Keratoconjunctivitis in children. Symptoms and treatment of different types of keratoconjunctivitis. Keratoconjunctivitis - main symptoms

Keratoconjunctivitis is an inflammation of the conjunctiva involving the cornea of ​​the eye of varying degrees of prevalence and depth of the process. The conjunctiva passes into the epithelium of the cornea, so in most cases the inflammation from it passes to the cornea.

The conjunctiva and cornea are constantly exposed to environmental factors. Natural mechanisms of defense against infection include blinking, lacrimation, a large number of immune cells, and the production of antibacterial substances (immunoglobulins, interferons, lysozyme). The surface of the conjunctiva is inhabited by many bacteria that are not pathogenic. Factors contributing to the development of keratoconjunctivitis: impaired tear film, impaired blinking, wearing contact lenses. Infections of the conjunctival cavity, as a rule, are contact (introduction of microorganisms through fingers, hygiene products, ophthalmic instruments).

Symptoms of keratoconjunctivitis

The disease is usually bilateral, the severity of the lesion is asymmetrical. Complaints of “sand in the eyes”, itching, pain, photophobia, redness of the eye, lacrimation (epiphora) (usually indicate the addition of keratitis), discharge from the conjunctival sac, gluing of the edges of the eyelids, swelling of the conjunctiva (chemosis), subconjunctival hemorrhage (mainly with viral keratoconjunctivitis), follicular reaction (with viral, chlamydial keratoconjunctivitis), papillary (papillary reaction with spring conjunctivitis of allergic etiology), membrane formation (true membrane in diphtheria - when separated, the surface of the conjunctiva bleeds, pseudomembranes in allergic and toxic keratoconjunctivitis).

Inflammation begins with conjunctivitis, corneal damage appears after 5-15 days in the form of coin-shaped clouding in epidemic keratoconjunctivitis. Peripheral subepithelial infiltrates with ingrowth of superficial vessels - in the chlamydial process. Vernal and atopic keratoconjunctivitis is characterized by the formation of whitish plaques along the limbus (Trantas point). With severe dry eye syndrome, filamentous keratitis appears. Chronic conjunctivitis associated with rosacea is accompanied by vascularization of the corneal periphery.

Diagnosis of keratoconjunctivitis

• determination of visual acuity,
• biomicroscopy,
• ophthalmoscopy,
• smear,
• scraping from the conjunctiva.

Treatment of keratoconjunctivitis

Treatment depends on the cause. Prescribed only after confirmation of the diagnosis by a medical specialist. Antibacterial drops, antiviral drugs, and sometimes corticosteroids are used locally.

Essential drugs

There are contraindications. Specialist consultation is required.

• (ophthalmic drug with antiviral, anti-inflammatory and immunomodulatory effects). Dosage regimen: locally. In the acute phase of the disease, 1-2 drops are instilled into the affected eye up to 6-8 times a day. As the inflammatory process subsides, the number of instillations is reduced to 2-3 times/day. The course of treatment is continued until the symptoms of the disease disappear completely.
• ) is a broad-spectrum antibiotic from the group of aminoglycosides for topical use in ophthalmology. Dosage regimen: the drug is instilled 1-2 drops into the conjunctival sac of the affected eye (or eyes) 6-8 times a day. If the dynamics are positive, the frequency of instillation is reduced to 4-5 times a day.
• (antimicrobial agent of the fluoroquinolone series, for topical use in ophthalmology). Dosage regimen: for mild to moderate infection, ciprofloxacin is instilled 1-2 drops into the conjunctival sac of the affected eye every 4 hours, for severe infection - 2 drops/hour. After the condition improves, the dose and frequency of instillations are reduced. For a bacterial corneal ulcer, the drug is instilled 1 drop every 15 minutes for 6 hours, then 1 drop every 30 minutes during waking hours. On the 2nd day, instill 1 drop/hour during waking hours. From the 3rd to the 14th day, instill 1 drop every 4 hours during waking hours.

