Bacterial Conjunctivitis
Introduction and Facts
Bacterial conjunctivitis is inflammation of the conjunctiva caused by bacteria. In this conjunctivitis, patients usually come with red eyes, eye discharge, and eye irritation (James, 2005).
Bacterial conjunctivitis can be divided into four forms, namely hyperacute, acute, subacute, and chronic. Hyperacute bacterial conjunctivitis is usually caused by Neisseria gonnorhoeae, Neisseria kochii, and Neisseria meningitidis. The acute form is usually caused by Streptococcus pneumoniae and Haemophilus aegyptyus. The most common causes of the subacute form of bacterial conjunctivitis are Haemophilus aemophilus influenza and Escherichia coli. In contrast, the chronic condition is most common in secondary conjunctivitis or patients with nasolacrimal duct obstruction (Jatla, 2009).
Bacterial conjunctivitis usually starts in one eye, affects the other eye through the hand, and can spread to other people. This disease usually occurs in people in too much contact with sufferers, sinusitis, and immunodeficiency states (Marlin, 2009).
Pathophysiology
The tissue on the eye's surface is colonized by normal flora such as streptococci, staphylococci, and Corynebacterium species. Changes in the body's defense mechanism or the number of typical flora colonies can cause clinical infection. Changes in normal flora can occur due to external contamination, spread from surrounding organs or through the bloodstream (Rapuano, 2008).
Long-term use of topical antibiotics is one of the causes of changes in the normal flora of the eye tissue and resistance to antibiotics (Visscher, 2009).
The primary defense mechanism against infection is the epithelial layer covering the conjunctiva. In contrast, the second defense mechanism is the immune system originating from conjunctival bleeding, lysozyme, and immunoglobulins found in the tear film, cleaning mechanisms by lacrimation and blinking. Any disturbance or damage to this defense mechanism can lead to infection of the conjunctiva (Amadi, 2009).
Clinical Symptoms and Complications
The symptoms that arise in bacterial conjunctivitis are usually found in either segmental or generalized conjunctival injection. In addition, the discharge in bacterial conjunctivitis is usually more purulent than other types of conjunctivitis, and in mild cases, eyelid edema is common (AOA, 2010).
Visual acuity is usually not impaired in bacterial conjunctivitis but may be slightly blurred due to secretions and debris in the tear film, while the pupillary reaction is normal. The most characteristic symptom is eyelids sticking together in the morning when you wake up. (James, 2005).
Diagnosis
That needs to be asked at the time of history, including age, because the disease may be related to the body's defense mechanisms in older patients. In sexually active patients, it is necessary to consider sexually transmitted diseases and a history of illness in sexual partners. It is also necessary to ask for the duration of the disease, previous history of the same disease, history of systemic disease, medications, use of chemotherapy drugs, work history that may be related to the disease, history of allergies and allergies to drugs, and history of contact lens use. (Marlin, 2009).
Medication and Treatment
The specific treatment of bacterial conjunctivitis depends on the finding of the microbiological agent. Therapy can be started with a broad-spectrum topical antimicrobial. Any purulent conjunctivitis suspected of being caused by gram-negative diplococci should be initiated immediately with topical and systemic therapy. In purulent and mucopurulent conjunctivitis, the conjunctival sac should be rinsed with saline solution to remove conjunctival secretions (Ilyas, 2008).
Reference:
Bacterial conjunctivitis [Internet]. Available from: http://repository.usu.ac.id/bitstream/handle/123456789/31458/?sequence=4
