Conjunctivitis. Let’s find out the symptoms, causes and natural remedies against conjunctivitis.

Conjunctivitis is an inflammation of the conjunctiva and constitutes the most common cause of “red eye”, being the conjunctiva very vascularized.

The conjunctiva is a thin and transparent mucous membrane that lines the front surface of the eye, up to the cornea, and the inner surface of the eyelids. It is like a “tapestry” that protects the exposed part of the eyeball (except the cornea). Inside the conjunctiva there are numerous small tear glands that contribute to the production of tears, the liquid that washes, protects and defends the eye.

Due to its exposed position, the conjunctiva comes into contact with numerous extraneous substances and microorganisms, to a much greater extent than the other mucous membranes.

Symptoms

In conjunctivitis symptoms are: redness of the eye, swelling eyelids that stick together during sleep. There may be pain and photophobia (annoyance to light). Other disorders are pruritus (allergic conjunctivitis), secretion (purulent secretion is suggestive of bacterial conjunctivitis, clear secretion is for viral or allergic secretion).

The causes

For conjunctivitis, the causes can be numerous: infections (bacterial, viral, fungal), allergies (e.g. pollen, cosmetics …), trauma, irritants (e.g. atmospheric contaminants, foreign bodies …), obstruction of the nasolacrimal canal, anterior uveitis, scleritis / episcleritis or use of drugs. Among infectious conjunctivitis, the incidence of viral conjunctivitis is higher than in bacterial conjunctivitis. The diagnosis is mainly clinical.

Conjunctivitis: different types

Viral conjunctivitis: it is usually caused by Adenovirus, it is the main cause of red eye, characterized by a mucous serum secretion, conjunctival hyperemia and, occasionally, small subconjunctival hemorrhages, membranes / pseudomembranes. Symptoms of viral conjunctivitis can include itching, burning, tearing and a foreign body sensation. Very frequently the eyelids are adhered to the morning awakening by drying the secretion produced during the night with the eyelid closed.

The disease often affects only one eye and after a few days the contralateral eye in about half of the cases. The eyelids appear edematous and the lower eyelid conjunctiva can present agglomerations of lymphocytes and plasma cells which appear as whitish, rounded and slightly raised lesions (follicles). Fever and upper respiratory infections often precede the onset of viral conjunctivitis. The virus is highly contagious so it is necessary to take the necessary precautions to avoid its transmission.

Bacterial conjunctivitis: infection in adults is often sustained by Staphylococcus aureus, while Streptococcus Pneumoniae and Haemophilus influenzae are the most frequent cause of bacterial conjunctivitis in children. Bacterial conjunctivitis typically has a sudden onset, presenting at the onset with tearing and eye irritation and affecting first one eye and then the contralateral eye, usually within 48 hours.

Bacterial conjunctivitis is recognized by the observation of the tear secretion: the typically infectious conjunctival secretion is abundant and purulent, and assumes a yellowish, sometimes greenish hue: this secretion develops within 1 or 2 days and tends to collect at the base of the eyelashes and eyelids which tend to stick, especially on awakening. Unlike allergic conjunctivitis, the bacterial form does not exhibit intense itching and tearing is not particularly abundant.

Allergic conjunctivitis (or rhinoconjunctivitis): it represents the most common cause of “red eye” in pediatrics. In relation to the frequency of symptoms and the probable allergen involved, two different clinical syndromes are distinguished: seasonal and perennial conjunctivitis. The diagnosis is clinical. Seasonal allergic conjunctivitis is the most common and occurs in spring / summer due to exposure to pollen in predisposed subjects.

Symptoms: conjunctival hyperemia, increased tearing and itching, associated with sneezing and nasal secretions, eyelid edema. Perennial allergic conjunctivitis is less common and causes symptoms throughout the year. The allergens in this case are the dust and fur of the animals. Symptoms: conjunctival hyperemia, persistent burning and chemosis, the itching is generally minimal.