Keratoconjunctivitis is a serious and dangerous eye disease that often leads to severe vision loss. The pathology is an inflammation of the conjunctiva with gradual involvement (over 5-15 days) of the cornea in this process. Keratoconjunctivitis is a common ophthalmological disease. This is due to the speed of the conjunctiva’s reaction to various external stimuli. The causes of the development of the pathological process are bacterial, mycotic, viral infection of the eye, autoimmune diseases, foreign body entry, allergic reactions. In some cases, the disease occurs as a result of penetration of a foreign object into the eye, long-term use of corticosteroids, or taking vitamins.

There are several forms of the disease. Depending on the etiology of the pathological process, atopic, chlamydial, adenoviral, dry, hydrogen sulfide, and herpetic keratoconjunctivitis are distinguished. According to the nature of the disease, it is divided into chronic and acute varieties.

The following table discusses the forms of keratoconjunctivitis and their features.

View.	Characteristics.
Hydrogen sulfide.	Appears after exposure of the conjunctiva to hydrogen sulfide over a long period. It occurs in the form of acute or and is accompanied by superficial keratitis.
Tuberculosis-allergic(scrofulous or phlyctenulous).	This form of keratoconjunctivitis appears as a special form of allergic reaction to infectious pathogens of tuberculosis.
Herpetic.	It develops due to the penetration of HSV (herpes simplex virus) into the body. It occurs, in some cases in the form of a developed one.
Dry.	It is characterized by the formation on the anterior surface of the conjunctiva of threads consisting of degenerated cells of the epithelial layer of the cornea. The threads are 1-15 mm long and can hang freely. It begins to progress as a result of dysfunction of the lacrimal glands. Dry keratoconjunctivitis or is characterized by the spread of the inflammatory process and redness of the conjunctiva due to a decrease in the secretion of the amount of tear fluid. This form of the disease is characterized by several stages of progression, accompanied by certain symptoms. Initially, redness of the conjunctiva and secretion in the form of threads are observed. Then the epithelial layer peels off, and it is affected by erosion. Threads appear on the cornea, about 5 mm long, which are attached at one end to the cornea, and the other hangs freely in the cornea. At the last stage, it is observed, which is accompanied by a significant deterioration in vision. In the presence of dry eye syndrome, itching, burning, and acute piercing pain are observed.
Epidemic.	A dangerous and contagious form of keratoconjunctivitis that develops due to the penetration of viruses into the cornea or conjunctival sac.
Adenoviral.	A contagious type of keratoconjunctivitis. Appears due to penetration.

Symptoms of keratoconjunctivitis

Symptoms vary depending on the type and form of the pathological process. Acute keratoconjunctivitis is characterized by unilateral damage to the organ of vision at the very beginning of its development. Gradually, the second eye is involved in the inflammatory process. There is an asymmetry of eye damage; one is involved in the inflammatory process more than the other.

The symptoms of the disease vary depending on the form and nature of its course, but there are a number of common signs. These include:

• increased lacrimation;
• fear of light;
• swelling of the conjunctiva and cornea;
• itching, burning, pain in the eye;
• feeling of the presence of a foreign object;
• redness of the conjunctiva;
• mucopurulent discharge from the eyes.

Chlamydial keratoconjunctivitis is complemented by the formation of peripheral infiltrates. The allergic form is characterized by pronounced itching, burning, and lacrimation. Viral is characterized by hemorrhage into the conjunctiva of the eye. The dry form is accompanied by dry eye syndrome.

Diagnostics

If you have one or more symptoms characteristic of keratoconjunctivitis, you should consult an ophthalmologist.

Important! You should act as quickly as possible, because some forms of the disease are contagious. The doctor conducts an external examination, asks the patient about symptoms and complaints.

Then he prescribes the following diagnostic procedures:

• determination of visual clarity (visometry);
• study of eye structures using a slit lamp;
• determination of visual fields (perimetry);
• test using fluorescein staining of eye structures;
• examination of tear fluid and discharge from the eye (histochemical and bacteriological).
• scraping from the conjunctiva and cornea to determine the causative agent of the disease.

The doctor will also send the patient for a general urine and blood test and a chest x-ray.

In some cases, consultation with a phthisiatrician, endocrinologist, or allergist may be required.

It is extremely important to differentiate keratoconjunctivitis from viral, , , .

