The conjunctiva can be inflammed being the thin, transparent mucous membrane that lines the front part of the eyeball over the white sclera as well as the inner aspect of the eyelids, forming a continuous layer that physically prevents debris such as fallen eyelashes from migrating to the back of the eye socket.
The conjunctiva secretes mucus and tears,contains immune cells to prevent infection. It is about 30 microns thick (roughly half the thickness of a human hair) and its supply of blood vessels dilate in response to inflammation.
Pain, sensitivity to light and visual disturbances are not the predominant features of conjunctivitis.
The bulbar tissue stops at the junction between the sclera and cornea.The palpebral or tarsal conjunctiva covers the inner surface of both the upper and lower eyelids
When the small blood vessels in the conjunctiva are inflamed, they swell and become more visible, which causes the eyes to appear in a red eye or pink eye state.
Infective causes can be very contagious eg coughing or sneezing in the viral form which may last for up to two weeks. Children with bacterial pink eye may return to school or day care 24 hours after starting eye drops or ointment. The conjunctivitis treatment depends upon the symptoms and cause.
Associations with trachoma,allergic rhinitis,red eye,gonococcal causes,irritant causes,nenoatal,giant papillary forms,degree of sticky eye,discarge,eye redness all have to be considered to avoid recontamination
Treatments depend upon cause but to limit spreading
Signs and symptoms:
In cases of corneal foreign bodies depth and size can be scanned by anterior OCT of the cornea
normally one eye
not so much in infants
Causes of Eye Swelling on Both Sides.
Most forms are due to allergy, dryness or viral eye infections.
To avoid cross infection
Inflammation is normally from autoimmune causes,allergic reactions, (sometimes requiring a diagnostic allergy test), dry eyes,mechanical irritation and not the bacterial form especially in adults.
A stye is a red and painful lump on the eyelid that occurs when a small gland on the edge of the eyelid becomes infected or inflamed.
It is used to treat a bacterial infection involving the mucous membrane of the surface of the eye and should ease after several days.
Chlorsig eye drops dosage:
For adults and children (2 years and over):
Instil 1 or 2 eye drops in the affected eye(s) every two to six hours for up to 5 days
For adults and children (2 years and over): Apply 1.5 cm of eye ointment every three hours for up to 5 days
If ointment is used together with drops for day and night coverage, eye ointment should be applied before bedtime while using the drops during the day.
If the condition does not get better after 2 days, seek advice.
Chlorsig eye drops:
Chlorsig eye drops is in a plastic dropper bottle with tamper seals. It is a clear to slightly hazy, slightly viscous, colourless, odourless liquid
chloramphenicol 5 mg/mL (0.5%)
Chlorsig eye drops contain the preservative phenylmercuric acetate (0.002% w/v).
Chlorsig eye ointment:
is a white opaque ointment in a 4 g tube with an ophthalmic cap.
chloramphenicol 10 mg/g (1%)
paraffin – liquid
paraffin – soft white
Chlorsig eye ointment is preservative free
Store in a cool dry place, protected from light, where the temperature stays below 25°C. Discard 4 weeks after opening.
Allergic reaction to Chlorsig may include irritation, pain and swelling in the eye. Skin rashes, blisters and fever may also occur,
CHLORSIG EYE DROPS have Phenylmercuric acetate (0.002% w/v) as as a preservative which can cause stinging.
CHLORSIG EYE OINTMENT contains no preservatives.
Chlorsig is overused and caution applies in cases
Allergic rhinitis (commonly known as hay fever) affects around 18% of people (children and adults) in Australia
A referral to a clinical immunology/allergy specialist may be required for further assessment including allergy testing. eg particular season allergies to grass, weed or tree pollens or all year round (usually house dust mites, moulds or animal hairs).
Complications of allergic rhinitis may include:
• Sleep disturbance
• Daytime tiredness
• Recurrent ear infections in children
• Recurrent sinus infections in adults
• Asthma which is more difficult to control
Active substances that can cause allergic conjunctivitis include
Conjunctitis is an inflammation of the eyeball’s protective coat called the conjunctiva that secretes mucus and tears,contains immune cells to prevent infection.It is a thin, transparent mucous membrane that is about 30 microns thick (roughly half the thickness of a human hair)and its supply of blood vessels dilate in response to inflammation.
Viral conjunctivitis is the most common form of infectious conjunctivitis. A virus called adenovirus (which also causes respiratory infections and diarrhoea) is responsible for 65-90% of all cases of viral conjunctivitis. Other viruses, such as herpes simplex virus (also responsible for cold sores) and varicella zoster virus (also responsible for chicken pox), can also cause conjunctivitis.
