Treatment of viral and bacterial keratoconjunctivitis

Keratoconjunctivitis is an inflammatory process in the eye, affecting both the conjunctiva and the cornea. This is one of the most common ophthalmic diseases, since the conjunctiva is sensitive to most exogenous and endogenous irritants. It is noteworthy that some types of keratoconjunctivitis can be contagious.

Causes and types of keratoconjunctivitis

The causes and pathogens of keratoconjunctivitis are varied. Inflammation can be caused by the activity of fungi, bacteria, viruses and parasitic infections. In some cases, the condition is a symptom of an allergic disease.

Keratoconjunctivitis sometimes develops with long-term use of corticosteroids, excess vitamins, or exposure to a foreign body on the conjunctiva or cornea. One of the most common reasons is improper use of contact lenses and insufficient cleaning.

Often, keratoconjunctivitis indicates another disease. Most often it is the flu, rubella, lupus erythematosus, rheumatoid arthritis or Sjögren's syndrome. Provoking factors for inflammation can be helminthiasis, food allergies, poor hygiene and lice.

Types of keratoconjunctivitis:

1. Herpetic. Inflammation occurs as a result of the activity of the herpes virus. Has symptoms of herpetic keratitis or acute diffuse conjunctivitis.
2. Hydrogen sulfide. Appears with prolonged exposure to hydrogen sulfide on the eyes. As a rule, the form of inflammation is acute or chronic; there are pronounced symptoms of conjunctivitis in combination with superficial keratitis.
3. Tuberculosis-allergic (scrofulous, phlyctenulous). It is a specific reaction to tuberculosis bacteria. On examination, conflicts are found in the eye.
4. Epidemic. Inflammation develops when pathogens enter the conjunctival sac and cornea. This is perhaps the most dangerous type of keratoconjunctivitis because it is contagious.
5. Adenoviral. The disease is caused by the activity of adenovirus in the body. This species is also contagious.
6. Dry. Characterized by the appearance of threads from degenerated epithelial cells. The threads can reach 5 mm and hang freely from the cornea. The progression of dry keratitis occurs against the background of hypofunction of the lacrimal glands and drying of the cornea.
7. Thygeson's keratoconjunctivitis. Caused by an allergic reaction or viral activity. It manifests itself as a point infection, which at the initial stage of inflammation is noticeable only under special lighting.
8. Atopic. Chronic inflammation, which is characterized by exacerbations during the cold season. During the examination, the doctor identifies whitish plaques on the surface of the eyeball.
9. Chlamydial. Inflammation develops when there is a large amount of chlamydia in the body, and is often a symptom of genitourinary disease. Chlamydia can enter the cornea during oral sex.
10. Spring. A chronic condition that worsens in the spring, less often in the fall. During diagnosis, whitish plaques are found on the mucous membrane.

Symptoms of keratoconjunctivitis

Acute infectious keratoconjunctivitis is characterized by first damage to one eye and gradual movement of inflammation to the other. Symptoms may differ for each patient depending on the type of lesion. The condition can be acute or chronic.

Common symptoms of keratoconjunctivitis:

• itching;
• burning;
• redness of the cornea and conjunctivitis;
• loose structure of the conjunctiva;
• profuse lacrimation;
• photophobia;
• sensation of a foreign body in the eye;
• mucopurulent discharge;
• swelling;
• hemorrhages in the conjunctiva.

Sometimes, during inflammation, various pathological elements (follicles, papillae) are formed. At first, the inflammation is localized only in the conjunctiva, and after 5-15 days it spreads to the cornea.

When chlamydia becomes the cause of inflammation, peripheral subepithelial infiltrates are added to the listed symptoms. With epidemic keratoconjunctivitis, the doctor sees a coin-shaped clouding of the cornea. The spring and atopic forms provoke the appearance of whitish plaques along the limbus.

Allergic keratoconjunctivitis causes severe burning and lacrimation. With dry inflammation, there is almost always dry eye syndrome and filamentous keratitis.

Diagnosis of inflammation of the conjunctiva and cornea

If any of the symptoms of keratoconjunctivitis occur, you should immediately consult a doctor, as some forms of the disease can be contagious. An ophthalmologist must conduct an examination, analyze complaints and anamnesis, as well as existing symptoms. According to indications, the patient may be referred for additional consultation with an endocrinologist, phthisiatrician or therapist.

Methods for diagnosing keratoconjunctivitis:

• visometry (determining visual acuity);
• biomicroscopy (study of eye structures);
• fluorescein test;
• perimetry (determination of visual fields);
• chest x-ray;
• general blood and urine analysis;
• RW blood test.

During the examination, it is very important to exclude blepharoconjunctivitis, viral and adenoviral conjunctivitis, as well as keratitis. Blepharoconjunctivitis is a type of conjunctivitis that is associated with inflammation of the eyelids (blepharitis).

Viral conjunctivitis is considered the most common ophthalmological disease; it affects the conjunctiva of the eye.

Adenoviral keratitis is an acute infection of the mucous membrane of the eyeball. The disease is contagious and therefore requires immediate treatment.