Treatment

The treatment tactics are chosen depending on the form of the pathological process, the depth of its prevalence and only after determining the form of the disease and identifying the causative agent. Tablets are also used for treatment. If keratoconjunctivitis is bacterial in nature, antibiotics are prescribed. In case of mycosis - antifungal, in the presence of viruses - antiviral.

The main drugs used to treat keratoconjunctivitis are:

1. Oftalmoferon. Anti-inflammatory, antiviral, immunomodulatory agent. To relieve symptoms of the acute phase of keratoconjunctivitis, Oftalmoferon is instilled dropwise into each eye up to 8 times a day. As the disease is eliminated, reduce the number of instillations to 2.
2. Tobramycin(Tobrex). A broad-spectrum antibacterial drug belonging to the group of aminoglycosides. For keratoconjunctivitis, Tobrex is instilled 1-2 drops up to 8 times a day, gradually reducing to 4 single drops as painful symptoms are eliminated.
3. Ciprofloxacin. Antimicrobial drug from the group of fluoroquinolones. Use as instillations, 2 drops in each eye every 4 hours for mild forms of the disease and every 2 hours for severe ones.
4. Levomycytin And Albucid. These antimicrobial drops help prevent re-infection of the conjunctiva and cornea.

the main means to combat keratoconjunctivitis

The drugs Lakrisin and Trisol help preserve the protective film of the eye. Reduce the outflow of tears from the conjunctival sac using laser coagulation or installing blockades with silicone plugs.

Features of the treatment of each form of the disease

Allergic keratoconjunctivitis is treated by taking antihistamines Tavegil, Suprastin. But the first step is to eliminate the allergen that causes the pathological process.

the main means to combat allergic keratoconjunctivitis

The herpetic form is eliminated with the help of antiviral and anti-inflammatory medications. Virolex, Zovirax, Bonafton ointments are used. Valtrex is taken internally, as well as the immunomodulators Polyoxidonium or Cycloferon. Tobrex drops are used and at the same time erythromycin and tetracycline ointments are placed behind the lower eyelid.

the main means to combat herpetic keratoconjunctivitis

Adenoviral Keratoconjunctivitis is treated with drops of Reaferon, Pyrogenal, Poludan.

the main means to combat adenoviral keratoconjunctivitis

The epidemic form of the disease is eliminated with broad-spectrum antiviral drugs. These are interferon-based products (Ophthalmoferon). In case of exacerbation, antihistamines (Spersallerg) are prescribed. If rashes appear on the cornea, corticosteroid therapy (Dexapos, Maxidex) is required.

main means to combat epidemic keratoconjunctivitis

To eliminate dry keratoconjunctivitis, drugs are required that restore the natural film of the eye (Taufon, Actovegin). The ophthalmologist prescribes special “eye” vitamins, artificial tears, and Vaseline oil. The doctor may prescribe special ointments, eye lubricants, vitamins A and E.

the main means to combat keratoconjunctivitis sicca

Chlamydial the form can be eliminated only with the help of antibacterial therapy. Use instillation of Ofloxacin, Ciprofloxacin. Additionally, erythromycin and tetracycline ointments and anti-inflammatory drops (Dexamethasone, Indomethacin) are used.

the main means to combat chlamydial keratoconjunctivitis

Tuberculous-allergic keratoconjunctivitis requires an integrated approach to treatment. First, steroid drops (Hydrocortisone) are instilled. For desensitization, it is necessary to use Prednisolone drops and a two percent solution of diphenhydramine. Corneal defects are eliminated using. If extraocular foci of tuberculosis infection occur, specific tuberculostatic agents are prescribed.

In some cases, surgery is required to correct keratoconjunctivitis. This is necessary if there is no effect from the therapy. In this case, keratoplasty is performed, that is, transplantation of the stratum corneum of the eye.

There are no specific preventive measures to prevent keratoconjunctivitis. However, several basic rules can be identified, the observance of which will help reduce the risk of pathology. These include strengthening the immune system, maintaining eye hygiene, and timely treatment of any eye diseases.

