Keratoconjunctivitis, the treatment of which will be discussed in this article, is a serious inflammatory disease that affects the conjunctiva and cornea of the eye. The disease is common, because the conjunctiva has a very high reactivity - it instantly responds to external stimuli and exposure factors.
Why does this disease occur? What are the symptoms? How to treat him? It’s worth trying to answer these and many other questions.
Causes
Before proceeding to consider the principles of treatment of keratoconjunctivitis, it is necessary to talk about the reasons why it occurs.
They are diverse. Inflammation may be due to the activity of parasitic infections, fungi, viruses and bacteria. Sometimes this condition should be taken as a symptom of an allergy.
Often keratoconjunctivitis develops as a result of prolonged use of corticosteroids or vitamins. Its appearance can also provoke the effect of a foreign body on the cornea or conjunctiva.
Also a common cause is improper wearing of contact lenses or insufficient cleaning.
It is important to make a reservation that keratoconjunctivitis can act as a symptom of another disease. As a rule, these are rubella, flu, rheumatoid arthritis, lupus erythematosus and Sjogren's syndrome.
Provoking factors include lice, non-observance of the basic principles of hygiene, helminthiasis and food allergies.
Types of disease
In total, 10 types of this disease are distinguished:
- Herpetic. The cause of inflammation is the herpes virus. Symptoms are similar to signs of acute diffuse conjunctivitis or herpetic keratitis.
- Hydrogen sulfide. Specific form. The cause of the occurrence is the prolonged effect of hydrogen sulfide on the eyes.
- Tuberculosis-allergic. It is fraught with the appearance of conflicts in the eyes. Appears due to the activity of tuberculosis bacteria.
- Epidemic. There is a consequence of getting into the cornea or conjunctival sac of microorganisms of pathogenic origin. This form is contagious.
- Adenovirus. Treatment of keratoconjunctivitis of this type should be started as soon as possible. After all, the ailment arises due to the activity of adenovirus. And he is also contagious.
- Dry. An ailment of this type is characterized by the formation of filaments from degenerated epithelial cells. They can reach a length of 5 mm, and hang freely from the cornea. The cause of the disease is its drying and hypofunction of the lacrimal glands.
- Chlamydial. Inflammation of this type occurs due to the presence of a large number of chlamydia in the body. May be a sign indicating the presence of genitourinary disease.
- Atopic. This is a chronic disease that worsens in the cold season. It is characterized by whitish plaques on the surface of the eyeball.
- Spring. This is a chronic ailment. Exacerbation, as the name implies, falls in the spring. Sometimes in the fall. Also characterized by the presence of whitish plaques.
- Keratoconjunctivitis Tigeson. It arises as a result of an allergy or a virus. It is characterized by a precise infection, almost imperceptible at the initial stage.
Symptomatology
Common signs by which one can judge the presence of keratoconjunctivitis, the treatment of which will be discussed later, include:
- Burning.
- Itching
- The loose structure of the conjunctiva and its redness.
- Profuse lacrimation.
- Swelling.
- Corneal redness.
- Photophobia.
- Mucopurulent discharge.
- Conjunctival hemorrhage.
- Not passing sensation of the presence of a foreign body in the eye.
In rare cases, various elements of pathological origin are formed (papillae, follicles). Initially, inflammation is localized only in the conjunctiva, and after 5-15 days it spreads to the cornea.
Other symptoms
In the event that the disease arose due to chlamydia in the body, subepithelial peripheral infiltrates will also be added to the symptoms. These are clusters of lymph and blood.
If a person is sick with an epidemic form of the disease, then he will still be visible clouding of the cornea, reminiscent of the appearance of a coin.
In the case of the atopic and spring type of ailment, whitish plaques appear along the limb. An allergic disease causes severe lacrimation and burning. But with dry inflammation, filamentous keratitis and, as a rule, dry eye syndrome are almost always observed.
Dry keratoconjunctivitis
The treatment of this disease is based on the use of drugs that can replace a tear. Viscous analogues should be chosen that cover the ocular surface much longer.
In some cases, doctors prescribe an ointment. It must be used before bedtime. When using the ointment, you can avoid irritation in the morning, after waking up. Ophthalmic lubricants may also be used.
It is also important to normalize the environment. A person must not be in a room with dry air, or where it is smoked or smoked.
Also, the doctor may prescribe topical use of cyclosporine or occlusion of nasolacrimal points. Warm compresses and antibiotic ointments such as Doxycycline and Bacitracin help.
Tuberculosis-allergic keratoconjunctivitis
About how the treatment of this disease is carried out, it is also important to tell. Treatment in adults of keratoconjunctivitis of this type is desensitizing, restorative, antibacterial.
Mydriatic agents for topical application, PASK in drops, and also streptomycin and cortisone help well. Often, the doctor prescribes the intake of a 10 percent solution of calcium chloride inside. It should be taken after meals, 1 tablespoon three times a day.
The use of fish oil and multivitamins is also useful. PASK is combined with phtivazide and streptomycin.