Features of treatment of keratoconjunctivitis

Treatment for keratoconjunctivitis will depend on the cause of the inflammation. Any drugs can be used only after confirmation of the diagnosis and identification of the pathogen. To relieve symptoms, topical drops and ointments can be used. They give a short-term effect, but eliminate redness, burning and itching. Some of them are capable of destroying pathogens in the cornea and conjunctiva.

If inflammation progresses due to exposure to bacteria, it is necessary to include antibacterial drugs in therapy. Antiviral agents will help against viruses, and antifungals against fungi. It must be remembered that uncontrolled use of medications can lead to aggravation of the symptoms of keratoconjunctivitis.

If the cause of the progression of inflammation is a foreign body, surgical intervention is resorted to. In rare cases, conservative therapy for keratoconjunctivitis is completely ineffective. The ophthalmologist may suggest a corneal transplant to the patient.

Main medications for keratoconjunctivitis

Before using any drug, you should consult your doctor. It should be remembered that every medicine has contraindications.

Oftalmoferon is an anti-inflammatory, antiviral and immunomodulatory agent. For acute keratoconjunctivitis, 1-2 drops are prescribed 6-8 times a day into the affected eye. As you recover, the dose is reduced by 2-3 instillations per day. Treatment can be continued until complete recovery.

Tobramycin or Tobrex is a broad-spectrum antibiotic. It belongs to the group of aminoglycosides. For inflammation of the conjunctiva and cornea, 6-8 instillations per day, 1-2 drops into the conjunctival sac, are permissible. When symptoms subside, the dose is reduced to 4-5 instillations.

Ciprofloxacin is an antimicrobial drug from the fluoroquinolone series. Mild and moderate inflammations are treated by instilling 1-2 drops every 4 hours, and severe inflammations by instilling 2 drops every 2 hours. As you recover, the intensity and dosage are reduced.

If a bacterial ulcer occurs, Ciprofloxacin is recommended drop by drop every 15 minutes for 6 hours, and then drop by drop every half hour while awake. On the second day of treatment, a drop is instilled every hour of the day, on days 3-14, a drop is instilled every 4 hours (in the afternoon).

Preservation of the precorneal film helps protect the cornea from metaplasia. Trisol, Lakrisin, sodium bicarbonate solution (2%) are suitable for these purposes. You should also reduce the outflow of tears from the conjunctival sac by coagulation or blockade with silicone plugs.

To prevent secondary infection, a solution of chloramphenicol (0.25%) or sodium sulfacyl (30%) is recommended. Preservation of visual function is only possible if treatment is started at the first or second stage of inflammation, preferably before the development of filamentous keratitis.

Treatment methods for different types of keratoconjunctivitis

Allergic

Allergic keratoconjunctivitis should be treated quickly as complications can occur very quickly. Most often, allergic eye inflammation occurs in spring and summer, when there are a large number of allergens. The first step is to eliminate the irritant or limit contact with it. It is necessary to take antihistamines and vitamins to strengthen general immunity.

Herpetic

It is necessary to prescribe anti-inflammatory and antiviral drugs, eye and antiherpetic ointments (Bonafton, Virolex, Zovirax, Acyclovir). Orally Valtrex for herpes, immunomodulator Cycloferon or Polyoxidonium. Tobrex antibacterial eye drops with antibiotics or placing tetracycline, erythromycin ointment behind the lower eyelid.

Adenoviral

For uncomplicated keratoconjunctivitis, Poludan, Reaferon or Pyrogenal drops are prescribed. Depending on the complications, it is possible to take antiallergic and antiherpetic drugs. Glucocorticosteroids can eliminate signs of inflammation, but they are powerless against adenovirus, which quickly turns the disease into a chronic one (Tobradex, Dexamethasone, Sofradex).

Epidemic

Prescription of broad-spectrum antiviral drugs is required. Interferons and interferon inducers (Lokferon, Ophthalmoferon) are suitable for these purposes. In case of acute inflammation, therapy is supplemented with antiallergic drops (Allergoftal, Spersallerg) and oral antihistamines. The subacute form requires instillation of Lecrolin or Alamid.

If a film or rash appears on the cornea, corticosteroids are needed (Oftan-Dexamethasone, Dexapos, Maxidex). During a relapse, immunocorrective therapy (Taktivip) is performed. After epidemic keratoconjunctivitis, discomfort and decreased tear production may occur, which can be eliminated with Liquifilm and Poliglyukin.

Keratoconjunctivitis sicca

Treatment consists of eliminating symptoms. The ophthalmologist prescribes vitamins, artificial tears, Lacrisin and petroleum jelly. Keratoconjunctivitis sicca requires the use of moisturizing drops. They help restore the natural film of the eyeball. The best in this group are Actovegin and Taufon.

Chlamydial

This form of keratoconjunctivitis can be cured only with the help of antibiotics (macrolides, tetracyclines, fluoroquinolones). Instillations of antibacterial (Ofloxacin, ciprofloxacin solution) and anti-inflammatory drops (Indomethacin, dexamethasone solution), applications of tetracycline or erythromycin ointment are recommended. Systemic treatment for chlamydia is also required.