Keratoconjunctivitis is a serious ophthalmological disease that does not have a very favorable prognosis. Only with its timely detection and correct treatment tactics can it be possible to avoid scarring of the mucous membrane and the transition of the pathology to a chronic form. Untreated keratoconjunctivitis leads to a progressive decrease in visual acuity, the formation of a cataract, and the appearance of filamentous keratitis.

Important! At the first signs of a pathological process, there is no need to hesitate. Contact your ophthalmologist as soon as possible.

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 reacts to external stimuli and influencing factors.

Why does this disease occur? What are the symptoms? How to treat it? It is worth trying to answer these and many other questions now.

Causes

Before moving on to consideration of the principles of treatment of keratoconjunctivitis, it is necessary to talk about the reasons why it occurs.

Keratoconjunctivitis often develops as a result of long-term use of corticosteroids or vitamins. Its appearance can also be provoked by the impact of a foreign body on the cornea or conjunctiva.

Another common cause is wearing contact lenses incorrectly or not cleaning them properly.

It is important to note that keratoconjunctivitis can act as a symptom of another disease. Typically, these are rubella, influenza, rheumatoid arthritis, lupus erythematosus and Sjögren's syndrome.

Provoking factors include lice, non-compliance with the basic principles of hygiene, helminthiasis and food allergies.

Types of disease

There are a total of 10 types of this disease:

1. Herpetic. The cause of inflammation is the herpes virus. Symptoms are similar to those of acute diffuse conjunctivitis or
2. Hydrogen sulfide. Specific form. The cause is the long-term effect of hydrogen sulfide on the eyes.
3. Tuberculosis-allergic. It is fraught with the appearance of conflicts in the eyes. Appears due to the activity of tuberculosis bacteria.
4. Epidemic. This occurs as a consequence of microorganisms of pathogenic origin entering the cornea or conjunctival sac. This form is contagious.
5. Adenoviral. Treatment of this type of keratoconjunctivitis should begin as early as possible. After all, the disease occurs due to the activity of the adenovirus. And it is also contagious.
6. Dry. This type of disease is characterized by the formation of threads 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 out and hypofunction of the lacrimal glands.
7. Chlamydial. This type of inflammation occurs due to the presence of a large number of chlamydia in the body. May be a sign indicating the presence of a genitourinary disease.
8. Atopic. This is a chronic disease that worsens during the cold season. It is characterized by whitish plaques on the surface of the eyeball.
9. Spring. This is a chronic illness. The exacerbation, as the name suggests, occurs in the spring. Sometimes - for the fall. It is also characterized by the presence of whitish plaques.
10. Thygeson's keratoconjunctivitis. Occurs as a result of an allergy or virus. It is characterized by a precise infection, almost imperceptible at the initial stage.

Symptoms

General signs by which one can judge the presence of keratoconjunctivitis, the treatment of which will be discussed below, include:

• Burning.
• Loose structure of the conjunctiva and its redness.
• Profuse lacrimation.
• Swelling.
• Redness of the cornea.
• Photophobia.
• Discharge of a mucopurulent nature.
• Hemorrhages into the conjunctiva.
• Persistent sensation of a foreign body in the eye.

In rare cases, various elements of pathological origin (papillae, follicles) are formed. Initially, the inflammation is localized only in the conjunctiva, and after 5-15 days it spreads to the cornea.

Other signs

In the event that the disease occurs due to chlamydia present in the body, subepithelial peripheral infiltrates will also be added to the symptoms. These are accumulations consisting of lymph and blood.

If a person is sick with an epidemic form of the disease, then he will still have noticeable opacities of the cornea, reminiscent of coins in appearance.

In the case of atopic and spring type of the disease, whitish plaques will appear along the limbus. The allergic disease causes severe lacrimation and burning. But with dry inflammation, dry eye syndrome is almost always observed.

Keratoconjunctivitis sicca

Treatment of this disease is based on the use of drugs that can replace tears. You should choose viscous analogs that cover the ocular surface much longer.

In some cases, doctors prescribe ointment. It should be used before bedtime. When using the ointment, you will be able to avoid irritation in the morning after waking up. Eye lubricants can also be used.

It is also important to normalize the living environment. A person should not be in a room with dry air, or where it is smoky or smoky.

