CONJUNCTIVITIS

It is an inflammation or infection of the conjunctiva, the thin

transparent layer of tissue that lines the inner surface of the eyelid and
covers the white part of the eye.
Often called pink eye, is a common eye disease, especially in
children.
May be caused by a viral or bacterial infection.
It can also occur due to an allergic reaction to irritants in the air like
pollen and smoke, chlorine in swimming pools, and ingredients in
cosmetics or other products that come in contact with the eyes.
Sexually transmitted diseases like Chlamydia and gonorrhea are less
common causes of conjunctivitis.

Causes
There are three main categories of conjunctivitis: allergic, infectious and
chemical:
1. Allergic Conjunctivitis

Allergic Conjunctivitis occurs more commonly among people who

already have seasonal allergies.

Giant Papillary Conjunctivitis is a type of allergic conjunctivitis

caused by the chronic presence of a foreign body in the eye.

2. Infectious Conjunctivitis

Bacterial Conjunctivitis is an infection most often caused by

staphylococcal or streptococcal bacteria from your own skin or
respiratory system.

Viral Conjunctivitis is most commonly caused by contagious viruses

associated with the common cold. The primary means of
contracting this is through exposure to coughing or sneezing by
persons with upper respiratory tract infections.

Ophthalmia Neonatorum is a severe form of bacterial conjunctivitis

that occurs in newborn babies. This is a serious condition that could
lead to permanent eye damage unless it is treated immediately.

3. Chemical Conjunctivitis
Chemical Conjunctivitis can be caused by irritants like air
pollution, chlorine in swimming pools, and exposure to noxious
chemicals.

Risk Factors
1. Exposure to something for which you have an allergy (allergic
conjunctivitis)
2. Exposure to someone infected with the viral or bacterial form of
conjunctivitis
3. Use of contact lenses
Pathophysiology
The conjunctiva is a loose connective tissue that covers the surface of
the eyeball (bulbar conjunctiva) and reflects back upon itself to form the
inner layer of the eyelid (palpebral conjunctiva). It is firmly adhered to the
sclera at the limbus, where it meets the cornea. The accessory lacrimal
glands, along with goblet cells, are contained within the conjunctiva and are
responsible for keeping the eye lubricated. Like any mucous membrane,
infectious agents may adhere to overwhelm the normal defense mechanisms
and produce clinical symptoms of redness, discharge, irritation, and possibly
photophobia. Viral etiologies are more common than bacterial etiologies.
Conjunctivitis typically is a self-limited process; however, depending on the
immune status of the patient and the etiology, conjunctivitis can progress to
more severe and sight-threatening infections.
Clinical Manifestations

A gritty feeling in one or both eyes

Itching or burning sensation in one or both eyes
Excessive tearing
Discharge coming from one or both eyes
Swollen eyelids
Pink-red discoloration to the whites of one or both eyes
Increased sensitivity to light

Medical Management
Diagnostic Exams

Patient history to determine the symptoms the patient is

experiencing, when the symptoms began, and the presence of any
general health or environmental conditions that may be contributing
to the problem.

Visual acuity measurements to determine the extent to which

vision may be affected.

Evaluation of the conjunctiva and external eye tissue using

bright light and magnification.

Evaluation of the inner structures of the eye to ensure that no

other tissues are affected by the condition.

Supplemental testing may include taking cultures or smears of

conjunctival tissue, particularly in cases of chronic conjunctivitis or
when the condition is not responding to treatment.

Pharmacological Management
The management of conjunctivitis depends on the type. Most
types of mild and viral conjunctivitis are self-limiting, benign conditions
that may not require treatment and laboratory procedures.
o For more severe cases, topical antibiotics, eye drops or ointment
are prescribed.
o Patients with allergic conjunctivitis especially recurrent or
seasonal conjunctivitis are usually given corticosteroids in
ophthalmic preparations.
o Use of vasoconstrictors such as topical epinephrine solution, cold
compresses, ice packs, and cool ventilation usually provide
comfort by decreasing swelling.
o For conjunctivitis caused by chemical irritants, the eye must be
irrigated immediately and profusely with saline or sterile water.
Nursing Management
Nursing Diagnosis
1. Acute pain related to inflammation of the conjunctiva.
2. Anxiety related to lack of knowledge about the disease process.

3. Risk of spread of infection associated with inflammatory

processes.
4. Impaired self-concept (body image decreases) related to the
change of the eyelids (swelling / edema).
5. Risk for injury related to limited vision.
Nursing Intervention
1. May use light cold compresses over the eye for about 10 minutes
four to five times a day to soothe the pain
2. Don't touch your eyes with your hands.
3. Need to stay at home. Children must not play outside. May return
to work or school after 7 days when the redness and discharge
have cleared
4. Do not share towels, linens, make up or toys
5. Wash hands thoroughly with soap and water frequently, including
and before and after applying artificial tears or cold compresses
6. Use a new tissue every time you wipe the discharge from the
eye. May dampen the tissue with clean water to clean the
outside of the eye
7. May wash face and take a shower as normally do
8. Discard all make up articles. Must not apply make up until the
disease is over
9. May weak dark glasses if bright lights bother
10.
If the discharge from the eyes turns yellowish and pus-like
or experience changes in the vision, need to return to the health
care providers for an examination.
References
o http://www.aoa.org/patients-and-public/eye-and-visionproblems/glossary-of-eye-and-vision-conditions/conjunctivitis?sso=y
o http://www.medindia.net/education/familymedicine/conjunctivitispathophysiology.htm
o http://www.nursing-nurse.com/medical-and-nursing-management-ofconjunctivitis-344/