Tuberculosis-allergic

Therapy should be comprehensive, with the joint work of an ophthalmologist and a phthisiatrician. First of all, steroid instillations (Dexasone, Hydrocortisone) are prescribed. To carry out desensitization, instillation of Dexamethasone, Prednisolone (1%), calcium chloride solution (3%) and diphenhydramine (2%) is indicated.

Corneal defects are eliminated using keratoplasty. If inflammation affects the iris, mydriatics are required. To prevent secondary infection, antibiotics, sulfonamides and bactericidal agents are prescribed. In the presence of extraocular foci of tuberculosis, specific tuberculostatic drugs should be taken.

Prevention of keratoconjunctivitis

In most cases, the prognosis for inflammation of the cornea and conjunctiva is unfavorable. Only with timely detection of inflammation and proper treatment can complications be avoided (scarring of the mucous membrane, transition to a chronic form, otitis media, bacterial damage, blurred vision).

Since the causes of keratoconjunctivitis are varied, the best preventive measure would be general strengthening of the body, compliance with hygiene rules and timely treatment of any diseases. It is very important to control allergic reactions and fight helminthiasis.

Keratoconjunctivitis is a serious and dangerous condition that often results in severe deterioration of visual function. To preserve your vision and the ability to lead an active lifestyle, you need to monitor the condition of your eyes and respond to any changes in a timely manner.

Source: https://BeregiZrenie.ru/konyuktivit/keratokonyunktivit/

Keratoconjunctivitis - symptoms and treatment of the disease

In medical practice, a huge number of pathologies of the visual apparatus are constantly diagnosed, occurring with inflammatory processes.

One of the most frequently reported diseases is keratoconjunctivitis, the symptoms and treatment of which are fully determined only after a thorough and comprehensive diagnosis.

Some signs of the disease are most pronounced, which gives patients a reason to consult an ophthalmologist. The sooner they are noticed, the higher the chances of recovery without complications.

Definition and description of the violation

Most inflammatory diseases of the visual apparatus spread to only one part of the mucous membrane. So, conjunctivitis affects only the conjunctiva. In turn, keratoconjunctivitis is a disease that affects not only the cornea, but also the cornea.

The mucous membranes of the visual apparatus have protective functions and reactions against external stimuli (blinking, tear production). This allows the eye to cope with dangerous infections on its own. For serious damage to occur, a catalyst is needed. In case of keratoconjunctivitis, it can be trauma, decreased immunity, the formation of an aggressive environment, and much more.

As a result of the lesion, inflammatory processes occur that create discomfort, cause swelling, redness, and soreness.

Classification, varieties

Keratoconjunctivitis is classified based on the causes of its occurrence, as well as the causative agents of the disease. Thus, the types of pathology are distinguished:

1. Herpetic. Often the disease develops against the background of reduced immunity, which causes penetration and progression of the herpes virus on the mucous membrane. It affects the conjunctiva, then gradually spreads to the cornea;
2. Chlamydial. It is bacterial in nature. The onset of the disease also occurs with damage to the conjunctiva;
3. Tuberculosis-allergic. It is a specific form in which an allergic reaction to Mycobacterium tuberculosis is observed. A characteristic symptom of the disease is the appearance of conflicts on the conjunctiva and cornea;
4. Adenoviral. Has a high risk of transmission to healthy people, and therefore poses a potential danger to those who are constantly in contact with the patient;
5. Atopic;
6. Dry. The main cause is drying of the cornea due to dysfunction of the lacrimal glands. A characteristic symptom is hanging threads from dead epithelial cells;
7. Spring. Occurs against the backdrop of changing climatic conditions and decreased immunity;
8. Hydrogen sulfide. It is a specific form of inflammation that occurs as a result of intense and prolonged exposure to hydrogen sulfide on the mucous membrane. May have an acute or chronic form. The depth of the lesion is usually small;
9. Epidemic. Occurs as a result of mucosal viral infection.

At the diagnostic stage, one of the most important tasks of the doctor is to recognize the type of disease and determine the cause of its occurrence.

This is required to select suitable and effective medications and prevent the recurrence of the disease. Regardless of the factors of occurrence, keratoconjunctivitis can take an acute or chronic form.

At the same time, a transition from the first to the last is possible with incorrect or untimely treatment.

General symptoms

The progression of any form of keratoconjunctivitis is accompanied by inflammatory processes. This, in turn, causes unpleasant symptoms, including:

• Redness of the cornea, whites of the eyes and conjunctiva, severe swelling of the mucous membrane and eyelids;
• Increased lacrimation;
• Soreness;
• Itching, pain and severe burning;
• Discharge of cloudy, mucous or purulent exudate;
• Photophobia;
• Sensation of foreign body or sand in the eyes;
• Hemorrhage and hematomas (in severe cases).

As a rule, unpleasant sensations along with inflammatory processes occur for the first five to ten days from the onset of the lesion only on the conjunctiva, then keratitis joins them. The formation of whitish plaques on the mucous membrane is possible.