The doctor may also prescribe topical cyclosporine or nasolacrimal punctal occlusion. Warm compresses and antibiotic ointments such as Doxycycline and Bacitracin help.

Tuberculous-allergic keratoconjunctivitis

It is also important to talk about how this disease is treated. Treatment for this type of keratoconjunctivitis in adults is desensitizing, restorative, and antibacterial.

Mydriatic agents for local use, PAS in drops, as well as streptomycin and cortisone help well. Often, the doctor prescribes taking a 10% solution of calcium chloride orally. It should be taken after meals, 1 tablespoon three times a day.

Taking fish oil and multivitamins is also helpful. PAS is combined with ftivazid and streptomycin.

Treatment is carried out only in conjunction with a phthisiatrician.

Epidemic keratoconjunctivitis

In the case of this form of disease, therapy turns out to be very problematic. Talking about the symptoms and treatment of this type of keratoconjunctivitis, it should be noted that there are no drugs yet that have a selective effect on adenoviruses. Therefore, therapy is fraught with difficulties.

As a rule, broad-spectrum medications are used. These are interferons (ophthalmoferon and lokferon) and their inducers, installations 6-8 times a day. If the stage is acute, then you additionally need to take antihistamines and take antiallergic drops, for example, “Spersallerg” or “Allergoftal”.

In the subacute form, Lecrolin and Alomide drops are used. If films have formed, you will need to take corticosteroids - Maxidex, Dexapos and Oftan-Dexamethasone. When the cornea is damaged, “Coperegel”, “Vitasik”, “Korpozin”, “Taufon” help.

Viral keratoconjunctivitis

We cannot ignore the disease of this form. Treatment of viral keratoconjunctivitis is aimed at eliminating the cause that caused it. So the doctor prescribes antibiotics and broad-spectrum drops. Only these drugs are capable of influencing a large number of bacteria known to science.

If a patient is diagnosed with a severe disease that is also progressing, then parenteral antibiotics are prescribed.

In parallel, it is necessary to use drugs that can protect the normal microflora of the intestines and other organs. Because with such treatment, against the background of changes occurring in it, the risk of developing fungal diseases and dysbacteriosis begins to increase.

As a rule, the elimination of symptoms and treatment of keratoconjunctivitis in adults is carried out with Tobrex and Sofradex drops. Acyclovir is also used. This drug prevents the infection from becoming chronic.

Vernal keratoconjunctivitis

As a rule, this disease occurs among boys 4-10 years old. Treatment of vernal keratoconjunctivitis primarily involves minimizing exposure to ultraviolet radiation to the eyes. Therefore, it is strongly recommended to wear sunglasses and not be outside during daylight hours.

The use of antihistamines, as well as mast cell stabilizers, is indicated. Sodium cromoglicate in the form of drops and Olopatadine are excellent. But this needs to be done systematically. Long-term use of these medications will help avoid exacerbation.

To reduce itching, you will have to use a 3% sodium bicarbonate solution. You can also make lotions from a solution of boric acid.

Herpetic keratoconjunctivitis

Treatment of this disease is aimed primarily at suppressing the virus that caused it. Therefore, it is necessary to take antiviral and anti-inflammatory drugs.

As a rule, Vidarabine, Riodoxol, Acyclovir, etc. are prescribed.

To treat the follicles you need to use brilliant green. Be sure to apply antiherpetic ointment under the lower eyelid. For example, Acyclovir, Virolex or Florenal.

If the area around the eyes is also affected, then you will need to start taking medications such as Polyoxidonium, Cycloferon and Valtrex.

But these are all strong drugs. How to treat keratoconjunctivitis in this case, interferons are prescribed. Most often they are treated with drops. A popular option is “Ophthalmoferon”. It is instilled 5-6 times a day for 3 days, always after washing the eyes with chamomile decoction.

Chlamydial keratoconjunctivitis

In this case, the use of antibiotics is also indicated. Elimination of symptoms and treatment of this type of keratoconjunctivitis is carried out with the use of tetracyclines, macrolides and fluoroquinolones.

Local therapy involves the use of eye drops (ciprofloxacin solution and ofloxacin solution), anti-inflammatory drugs (dexamethasone solution and indomethacin solution) and ointment applications over the eyelids.

