Purulent conjunctivitis is common, but only a few infectious agents can cause illness, complicated by the visually impaired. These pathogens are Pseudomonas aeruginosa and gonococcus. Conjunctivitis caused by these pathogens should be treated with special care.

What causes purulent conjunctivitis

The disease is mainly caused by pyogenic bacteria that can cause purulent inflammation of the mucous membranes. These bacteria are pyogenic cocci (many staphylococcus, streptococcus, gonorrhea), the group Proteus, Pseudomonas aeruginosa, and others. At the same time, purulent conjunctivitis can be caused by negnoerodnymi microorganisms, such as E. coli or a stick diphtheria.

The greatest danger is purulent conjunctivitis caused by Pseudomonas aeruginosa and gonococci, as they may be complicated by the defeat of the cornea and reduced vision, including blindness.

Staphylococcal conjunctivitis is transmitted from person to person by contact (for example, through the hands, on which there are particles of pus) or items to which touched the patient. Pseudomonas aeruginosa is most often implemented in the presence of conjunctival microtrauma (arising, for example, when wearing contact lenses and the wrong care of them). Gonococcal conjunctivitis (ophthalmia) is usually accompanied by the defeat of gonorrhea genital organs (eye infection entered into with the dirty hands of the patient). Thanks to a special hospital in the prevention of ophthalmia today practically does not occur in the newborn.

Symptoms of purulent conjunctivitis

Staphylococcal conjunctivitis can be acute or chronic. Acute suppurative conjunctivitis, caused by staphylococcus, begins suddenly occurs rapidly, but seldom gives complications.

The disease may begin with a general malaise, headache Headache: Causes and Complications , Photophobia, lacrimation. Initially, one eye is affected, then, after about twenty-four hours - the second. The conjunctiva is reddened, swollen eyelids, eyelashes and eyelids glued to the edge of pus. Drainage has a slimy character at first and then mucopurulent and purulent. Mucous film shrouded the entire front surface of the eyeball, which is why suffering vision. Pus flows from the eye, irritates the lid margin, causing burning and itching. The disease lasts 1-2 weeks, but at the wrong treatment of the acute process can turn into chronic. Purulent conjunctivitis in children is most often caused by staphylococci.

In chronic staphylococcal conjunctivitis symptoms less severe, characterized by photophobia, slight irritation of the eyes and fatigue. The conjunctiva is reddened, swollen eyelids modestly, on the edges of eyelids can see dried purulent crusts.

Acute suppurative conjunctivitis, caused by Pseudomonas aeruginosa, usually affects one eye, but sometimes the infection still goes on the second eye. The disease usually develops in the background wearing contact lenses Contact lenses - whether they can completely replace the glasses? It begins abruptly, with redness and swelling of the conjunctiva, photophobia, lacrimation. Drainage is rapidly becoming purulent, causing superficial irritation and erosion of the cornea, through which penetrates the infection. The process is almost always complicated by keratitis (inflammation of the cornea). Corneal ulcer, followed by formation thereon and reduction of scarring.

Acute suppurative conjunctivitis, caused by gonococci, manifested in adults as a copious purulent discharge, pronounced swelling of the eyelids, redness and swelling of the conjunctiva and the trend towards the rapid development of corneal ulcers, its perforation (perforation), followed by complete blindness.

Purulent conjunctivitis in the newborn gonorrheal origin develops 2-5 days after birth - the child gets an infection from an infected mother during childbirth. Usually affects both eyes, which is manifested in the form of edema Prevention and treatment of edema - it is important to understand the root cause   eyelids, redness of the conjunctiva with a bluish tint, and the appearance of bloody discharge from the eyes. Three days later the discharge becomes purulent surrounding sclera conjunctiva swells dramatically (chemosis) and takes the form of a roller. On infiltration of the cornea appear, turning into ulcers, perforations have a tendency to spread the infection to the internal tissues of the eye. Loss of the eye in such cases is almost inevitable.

How to treat purulent conjunctivitis

When staphylococcal purulent conjunctivitis is usually carried out local treatment. Only if severe, especially in cases of suspected keratitis, systemic antibiotic therapy is appointed. Eyes several times a day are washed with disinfectant solution: light solution of potassium permanganate, tincture and decoction of herbs (eg infusion of chamomile), buried antibacterial solution in the conjunctival sac lay antibacterial eye ointment.

In recent years, the increased resistance of staphylococci to many antibacterial agents. Treatment of purulent conjunctivitis in this case, a fluoroquinolone antibacterial agents, for example, 0, 3% solution and ofloxacin eye ointment - resistance to pathogens it is developing very slowly.

Babies do not prescribe fluoroquinolones, so the treatment of purulent conjunctivitis in children is 15% sulfacetamide drops, 0, 05% drops pikloksidin (vitabakt), erythromycin ophthalmic ointment.

Purulent conjunctivitis in most cases perfectly treatable, but some species can be very dangerous.

