General information
Treatment of conjunctivitis: how we select therapy
The main principle of our work is the pathogenetic approach. We do not just strive to temporarily relieve redness, but act directly on the cause that caused the symptoms of conjunctivitis.
Principles of treatment of bacterial form
If the bacterial nature of the disease is confirmed, the basis of therapy is local antibacterial drugs. The doctor prescribes antimicrobial eye drops, and in some cases, special ointments that are placed behind the lower eyelid at night for prolonged action. It is important to strictly observe the frequency of use and continue the course recommended by the doctor, even if visible symptoms disappear on the second day. Premature discontinuation of an antibiotic can lead to the development of bacterial resistance and the process becoming chronic.
Principles of treatment of the viral form
For viral infections, antibiotics are ineffective; their unreasonable use can only intensify the toxic-allergic reaction of the mucous membrane. Our treatment for conjunctivitis of viral origin includes the administration of local antivirals, interferons and immunomodulators. To reduce discomfort, alleviate the burning sensation and wash out viral particles, tear replacement solutions are actively used. If a secondary bacterial infection occurs, the doctor can add a targeted antibacterial drug.
Principles of treatment of allergic forms
First, we recommend minimizing exposure to the irritating factor. Drug treatment includes topical antihistamines and mast cell membrane stabilizers. These drugs quickly block the release of histamine, which helps relieve itchy eyes and swelling. In severe cases, short courses of anti-inflammatory hormonal drops may be prescribed.
What you can and cannot do at home
At home, the patient must strictly follow all doctor's instructions. It is permissible to gently wash the eyes with sterile saline or special pharmaceutical solutions to remove crusts and mucus. This should be done in the direction from the outer corner of the eye to the inner, using a separate sterile gauze swab for each eye.
FAQ
Can conjunctivitis be treated at home?
Is conjunctivitis contagious?
How long does treatment last?
Should I stop wearing contact lenses?
Category of Clinical Guidelines of the Ministry of Health of the Russian Federation — https://cr.minzdrav.gov.ru/
Ministry of Health of the Russian Federation — https://minzdrav.gov.ru/
MSD Manuals, Russian version — https://www.msdmanuals.com/ru/home/eye-disorders/conjunctivitis-and-scleritis/conjunctivitis
Vidal, Russian-language medical reference book — https://www.vidal.ru/
RLS, Russian-language drug reference book — https://www.rlsnet.ru/
Eyepress, Russian-language ophthalmology portal/magazine — https://eyepress.ru/
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What is conjunctivitis and why shouldn't you ignore it?
The mucous membrane of the eye performs a vital protective function, secreting components of the tear fluid and preventing infectious agents from penetrating deeper into the orbital structures. When this protective barrier is compromised, conjunctival inflammation occurs. This condition should not be ignored for several reasons. At first glance, it may seem like the eye is simply tired or has a speck of dirt in it, but a serious eye infection often lurks beneath the guise of simple irritation.
If a person tries to tolerate the discomfort or self-medicates, the inflammatory process can spread to adjacent tissues. In severe cases, the cornea becomes involved, leading to keratitis or concomitant blepharitis, which poses a direct threat to visual acuity. Only timely diagnosis and proper treatment of the conjunctiva by a specialist can stop the pathological process at an early stage.