Opthalmic Disorders

Conjunctivitis:


  • It is the inflammation of the conjunctiva, a thin mucous membrane lining the inner aspect of eyelids. It is also known as Pink eye.

Etiology:

  1. All ages and all seasons especially autumn and spring.
  2. Bacterial Infections
  3. Viral Infections
  4. Chlamydia Infections
  5. Chemicals
  6. Chronic irritation
Clinical Manifestations: ( REDBV)
  1. Unilateral or bilateral RED EYE.
  2. EYE IRRITATION.
  3. DISCHARGE from eyes: which may be watery, mucoid, mucopurulent or purulent.
  4. BURNING SENSATION.
  5. Blurred VISION, clears with blinking.
Types:
1. Allergic Conjunctivitis: 
  • Due to allergic reactions. (poison, cosmetics, dust)
  • Lacrimation (excessive tear flow), photophobia, redness, itching of eye, edema of eyelids, watery discharge are the clinical features.
2. Bacterial Conjunctivitis: 

  • Due to bacteria like Staphylococcus, Pneumonococcus, Pseudomonas species.
3. Viral Conjunctivitis:
  • Caused by a wide variety of viruses. Like Adenovirus, Herpes simplex.
  • Irritation, mucoid discharge, Lacrimation, Photophobia, Hyperemia are the clinical features.
4. Infective Conjunctivitis:
  • Highly infectious, usually seen among school children.
Causes:
  • Chemical irritants: acids, smoke, wind, UV light.
  • Chronic irritants: due to rubbing, wearing of contact lenses.
  • Fungal Infection: Candida, Albicans.
  • Chlamydia Infection: Chlamydia trachomitis, through vector flies.
  • Through personal equipments like towels, handerchief.


Diagnosis:

  • History taking
  • Physical Health examination.
  • Culture and sensitivity test: Conjunctival culture.
  • Bacterioogical examination.
Treatment:
  • Use cold compress to relieve itching.
  • Identify and remove substances that causes irritation.
  • Do not rub or apply hot compress.
  • Maintain personal hygiene.
  • Wear protective glasses to soothe the eyes.
  • Wash hands before and after touching the eyes.
  • Wash conjunctival sac with normal saline 3 times a day.
  • Clean the crusts (outer layer) of eyelid and lashes with cotton.
  • Do not use pressure on eyeball.
  • Antibiotic therapy: In case of bacterial Conjunctivitis
         -Eyedrops:  4-6 times daily 
               Like Norfloxacin, Ciprofloxacin, Gentamycin, Framycin, Neomycin, 
         - Ointment:
                Chloromycentin, Gentamycin, Tetracycline, Framycin, Neomycin.
  • Anti- Histamine should be given orally or drops.
  • Steroids: Prednisolone, Dexamethasone.
  • Cycloplegic and Mydriatic action: Atropine sulphate, Cyclopentolate hydrochloride, Homatrophine hydrobromide.
  • No specific treatment for viral conjunctivitis (usually lasts 7-10 days).
Nursing Management:
  1. Assessment: Assess the signs, symptoms, severity of conjunctivitis.
  2. Nursing Diagnosis:
  • Acute pain related to infection in eyes.
  • Alteration in comfort related to foreign body sensation in eyes.
  • Altered visual perception related to stickyness in eyes.
  • Deficit Knowledge related to disease process.

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