The treatment of this disease cannot be called simple. It is carried out comprehensively. That is, they carry out therapy aimed simultaneously against all pathogens identified during the tests.

Any doctor will say that the treatment of dry keratoconjunctivitis in a person will differ from therapy aimed at eliminating the same disease, but only of a different type.

Allergic keratoconjunctivitis must be treated immediately, since complications in this case arise quickly. First of all, it is necessary to either eliminate the irritant or limit contact with it. You also need to take vitamins and antihistamines to strengthen your overall immunity.

If the course of a viral type disease is not complicated, then you can use Pyrogenal, Reaferon and Poludan.

It is also worth knowing that the notorious glucocorticosteroids eliminate signs of inflammation, but are powerless against adenovirus. They only relieve symptoms. Therefore, due to improper treatment, the disease quickly becomes chronic.

For dry type, in addition to using artificial tears, you can use Vaseline oil and Lacrisin - this will help restore the natural film on the eyeball.

And, of course, in any case you need to take vitamin complexes. The doctor will tell you which ones exactly. But you can’t 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 a relapse can quickly occur.

In general, treatment for this disease should begin as early as possible. Timely therapy helps to avoid complications such as blurred vision, otitis media, scarring of the mucous membrane, and bacterial damage. But the worst thing is when keratoconjunctivitis becomes chronic.

Keratoconjunctivitis sicca is chronic dry eye disease that causes dehydration of the conjunctiva and cornea. This pathology is a real scourge of the modern world. It most often occurs in the older age category of people, however, every year there is a negative trend in the manifestation of the disease in young people whose work activity is closely related to the computer.

Features of the pathology and causes

Dry keratoconjunctivitis or filamentous keratitis still remains a disease with an unknown cause and is a consequence of a general malaise of the whole body called Sjögren's syndrome. The main difference between this pathology is the appearance of dryness of the mucous membranes of the eyes as a result of contraction and lack of fluid discharge from the lacrimal or salivary glands. With this type of dryness, there is no protective covering of the conjunctiva and cornea of ​​the eye in the form of a continuous tear film.

The appearance of pathology may be an integral part of Sjogren's syndrome, and its occurrence in women may be due to the postmenopausal period. In rare cases, the disease may develop as a result of other pathologies that have led to scarring of the tear ducts, dysfunction of the lacrimal gland, or are the result of radiation therapy.

Various factors can contribute to the development of pathology with poor consequences for eye function.

Main reasons:

1. Age-related changes in the body. Upon reaching the age of forty, there is a decrease in the production of tear fluid, which further worsens in the future. The composition of the produced fluid also changes, and therefore it is not able to fully meet the needs of the eye as before for its full hydration.
2. Taking medications that can cause dry eyeballs. These are mainly medications to stabilize blood pressure and heart rate.
3. The presence of various chronic diseases.
4. Long hours of work at the computer.
5. Increased environmental pollution.
6. Constant use of contact lenses.
7. Side effect due to surgery on the cornea of ​​the eye.
8. Drastic changes in diet with the consumption of insufficient amounts of fat, which significantly changes the composition of the tear fluid.

In some cases, keratoconjunctivitis can cause the formation of erosions on the cornea, which, when infected, develop an inflammatory process and form ulcers. As a result, scars and characteristic opacities appear on the cornea, which prevents the passage of light and ultimately reduces a person’s visual acuity.

Important! Often the pathology is associated with a lack of water in the body; with an increase in the amount of water consumption per day, an improvement in the person’s condition is felt.

Common signs and symptoms of pathology

As the disease develops, a burning, itching, and pulling sensation is felt in the eye area.

There are also main symptoms of the disease:

• feeling of sand in the eyes;
• fear of bright light;
• irritation of the organs of vision, resulting in excessive lacrimation;
• heaviness in the eyes;
• blurred vision;
• stinging in the eyes after waking up.

Symptoms of the disease can appear periodically: decrease or increase in proportion to eye strain.

Keratoconjunctivitis sicca is divided into two main types:

• typical or idiopathic;
• atypical or postoperative.