Conjunctivitis of the newborn: it begins within the first month of life and often in the first days of life. Given the immaturity of the defense mechanisms in the newborn, the conjunctivitis of the newborn must always be treated in a timely manner to avoid the appearance of serious complications. The microorganisms responsible are the bacteria present in the maternal genital secretions, which are transmitted to the newborn at the time of delivery.

The main infectious agents are Neisseria gonorrhocae and Chlamydia trachomatis. Gonococcal conjunctivitis is a serious but currently rare disease in developed countries, while Chlamydia conjunctivitis is the most frequent cause of neonatal conjunctivitis in developing countries, associated with pneumonia, otitis or rhinitis.

Conjunctivitis: remedies

In the case of viral conjunctivitis, the course is generally self-limiting within a couple of weeks; symptomatic treatment involves the use of artificial tears. Bacterial superinfection is not uncommon and is treated with antibiotic eye drops.

In cases of bacterial, therapy uses eye drops and ophthalmic ointments. Typically, broad-spectrum topical antibiotics are used but, in the event that the culture test shows the presence of a specific pathogen, the therapeutic choice must be aimed at the outcome of the antibiogram. For example, for the treatment of eye infection by Pseudomonas aeruginosa the most suitable eye drops are formulated with gentamicin; fusidic acid is recommended for staphylococcal bacterial conjunctivitis. Other drugs used to treat bacterial conjunctivitis are tobramycin, neomycin, ciprofloxacin and erythromycin.

In the case of seasonal allergic conjunctivitis topical antihistamines are used to relieve symptoms during the acute episode; topical mast cell stabilizers (sodium cromoglycate, sodium nedocromil, lodoxamide 3-4 times a day) are used instead in chronic maintenance therapy.

Natural remedies

Classic officinal herbs indicated for the well-being of the eyes and present in almost all natural eye drops are euphrasia and chamomile. Euphrasia is par excellence the “eye herb”, rich in flavonoids, tannins, iridoids with antibacterial action. Chamomile boasts soothing properties.

Scientific research includes hyaluronic acid as beneficial substances for the eyes. It would seem that hyaluronic acid adheres to the surface of the eye, creating a barrier that protects the eye from external agents such as sun, wind, dust. In high concentration (0.2%) it guarantees a remarkable lubricating action finding use for those suffering from low watering and dry eye.

In the medical device Fitoeye eye drops for dry eyes, natural eye drops selected by Erboristeria Como for quality, efficacy and innovation, it contains 0.2% hyaluronic acid, echinacea stem cells (meristematic), euphrasia and chamomile.

The exclusive echinacea extract from meristematic cells contains 5 unique fractions: phytosterols with antioxidant action, amino acids with nourishing activity, mineral salts with osmotic balancing activity, echinacoside with anti-inflammatory action, polysaccharides that increase the natural defenses of the tear film.

Fitoeye, effective natural eye drops is a medical device indicated for: Video terminal operators, seasonal or perennial conjunctivitis, dry eye, topical irritant therapies, eyes reddened by external agents. This medical device can safely be associated with eye drops containing Benzalkonium Chloride (Tobradex, Tobral, Latanaprost / timolol, Colbiocin).

Dr. Laura Comollo

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Main bibliography

“Manuale di Pediatria. La Pratica Clinica”, a cura di Gian Vincenzo Zuccotti
“Clinica dell’apparato visivo II ed.: Seconda edizione”, Di Claudio Azzolini, Francesco Carta, Stefano Gandolfi, Ugo Menchini, Francesca Simonelli, Carlo Enrico Traverso
“La somministrazione di un collirio monodose con acido ialuronico, aminoacidi ed echinacea purpurea migliora i parametri di qualità della vita nei soggetti in terapia cronica per il glaucoma”, Morreale Bubella R., Minerva Oftalmologica 2014 March;56(1):1-7

Conjunctivitis, causes and remedies