Predisposing factors and prerequisites for the onset of the disease

Each type of keratoconjunctivitis has its own causes. However, there are also factors predisposing to this:

• Blink reflex disorder, eyelid dysfunction;
• Destruction of the tear film under the influence of external factors;
• Entry of a foreign body and mechanical damage to the cornea and conjunctiva;
• Infectious lesion (infection with a viral or bacterial infection as a result of close contacts with patients, addition of a fungal infection);
• Allergic reactions;
• Frequent infectious lesions, decreased level of body resistance;
• Systemic diseases of the body;
• Autoimmune pathologies;
• Endocrine disorders;
• Constant or frequent wearing of contact lenses;
• Failure to comply with personal hygiene rules;
• Injuries and mechanical damage to the mucous membrane.

If there are predisposing factors, the occurrence of inflammatory processes can be prevented by visiting an ophthalmologist.

Diagnostic methods

The first and most important step in the comprehensive diagnosis of keratoconjunctivitis is the initial examination and testing of the visual apparatus. Then the ophthalmologist must conduct an anamnesis and make an initial conclusion. Additional mandatory measures:

1. Checking the functions of the visual apparatus (ophthalmoscopy, visometry, tonometry);
2. Biomicroscopy;
3. Examination of the fundus for possible complications and the depth of the lesion;
4. Laboratory tests of secreted exudate and tear fluid;
5. Laboratory blood tests (general, biochemical).

In most cases, an examination and additional research from doctors in other fields is also required. To obtain other important information, it is necessary to review the patient's medical history.

Treatment

The choice of therapeutic method depends on the form of the disease, as well as the stage of its progression. Most often, in the early stages only conservative treatments are used, in later and more severe cases – surgical treatments.

Drug effects

Drug treatment should be aimed not only at eliminating keratoconjunctivitis, but also at relieving its causes. In this case, the selection of medications is made on an individual basis.

The following drugs are most often used in the treatment of keratoconjunctivitis:

• Oftalmoferon. The drug is one of the immunomodulatory, antiviral and anti-inflammatory drugs. Effectively copes with the main symptoms and alleviates the course of the disease;
• Ciprofloxacin. Eye drops not only eliminate the main symptoms and signs of the disease, but also eliminate the bacterial infection. In addition, the drug is able to prevent microbial infection in other types of keratoconjunctivitis;
• Levomycetin. It is also one of the most effective bactericidal agents. Can be used in the form of tablets and eye drops, and also as a means to wash affected areas;
• Tetracycline ointment 1%. Eliminates bacterial infection and prevents the proliferation of microbes. Has a long-lasting effect;
• Albucid. It is one of the most effective anti-inflammatory and bacterial agents.

Before using ointments and eye drops, it is necessary to rinse with warm water or solutions of Furacilin or potassium permanganate. It is also necessary to thoroughly wash your hands with soap and water before and after therapeutic procedures.

For allergic keratoconjunctivitis, the use of antihistamines (Suprastin, Loratadine, Zodak) is recommended. Antiallergy eye drops may also be indicated.

The herpetic type of lesion is eliminated with the help of Tobrex instillation solution, as well as the immunomodulators Cycloferon and Polyoxidonium. To relieve dry mucous membranes, artificial tears, Actovegin and Taufon, are prescribed.

To avoid re-infection and spread of infection, it is necessary to refrain from using general hygiene products and place the patient in quarantine.

Surgery

A radical treatment method may be required in two cases:

1. If necessary, restore the functionality of the lacrimal glands and blockage of the lacrimal ducts. These operations are necessary to treat dry cornea, in which the transition of acute keratoconjunctivitis to a chronic form is inevitable;
2. Lack of effectiveness of conservative methods. The operation involves a corneal transplant and is required only in the most severe cases, including when severe complications occur.

In most cases, doctors try to avoid surgical treatment of keratoconjunctivitis, but the patient’s delay before visiting an ophthalmologist can prompt its use.

Prognosis and possible complications of the disease

The prognosis can be favorable only with timely diagnosis of the disease and a correctly selected therapeutic method. Otherwise, the following dangerous problems are likely to occur:

• Rapid decrease in visual acuity;
• Cloudiness of the cornea;
• Filamentous keratitis;
• Belmo;
• Blepharitis.

Inflammation may transform into a recurrent form. In this case, the patient will require ongoing maintenance therapy.

Preventive measures

The occurrence of keratoconjunctivitis may have several different causes. The disease itself has a complex development mechanism, which complicates its prevention. However, it is possible to minimize the likelihood of inflammation using the following recommendations:

1. Observe basic hygiene rules;
2. Follow the rules of wearing glasses and contact lenses;
3. Monitor your immune system;
4. Avoid traumatic situations;
5. Avoid close contact with infected patients;
6. Undergo medical examinations in a timely manner and eliminate systemic diseases.

Conclusion

Keratoconjunctivitis is one of the most dangerous inflammatory diseases of the visual apparatus. It has a complex nature of occurrence and many possible prerequisites, which are important to establish during diagnosis. If a diagnosis is not made in a timely manner or ineffective medications are prescribed, the problem may worsen and severe complications may occur.