The disease usually self-resolves in two to three weeks.
Bacterial conjunctivitis is less common than viral conjunctivitis. It is caused by bacteria such as Streptococcus pneumoniae, Staphylococcus aureus, Moraxella catarrhalis and Haemophilus influenzae.
These bacteria are members of the normal colonies living on healthy eyes and usually do not cause disease. However, they can proliferate and cause conjunctivitis in certain conditions, such as dry eye, after damage to the eye, or in a weakened immune system. More commonly, though, these bacteria simply cause conjunctivitis when transmitted from an infected person to a non-infected person.
Broad-spectrum antibiotic eye drops, such as chloramphenicol are effective but not in cases of STIs such as Neisseria gonorrhoeae (gonorrhoea) and Chlamydia trachomatis (chlamydia)
Allergic conjunctivitis is triggered by exposure to allergens. These include pollen, dust mites and animal dander (microscopic flecks of skin). Because it is not caused by micro-organisms, this condition is not contagious and avoiding school or work is not required.
Redness, itchiness and watering of both eyes are the prominent features. These may be accompanied by an itchy nose, itchy throat and sneezing.
Identifying and avoiding the offending allergen(s) is important for treatment. This may require an allergy test.
Symptom relief can be achieved through lubricating eye drops, cold compresses and antihistamine eye drops and tablets. These are available over the counter at pharmacies.
However, eye drops containing the active ingredients antazoline and naphazoline (vasoconstrictors*, which reduce redness) should not be used for long periods as these may cause a rebound red eye when they are stopped.
It is important to note that pain, sensitivity to light and visual disturbances are not features of conjunctivitis.
Sneezing,itchy mouth,sinus pressure,runny or blocked nose,headaches,red, sore and itchy eyes around springtime is classic of hay fever and allergies.
Inflammation can be moderated with antihistamine tablets, syrups, intranasal sprays and eye drops (non-sedating)
Cold compresses help soothe red, inflamed eyes. Avoid eye rubbing ss it releases histamine increasing the inflammation.
Severe hay fever or chronic allergies can be treated with mast cell stabilisers or steroid eye drops.
• Intranasal corticosteroid nasal sprays (INCS)
• Decongestant sprays for no more than a few days.
• Decongestant tablets used with caution as they can have ‘stimulant’ side effects eg tremors, anxiety or blood pressure issues.
The bacterial eye infection trachoma (known as ‘sandy blight’) has long been the leading infectious cause of blindness in the impoverished world.
Repeated infections by contact with an infected person’s hands or clothing can over years eventually lead to scarring that causes the margin of the eyelid to turn inwards damaging the cornea, painfully scratching it and causing damage.
Australia is the only developed country in the world where trachoma is endemic.
ECZEMA and EYES
External irritant or allergen conditions can cause eczema which affect the eye area. These occur more commonly in people with eczema elsewhere on the body – usually those with atopic eczema and related conditions (asthma and hay fever)
Eczema of the eyelid skin
Seborrhoeic eczema of the eyelids tends to affect just the eyelid margins and is seen more frequently in adults.
The itchy, red, dry, scaling skin found in eyelid eczema in all ages. Eyelid eczema is treated by emollients or topical steroids.
(0.5–1% hydrocortisone) for eyelid eczema
Topical calcineurin inhibitors (TCI’s) are treatments that alter the immune system and have been developed for controlling eczema.
Tacrolimus ointment (Protopic) for moderate to severe eczema and Pimecrolimus cream (Elidel) for mild to moderate eczema.
Use bland emollient to wash and moisturise with.
Contact dermatitis of the eyelids may be either allergic or irritant in origin such as make-up, detergents or solvents eg
When manufacturers change the formulation of a product and you are sensitive to the new ingredient(s).
Allergy to nail varnish (or varnish remover).
Hair dye,perfume sprays.
An allergic skin reaction can be sudden and dramatic, and/or sometimes occur hours or days after contact with the allergen eg medications such as atropine , neomycin drops, or preservatives in contact lens systems.
Blepharitis refers to inflammation of the eyelid skin, and is a very common problem found with sebhorrhoeic dermatitis that affects the face, scalp, ears and eyebrows as well as the eyelids.
Small yellowish skin scales (dandruff scalp) collect around the eyelashes, making the eyes look tired, puffy and wrinkled.