Treatment is carried out only in conjunction with a TB specialist.
Epidemic keratoconjunctivitis
In the case of a disease of this form, therapy is very problematic. Talking about the symptoms and treatment of keratoconjunctivitis of this type, it should be noted that there are still no drugs that have a selective effect on adenoviruses. Therefore, therapy is fraught with difficulties.
As a rule, drugs of wide action are used. These are interferons (ophthalmoferon and lokferon) and its inductors, installations 6-8 times a day. If the acute stage, then it is additionally necessary to drink antihistamines and take anti-allergic drops, for example, Spersallerg or Allergofthal.
In the subacute form, Lecrolin and Alomid drops are used. If films have formed, you will need to take corticosteroids - Maxidex, Dexapos and Oftan-Dexamethasone. In case of corneal damage, Koperegel, Vitasik, Korpozin, and Taufon help.
Viral keratoconjunctivitis
You can not ignore the disease of this form. Treatment of viral keratoconjunctivitis is aimed at eliminating the reason why it arose. So the doctor prescribes antibiotics and drops of a wide spectrum of action. Only these drugs can affect a large number of bacteria known to science.
If the patient is diagnosed with a severe disease that is also progressing, then parenteral administration of antibiotics is prescribed.
In parallel, you need to use drugs that can protect the normal microflora of the intestine and other organs. Because with this treatment, against the background of the changes occurring in it, the risk of developing fungal diseases and dysbiosis begins to increase.
As a rule, the elimination of symptoms and treatment of keratoconjunctivitis in adults is carried out with Tobrex and Sofradex drops. Also used "Acyclovir." This drug prevents the infection from becoming chronic.
Spring keratoconjunctivitis
As a rule, this disease occurs among boys 4-10 years old. Treatment of spring keratoconjunctivitis primarily means minimizing the effects of ultraviolet radiation on the eyes. Therefore, it is highly recommended that you wear sunglasses and not be outdoors during daylight hours.
The use of antihistamines, as well as mast cell stabilizers, has been shown. Cromolyn sodium in the form of drops and Olopatadine is great. But this must be done systematically. Long-term use of these medicines will help to avoid exacerbation.
To reduce itching, you will have to apply a 3% solution of sodium bicarbonate. You can also make lotions from a solution of boric acid.
Herpetic keratoconjunctivitis
The treatment of this disease is primarily aimed at suppressing the virus that provoked it. Therefore, it is necessary to take antiviral and anti-inflammatory drugs.
As a rule, “Vidarabine”, “Riodoxol”, “Acyclovir”, etc. are prescribed.
For the treatment of follicles, you need to use brilliant green. Under the lower eyelid, it is necessary to lay an antiherpetic ointment. For example, “Acyclovir”, “Virolex” or “Florenal”.
If the area around the eyes is also affected, then you will need to start taking drugs such as Polyoxidonium, Cycloferon and Valtrex.
But these are all powerful drugs. How to treat keratoconjunctivitis in children? In this case, babies are prescribed interferons. Most often they are treated with drops. A popular option is Ophthalmoferon. It is instilled 5-6 times a day for 3 days, be sure to rinse the eyes with chamomile broth.
Chlamydial keratoconjunctivitis
In this case, the use of antibiotics is also indicated. The elimination of symptoms and treatment of keratoconjunctivitis of this type is carried out using tetracyclines, macrolides and fluoroquinolones.
Local therapy involves the use of eye drops (r-ciprofloxacin and r-r-ofloxacin), anti-inflammatory (r-r-dexamethasone and r-r-indomethacin) and ointment applications for the eyelids.
The treatment of this disease can not be called simple. It is carried out comprehensively. That is, they conduct therapy aimed at the same time against all pathogens identified during the tests.
General therapeutic recommendations
Any doctor will say that the treatment of dry keratoconjunctivitis in a person will be different from therapy aimed at eliminating the same disease, but only of a different type.
But there are general recommendations that must be considered.
Allergic keratoconjunctivitis should be treated immediately, since complications in this case arise quickly. First of all, it is required either to eliminate the irritant or to limit contact with it. You also need to take vitamins and antihistamines to strengthen general immunity.
If the form of the course is not complicated in a viral type disease, then Pyrogenal, Reaferon and Poludan can be used.
It is also worth knowing that the notorious glucocorticosteroids eliminate the signs of inflammation, but are powerless against adenovirus. They only stop the symptoms. Therefore, due to improper treatment, the disease quickly becomes chronic.
With the dry type, in addition to the use of artificial tears, you can use liquid paraffin and Lacrisin - this will help restore the natural film on the eyeball.
And, of course, in any case, you need to take vitamin complexes. Which ones - the doctor will say. But you can not do without them, since keratoconjunctivitis of any type has a negative effect on the immune system. And if the body does not have the strength, then after recovery, relapse can quickly occur.
In general, treatment for this disease should be started as early as possible. Timely therapy helps to avoid complications such as visual impairment, otitis media, mucosal scarring, and bacterial damage. But worst of all, when keratoconjunctivitis becomes chronic.