Source: https://zrenie.guru/keratokonyunktivit-simptomy-i-lechenie

Keratoconjunctivitis: types, causes, symptoms, treatment

Keratoconjunctivitis is an inflammatory disease that affects the cornea and conjunctiva of the eye. This disease is one of the most common among all eye diseases.

This is explained by the fact that the conjunctiva is highly reactive - it quickly and easily responds to exogenous and endogenous factors. Some types of keratoconjunctivitis are highly contagious.

According to the nature of the pathological process, acute and chronic keratoconjunctivitis are distinguished.

Etiology

The disease can be caused by the following factors:

• bacteria;
• viruses;
• fungi;
• various parasitic infections;
• allergic diseases;
• taking corticosteroids;
• foreign body in the conjunctiva or cornea;
• excess or deficiency of vitamins in the human body.

Sometimes inflammation of the conjunctiva and cornea can be caused by constantly wearing contact lenses (removing and putting them on with dirty hands). The following diseases can also cause the progression of keratoconjunctivitis:

Sjögren's syndrome

Kinds

1. Herpetic keratoconjunctivitis. This form of the disease develops due to the penetration of the herpes simplex virus into the body. As a rule, it occurs in the form of herpetic keratitis or acute diffuse conjunctivitis.
2. Hydrogen sulfide conjunctivitis.

   Develops due to prolonged exposure to hydrogen sulfide on the conjunctiva and cornea. It occurs in the form of acute or chronic conjunctivitis, and is accompanied by superficial keratitis.

3. Tuberculosis-allergic keratoconjunctivitis. In the medical literature it is also called scrofulous or phlyctenular conjunctivitis.

   The disease develops as a specific allergic reaction to Mycobacterium tuberculosis, which is in the body. This form is characterized by the formation of specific conflicts on the cornea, as well as on the conjunctiva.

4. Epidemic keratoconjunctivitis. It develops due to the entry of viruses into the conjunctival sac and cornea.

   Epidemic keratoconjunctivitis is a dangerous disease as it is highly contagious.

5. Adenoviral keratoconjunctivitis. Develops due to the penetration of adenoviruses into the conjunctiva. Adenoviral keratoconjunctivitis is also contagious.
6. Dry keratoconjunctivitis.

   It is characterized by the formation of threads on the front surface, 1 to 5 mm long. They can hang freely from this area. Pathological threads consist of degenerated corneal epithelial cells. Dry keratitis begins to progress due to drying of the cornea, which occurs as a result of hypofunction of the lacrimal glands.

7. Thygeson's keratoconjunctivitis.
8. Atopic.
9. Spring.
10. Chlamydial.

Symptoms

Acute infectious keratoconjunctivitis first affects one eye, and then moves to the second. Symptoms of the disease may vary slightly depending on what type of disease affects the person. But it is also worth highlighting the general symptoms characteristic of all forms:

• burning;
• itching in the eye;
• hyperemia of the conjunctiva and cornea;
• lacrimation;
• mucopurulent discharge from the eye;
• upon visual examination, it can be revealed that the conjunctiva is edematous and has a loose structure. In some cases, pathological elements may form on it - follicles, papillae, etc.;
• photophobia;
• feeling of a “mote in the eye”;
• perhaps the appearance of hemorrhages in the conjunctiva.

The inflammatory process begins to progress from the conjunctiva, but after 5–15 days damage to the cornea occurs. In case of progression of epidemic keratoconjunctivitis, the clouding of the cornea has a coin-shaped shape. If the causative agent of the disease is chlamydia, then the general list of symptoms is supplemented by the formation of peripheral subepithelial infiltrates.

A characteristic symptom of atopic and vernal keratoconjunctivitis is the appearance of whitish plaques along the limbus. If the disease was provoked by an allergic reaction, then in this case there is a strong burning sensation in the eyes and profuse lacrimation.

Keratoconjunctivitis sicca is almost always accompanied by dry eye syndrome. This pathological process can be complicated by filamentous keratitis. For dry keratoconjunctivitis, it is advisable to use drops of “artificial tears” to moisturize the mucous membrane of the eye.

Keratoconjunctivitis sicca in a patient with dry eye syndrome

Diagnostics

If you suspect the development of dry keratoconjunctivitis or another form of this disease, it is recommended to seek qualified medical help from an ophthalmologist as soon as possible.

The first stage of diagnosis is a personal examination of the patient, collection of complaints, assessment of existing symptoms.

After this, in order to accurately establish the diagnosis, the patient is prescribed a series of instrumental and laboratory tests.

Instrumental techniques:

• visometry;
• staining the affected area with fluorescein;
• perimetry;
• chest x-ray;
• biomicroscopy.

Laboratory techniques:

• general blood analysis;
• general urine analysis;
• blood donation at RW.

If necessary, the patient can be referred for consultation to other specialists - an endocrinologist, therapist or phthisiatrician.