Galina Romanenko

The retina - is the inner shell wall of the eyeball, which is normally tightly adherent to the middle (vascular) shell. It has a very complex structure and consists of ten layers. If between the layer of rods and cones, and the pigment layer of the fluid begins to accumulate, the developing retinal detachment. Due to the fact that power is disrupted outer retinal layers, there is a rapid loss of vision.

Causes of retinal detachment

Most often the disease develops in people between the ages of twenty-five to fifty years. There are a number of factors, the presence of a person which increases the risk of developing retinal detachment. These include:

• Myopia with the development of complications;
• Degenerative changes of the retina;
• Eye injuries;
• Congenital diseases of the organ of vision;
• The work, which is associated with weight lifting or other significant physical activity;
• The presence of retinal detachment or macular degeneration in the immediate family.

There are three types of retinal detachment:

• The primary (rhegmatogenous);
• Secondary (exudative);
• Traction.

Primary detachment develops in the retina break. Through this defect vitreous fluid penetrates the retina and separates it from the choroid.

The gap may be associated with thinning of retinal dystrophy in a zone that is at its periphery and in the region of the equator of the eyeball. Most degenerative changes occur with age and have no symptoms, but sometimes in the retina are formed through defects.

Another mechanism for breaking the retina is associated with the presence of tension (traction) for the vitreous. The latter is a transparent gelatinous mass consistency. Vitreous limited hyaloid membrane, the rear of which is adjacent to the retina. With age occurs the liquefaction of the vitreous body, the posterior hyaloid membrane separates from the retina to form discontinuities therein a valve.

In some diseases (e.g. diabetic retinopathy) in the vitreous appear dense fibers. At movement of the eyeballs, they pull the retina, and it peels off without forming gaps. This kind of disease is called traction.

Secondary retinal detachment can occur when tumors and inflammatory diseases of the vascular net and shells. As a result, liquid accumulates under the retina.

Symptoms

Before the development of retinal detachment appear photopsias - light phenomena as "sparks", "lightning", "bursts". They are particularly pronounced when the patient closes his eyes. Pulling from the vitreous leads to irritation of photosensitive cells and the appearance of photopsias. Characterized metamorphopsia - distortion of the shape and size of the considered objects or letters.

Frequently the patient notices the appearance of haze in sight. This is due to rupture of the retina, damage to blood vessels and vitreous hemorrhage. The size may increase haze of black dots or "flakes of soot" to black "curtain" in front of his eyes, which occupies a large part of the field of view.

The time during which the reduced visual acuity and visual field loss occurs, depends on the location of retinal detachment. If this occurs initially in the lower portion of the fundus, the disease progresses gradually, over several weeks or months. Signs of detachment of this localization is usually detected only with involvement in the pathological process of the macula - the highest place of visual acuity in the retina.

If retinal detachment occurs in the upper part of the fundus, the signs of disease are increasing rapidly. The fluid that accumulates under the retina, gradually going down and detaches the inner shell wall of the eyeball.

The patient may notice that in the morning vision improves. This is due to the fact that during sleep Dreams: how to understand our dreams   supine detached retina back into place. When a person stands up, visual disturbances resumed.

Diagnostics

Diagnosis of the disease should be early, as this will allow time to begin treatment and keep the patient's vision. There are standard and special laboratory methods.

The standard methods of ophthalmologic research include:

• Visometry - visual acuity;
• Perimeter - the study of the visual fields;
• Ophthalmoscopy - examination of the fundus;
• Tonometry - intraocular pressure measurement;
• Research entopicheskih phenomena: mehanofosfena (sclera jam on a glass rod, and the patient sees the dark or light spot) and the phenomenon autooftalmoskopii (sclera light source of bright light, and the person sees their own blood vessels of the retina in a tree or "crack").

If necessary, perform minor (special) surveys. Ultrasonography B-mode is performed when the ophthalmoscopy not possible to get the information you need (for example, clouding of the lens). To determine the viability of the retina used electrophysiological studies.

Before hospitalization conducted a series of laboratory tests. These include general and biochemical blood tests, urine tests, blood tests for markers of hepatitis B and C, HIV, syphilis, Syphilis - punishment of Venus . Also appointed consult some experts.

Treatment

The main method of treatment of retinal detachment - surgery. It is necessary to bring together the layer of rods and cones and pigment epithelium and delimit the gap with the help of local sterile inflammation. The retina is glued to the choroid, scars are formed and it prevents further detachment.

The following types of transactions:

• Local or circular sealing projection of the sclera at the site of retinal breaks. Outside on the sclera is applied seal, which pushes it in and brings the choroid and detached retina;
• Vitrectomy - removal of the vitreous. Instead injected liquid silicone, saline or a special gas, and the retina to the choroid is pressed down;
• Laser coagulation, which is carried out as a prophylactic and therapeutic purposes.

The amount of treatment is chosen individually, depending on the size of the retinal tear, their location and duration of the disease. In some cases, the operations are combined with each other.

If a person has myopia Myopia - when visual acuity falls   or retinal dystrophy Macular degeneration - loss of vision possible He must regularly visit an ophthalmologist and, if necessary, carry out preventive treatment. To prevent damage to the eyes, which often lead to retinal detachment, we must not forget about safety in the home and at work.