Typical filamentous keratitis is in most cases bilateral and is characterized by the following symptoms:

• dry crying;
• dryness in the nasopharynx, mouth;
• characteristic hoarseness;
• difficulty swallowing.

The postoperative type of disease occurs in the case of vitreous prolapse, in which the inner layer of the eye vessels is desquamated.

Diagnosis of the disease

To determine an accurate diagnosis of pathology, a combination of visual examination, special tests and clinical studies are required. An accurate method for diagnosing this disease has not yet been developed.

First of all, the doctor conducts a survey of the patient in order to determine the cause of the pathology and the characteristics of working conditions. Then an examination of the organs of vision is carried out with a detailed examination of the cornea, conjunctiva and edges of the eyelids using a slit lamp.

In order to clarify the diagnosis, additional examinations are prescribed to measure the stability of the tear film and conduct an in-depth analysis of the composition of the tear fluid.

Based on the examinations and examinations performed, a diagnosis is established and appropriate treatment is prescribed based on the cause contributing to the development of the pathology.

Methods of treating the disease

Treatment of keratoconjunctivitis sicca is aimed at increasing the amount of tear fluid and preventing its excessive evaporation.

Treatment of the initial stage of the disease

If the patient does not have any concomitant pathologies, and the development of the disease is a consequence of many hours of work at the computer, then treatment is carried out using special drops or ointments to restore the amount of moisture in the eyes. As a result, these drugs are called “artificial tears.”

Important! The use of drops should be constant while working at the computer.

The number of times of instillation for each person is determined based on his individual characteristics and only as prescribed by an experienced specialist. But the daily norm should be at least 3 times and no more than 8, the exact amount is determined by the doctor.

The most common eye drops for the treatment of dry eye syndrome are:

1. Khilozar-Komod contains hyaluronic acid, which promotes intensive hydration of the surface of the eye, also helps to smooth out discomfort from using contact lenses, remove dryness and relieve fatigue from the visual organs;
2. Hypromelose-P, is a viscous drop with a long-lasting effect, effectively helps after surgical operations, in the presence of mechanical injuries or toxic origin, perfectly softens the cornea, which allows you to quickly relieve eye irritation;
3. Oftagel, the drug contains carbomer, which allows you to increase the viscosity of the tear fluid, as a result of which a protective film appears that helps protect the eyes from drying out, the only drawback of the drug is that after instillation it causes a burning sensation and a temporary decrease in visual acuity;
4. Hilo-chest, the drug contains a solution of sodium hyaluronate, which protects the cornea from possible drying out, has a long period of action and does not cause a burning sensation after instillation, is necessary for people who have suffered injuries, burns of the cornea or after surgery, and is also excellent for regular use contact lenses;
5. Visin is a drug consisting of several active components, which helps relieve irritation and eye fatigue, and also protect the surface of the cornea from damage and drying out.

Basic methods of treating moderate and severe forms of the disease

Moderate to severe keratoconjunctivitis sicca is treated to prevent the outflow of tear fluid. For this purpose, there are 2 types: surgical and orthopedic therapy.

The surgical treatment method involves blocking the lacrimal glands, which further prevents tear fluid from entering the nasopharynx. This method ultimately leads to the formation of irreversible processes in the body and is therefore used in especially severe cases of pathology.

The orthopedic method consists of blocking the tear duct itself; this technique is more preferable, since it does not affect the body as a whole and does not cause any allergic reactions in humans. As a result of this method, there is no need for surgery.

In addition to the main treatment methods, a course of additional therapy is provided, consisting of certain measures:

• therapy of cardiovascular diseases;
• treatment of concomitant ocular inflammation;
• increasing the body's immunity;
• treatment of other diseases that cause increased dry eyes.

Important! Keratoconjunctivitis sicca is a pathology that is subject to mandatory treatment, as it affects the general well-being and performance of a person. Ignoring this problem can lead to more complex diseases.

Disease prevention

To prevent the occurrence of pathology, you should follow simple recommendations that will help maintain eye health.

Basic Rules:

Keratoconjunctivitis is an inflammatory process in the eye, affecting both the conjunctiva and the cornea. This is one of the most common ophthalmic diseases, since the conjunctiva is sensitive to most exogenous and endogenous irritants. It is noteworthy that some types of keratoconjunctivitis can be contagious.