Treatment

Treatment directly depends on the cause that caused the progression of allergic or other types of keratoconjunctivitis. It is prescribed only after confirmation of the appropriate diagnosis by a doctor.

To reduce the symptoms of the disease, topical medications are used - drops and ointments.

They help to eliminate unpleasant symptoms, hyperemia in a short period of time, and will also destroy pathogenic microorganisms that are in the conjunctiva or cornea.

If the cause of disease progression is bacteria, then the main course of treatment will necessarily include antibacterial drugs. In case of viral infection, antiviral drugs are prescribed for treatment.

If the cause of progression of keratoconjunctivitis is a fungus, then the patient should take antifungal drugs.

It should be noted that it is prohibited to take these medications uncontrollably for treatment, as this can only aggravate the situation.

Treatment of dry keratoconjunctivitis involves the use of compositions that moisturize the surface of the eyes. This is necessary as it will help restore the film of the eye. The drugs of choice for the treatment of dry keratoconjunctivitis are Actovegin and Taufon.

The allergic form of the disease also needs to be treated as soon as possible, as various complications may begin to develop. In this case, the first thing to do is eliminate the allergen.

Allergic keratoconjunctivitis most often occurs in the spring and summer, when there are a lot of allergens floating around - pollen, dust, etc. Further, antihistamines and vitamin complexes are prescribed for treatment.

An allergic type of pathology can affect people from different age groups.

If the treatment is ineffective and the patient’s condition does not improve and the symptoms only worsen, doctors may resort to corneal transplant surgery. Most often, the prognosis of this disease is unfavorable. Only early detection and adequate treatment of pathology can help preserve vision.

Source: https://SimptoMer.ru/bolezni/zrenie/1098-keratokonyunktivit-simptomy

Keratoconjunctivitis in humans: what is it and how to treat

Keratoconjunctivitis is a serious and dangerous eye disease that often leads to severe vision loss. The pathology is an inflammation of the conjunctiva with gradual involvement (over 5-15 days) of the cornea in this process. Keratoconjunctivitis is a common ophthalmological disease.

This is due to the speed of the conjunctiva’s reaction to various external stimuli. The causes of the development of the pathological process are bacterial, mycotic, viral infection of the eye, autoimmune diseases, foreign body entry, allergic reactions.

In some cases, the disease occurs as a result of penetration of a foreign object into the eye, long-term use of corticosteroids, or taking vitamins.

Varieties

There are several forms of the disease. Depending on the etiology of the pathological process, atopic, chlamydial, adenoviral, dry, hydrogen sulfide, and herpetic keratoconjunctivitis are distinguished. According to the nature of the disease, it is divided into chronic and acute varieties.

The following table discusses the forms of keratoconjunctivitis and their features.

View.	Characteristics.
Hydrogen sulfide.	Appears after exposure of the conjunctiva to hydrogen sulfide over a long period. It occurs in the form of acute or chronic conjunctivitis and is accompanied by superficial keratitis.
Tuberculosis-allergic (scrofulous or phlyctenulous).	This form of keratoconjunctivitis appears as a special form of allergic reaction to infectious pathogens of tuberculosis.
Herpetic.	It develops due to the penetration of HSV (herpes simplex virus) into the body. It occurs in the form of herpetic keratitis, in some cases in the form of developed acute conjunctivitis.
Dry.	It is characterized by the formation on the anterior surface of the conjunctiva of threads consisting of degenerated cells of the epithelial layer of the cornea. The threads are 1-15 mm long and can hang freely. It begins to progress as a result of dysfunction of the lacrimal glands. Keratoconjunctivitis sicca or dry eye syndrome is characterized by the spread of the inflammatory process and redness of the conjunctiva due to a decrease in the amount of tear fluid. This form of the disease is characterized by several stages of progression, accompanied by certain symptoms. Initially, redness of the conjunctiva and secretion in the form of threads are observed. Then the epithelial layer of the cornea peels off, and it is affected by erosion. Threads about 5 mm long appear on the cornea, which are attached at one end to the cornea, and the other hangs freely into the conjunctival sac. At the last stage, clouding of the cornea is observed, which is accompanied by a significant deterioration in vision. In the presence of dry eye syndrome, itching, burning, and acute piercing pain are observed.
Epidemic.	A dangerous and contagious form of keratoconjunctivitis that develops due to the penetration of viruses into the cornea or conjunctival sac.
Adenoviral.	A contagious type of keratoconjunctivitis. Appears due to the penetration of adenoviruses into the conjunctiva.

Symptoms of keratoconjunctivitis

Symptoms vary depending on the type and form of the pathological process. Acute keratoconjunctivitis is characterized by unilateral damage to the organ of vision at the very beginning of its development. Gradually, the second eye is involved in the inflammatory process. There is an asymmetry of eye damage; one is involved in the inflammatory process more than the other.

The symptoms of the disease vary depending on the form and nature of its course, but there are a number of common signs. These include:

• increased lacrimation;
• fear of light;
• swelling of the conjunctiva and cornea;
• itching, burning, pain in the eye;
• feeling of the presence of a foreign object;
• redness of the conjunctiva;
• mucopurulent discharge from the eyes.

Chlamydial keratoconjunctivitis is complemented by the formation of peripheral infiltrates. The allergic form is characterized by pronounced itching, burning, and lacrimation. Viral is characterized by hemorrhage into the conjunctiva of the eye. The dry form is accompanied by dry eye syndrome.

Diagnostics

If you have one or more symptoms characteristic of keratoconjunctivitis, you should consult an ophthalmologist. 

Then he prescribes the following diagnostic procedures:

• determination of visual clarity (visometry);
• study of eye structures using a slit lamp;
• determination of visual fields (perimetry);
• test using fluorescein staining of eye structures;
• examination of tear fluid and discharge from the eye (histochemical and bacteriological).
• scraping from the conjunctiva and cornea to determine the causative agent of the disease.

The doctor will also send the patient for a general urine and blood test and a chest x-ray.

In some cases, consultation with a phthisiatrician, endocrinologist, or allergist may be required.

It is extremely important to differentiate keratoconjunctivitis from viral, adenoviral conjunctivitis, keratitis, and blepharoconjunctivitis.

Treatment

The treatment tactics are chosen depending on the form of the pathological process, the depth of its prevalence and only after determining the form of the disease and identifying the causative agent. For treatment, ointments, drops and tablets are used. If keratoconjunctivitis is bacterial in nature, antibiotics are prescribed. In case of mycosis - antifungal, in the presence of viruses - antiviral.

The main drugs used to treat keratoconjunctivitis are:

1. Oftalmoferon. Anti-inflammatory, antiviral, immunomodulatory agent. To relieve symptoms of the acute phase of keratoconjunctivitis, Oftalmoferon is instilled dropwise into each eye up to 8 times a day. As the disease is eliminated, reduce the number of instillations to 2.
2. Tobramycin (Tobrex). A broad-spectrum antibacterial drug belonging to the group of aminoglycosides. For keratoconjunctivitis, Tobrex is instilled 1-2 drops up to 8 times a day, gradually reducing to 4 single drops as painful symptoms are eliminated.
3. Ciprofloxacin. Antimicrobial drug from the group of fluoroquinolones. Use as instillations, 2 drops in each eye every 4 hours for mild forms of the disease and every 2 hours for severe ones.
4. Levomitin and Albucid. These antimicrobial drops help prevent re-infection of the conjunctiva and cornea.

the main means to combat keratoconjunctivitis

The drugs Lakrisin and Trisol help preserve the protective film of the eye. Reduce the outflow of tears from the conjunctival sac using laser coagulation or installing blockades with silicone plugs.

Features of the treatment of each form of the disease

Allergic keratoconjunctivitis is treated by taking antihistamines Tavegil, Suprastin. But the first step is to eliminate the allergen that causes the pathological process.

the main means to combat allergic keratoconjunctivitis

The herpetic form is eliminated with the help of antiviral and anti-inflammatory medications. Virolex, Zovirax, Bonafton ointments are used. Valtrex is taken internally, as well as the immunomodulators Polyoxidonium or Cycloferon. Tobrex drops are used and at the same time erythromycin and tetracycline ointments are placed behind the lower eyelid.

the main means to combat herpetic keratoconjunctivitis

Adenoviral keratoconjunctivitis is treated with drops of Reaferon, Pyrogenal, Poludan.

the main means to combat adenoviral keratoconjunctivitis

The epidemic form of the disease is eliminated with broad-spectrum antiviral drugs. These are interferon-based products (Ophthalmoferon). In case of exacerbation, antihistamines (Spersallerg) are prescribed. If rashes appear on the cornea, corticosteroid therapy (Dexapos, Maxidex) is required.

main means to combat epidemic keratoconjunctivitis

To eliminate dry keratoconjunctivitis, drugs are required that restore the natural film of the eye (Taufon, Actovegin). The ophthalmologist prescribes special “eye” vitamins, artificial tears, and Vaseline oil. The doctor may prescribe special ointments, eye lubricants, vitamins A and E.

the main means to combat keratoconjunctivitis sicca

The chlamydial form can only be eliminated with the help of antibacterial therapy. Use instillation of Ofloxacin, Ciprofloxacin. Additionally, erythromycin and tetracycline ointments and anti-inflammatory drops (Dexamethasone, Indomethacin) are used.

the main means to combat chlamydial keratoconjunctivitis

Tuberculous-allergic keratoconjunctivitis requires an integrated approach to treatment. First, steroid drops (Hydrocortisone) are instilled.

For desensitization, it is necessary to use Prednisolone drops and a two percent solution of diphenhydramine. Corneal defects are corrected using keratoplasty.

If extraocular foci of tuberculosis infection occur, specific tuberculostatic agents are prescribed.

There are no specific preventive measures to prevent keratoconjunctivitis. However, several basic rules can be identified, the observance of which will help reduce the risk of pathology. These include strengthening the immune system, maintaining eye hygiene, and timely treatment of any eye diseases.

Keratoconjunctivitis is a serious ophthalmological disease that does not have a very favorable prognosis.

Only with its timely detection and correct treatment tactics can it be possible to avoid scarring of the mucous membrane and the transition of the pathology to a chronic form.

Untreated keratoconjunctivitis leads to a progressive decrease in visual acuity, the formation of a cataract, and the appearance of filamentous keratitis. 

Bakhareva Elena Sergeevna, specialist for the website glazalik.ru
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Source: https://GlazaLik.ru/bolezni-glaz/konyunktivit/keratokonyunktivit-u-cheloveka-chto-eto-i-kak-lechit/

Adenoviral keratoconjunctivitis: symptoms and treatment in adults and children, acute and complications, how long it lasts

This disease is far from uncommon, given how contagious it is. A timely course of treatment and a correct diagnosis will speed up the recovery period, eliminating complications and unpleasant consequences. In this article you will learn what this virus is, how to detect it, what treatment specialists offer, and what prevention measures are the most effective.

Definition of disease

Adenoviral keratoconjunctivitis is a disease that affects the conjunctiva and cornea of ​​the eyeball. Complications are very dangerous and can have dire consequences. There may even be loss of vision.

This disease is the result of infection with an adenovirus, as a result of which the eye becomes inflamed.

Most often, infection occurs through contact with a person who already carries this virus, but cases of infection are possible during examination of the visual organ.

Causes

This virus lives in the upper respiratory tract on the mucous membrane. As a result, infection can occur through respiratory droplets when an infected person sneezes or coughs. Sometimes adenoviral conjunctivitis is a complication of a respiratory virus.

Because of this, typical fever, enlarged lymph nodes and increased temperature may appear. There are a great many ways to catch this disease. Spring is considered to be a particularly aggravated period for the peak of conjunctivitis.

It is at this time, when everything is blooming and there is a lot of dust in the air, that the development of the disease is quite possible.

Symptoms of the disease appear within approximately seven days of infection. The virus is highly contagious and easily transmitted, which is why outbreaks of epidemics are common.

Symptoms of the disease

Adults tolerate this infection much better than children, but the symptoms are essentially identical in all age groups. The only difference may be in the timing of the manifestation of the disease, sometimes this period is only 3 days. So, here are the signs that can identify adenoviral keratoconjunctivitis:

• The appearance of symptoms of a common cold. It can be a high temperature, sometimes there may be signs of pharyngitis, a stuffy nose or rhinitis may begin.
• Headache.
• Digestive disorder.
• Lymph nodes become larger in volume.
• After a few days, a clearly visible manifestation of the infection begins. One eye becomes red, and very soon the other eye becomes affected.
• The eyelids are drooping. Some patients complain of the release of tear fluid.
• A very painful reaction to light and its flashes, a feeling that there is an object in the eye.

There are a lot of symptoms, if most of them match what you have, then we can assume that you have adenoviral keratoconjunctivitis.

Remember that the disease begins with symptoms that are characteristic of a common cold. With the further development of the disease, it is necessary to take timely measures, otherwise there may be terrible complications.

Possible complications

Like any other viral disease, it also has a number of complications. Those people who have a weakened immune system are at risk of having serious consequences after adenoviral keratoconjunctivitis. The virus can flow into the bacterial form of conjunctivitis, otitis media, and scars may appear on the mucous membrane of the eye. Acute forms of the virus can become chronic.

Treatment

Often mutating adenoviruses can become a problem when choosing an effective treatment method. There are two ways to effectively get rid of this disease:

Medication method

There are a number of drugs that can have a quick effect. These include antibiotics, such as macropen or salutab, corticosteroids, all kinds of immunotropic drugs Reoferon, Poludan, Pyrogenal and others. It is also possible to take medications that help increase immunity and various antiviral drugs.

Use of antihistamines

Artificial eye hydration using Oftagel or Vidisik. You can use both drops and ointment. Immunomodulators will be a good addition to the main course of treatment, because adenoviral keratoconjunctivitis is accompanied by symptoms of rhinitis and pharyngitis.

Select medications according to the recommendations of doctors, this way you will achieve a quick recovery, which will be extremely effective. The average period of taking the drugs is no more than 10-14 days.

Disease prevention

It is quite simple to follow the rules to help avoid infection of the visual organs. But often we forget such simple truths. Please adhere to the following points:

• Do not touch your eyes with dirty hands.
• Timely isolation of people with conjunctivitis.
• Ventilate the room where you spend most of your time.
• Clean with products that destroy harmful viruses and bacteria.
• If you visit a swimming pool, it must meet all standards.
• Wet clean your home at least once a week.
• At the first symptoms, visit a specialist. This way you will avoid more dire consequences.

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conclusions

Adenoviral keratoconjunctivitis is a completely curable virus. However, it spreads easily and treatment should be selected individually.

Knowing the symptoms of this disease, you can easily start taking the necessary medications on time. By following preventive measures you will be able to reduce the risk of infection.

We hope that this article has helped you and in the future you will know what this disease is.

Also read about retinal angiopathy and astigmatism.

Source: https://EyesDocs.ru/zabolevaniya/konyunktivit/adenovirusnyj-keratokonyunktivit.html