Keratoconjunctivitis sometimes develops with long-term use of corticosteroids, excess vitamins, or exposure to a foreign body on the conjunctiva or cornea. One of the most common reasons is improper use of contact lenses and insufficient cleaning.

Often, keratoconjunctivitis indicates another disease. Most often it is influenza, rubella, lupus erythematosus, rheumatoid arthritis or. Provoking factors for inflammation can be helminthiasis, food allergies, poor hygiene and lice.

Types of keratoconjunctivitis:

1. Herpetic. Inflammation occurs as a result of the activity of the herpes virus. Has symptoms of either acute diffuse conjunctivitis.
2. Hydrogen sulfide. Appears with prolonged exposure to hydrogen sulfide on the eyes. As a rule, the form of inflammation is acute or there are severe symptoms of conjunctivitis in combination with superficial keratitis.
3. Tuberculosis-allergic (scrofulous, phlyctenulous). It is a specific reaction to tuberculosis bacteria. On examination, conflicts are found in the eye.
4. Epidemic. Inflammation develops when pathogens enter the conjunctival sac and cornea. This is perhaps the most dangerous type of keratoconjunctivitis because it is contagious.
5. Adenoviral. The disease is caused by the activity of adenovirus in the body. This species is also contagious.
6. Dry. Characterized by the appearance of threads from degenerated epithelial cells. The threads can reach 5 mm and hang freely from the cornea. The progression of dry keratitis occurs against the background of hypofunction of the lacrimal glands and drying of the cornea.
7. Thygeson's keratoconjunctivitis. Caused by an allergic reaction or viral activity. It manifests itself as a point infection, which at the initial stage of inflammation is noticeable only under special lighting.
8. Atopic. Chronic inflammation, which is characterized by exacerbations in the cold season. During the examination, the doctor identifies whitish plaques on the surface of the eyeball.
9. . Inflammation develops when there is a large amount of chlamydia in the body, and is often a symptom of genitourinary disease. Chlamydia can enter the cornea during oral sex.
10. Spring. A chronic condition that worsens in the spring, less often in the fall. During diagnosis, whitish plaques are found on the mucous membrane.

Symptoms of keratoconjunctivitis

Acute infectious keratoconjunctivitis is characterized by first damage to one eye and gradual movement of inflammation to the other. Symptoms may differ for each patient depending on the type of lesion. The condition can be acute or chronic.

Common symptoms of keratoconjunctivitis:

• burning;
• redness of the cornea and conjunctivitis;
• loose structure of the conjunctiva;
• profuse lacrimation;
• photophobia;
• sensation of a foreign body in the eye;
• mucopurulent discharge;
• swelling;
• hemorrhages in the conjunctiva.

Sometimes, during inflammation, various pathological elements (follicles, papillae) are formed. At first, the inflammation is localized only in the conjunctiva, and after 5-15 days it spreads to the cornea.

When chlamydia becomes the cause of inflammation, peripheral subepithelial infiltrates are added to the listed symptoms. With epidemic keratoconjunctivitis, the doctor sees a coin-shaped clouding of the cornea. The spring and atopic forms provoke the appearance of whitish plaques along the limbus.

Allergic keratoconjunctivitis causes severe burning and lacrimation. With dry inflammation, there is almost always dry eye syndrome and filamentous keratitis.

Diagnosis of inflammation of the conjunctiva and cornea

If any of the symptoms of keratoconjunctivitis occur, you should immediately consult a doctor, as some forms of the disease can be contagious. An ophthalmologist must conduct an examination, analyze complaints and anamnesis, as well as existing symptoms. According to indications, the patient may be referred for additional consultation with an endocrinologist, phthisiatrician or therapist.

Methods for diagnosing keratoconjunctivitis:

• visometry (determining visual acuity);
• biomicroscopy (study of eye structures);
• fluorescein test;
• perimetry (determination of visual fields);
• chest x-ray;
• general blood and urine analysis;
• RW blood test.

It is very important to exclude during the examination, and, and also. Blepharoconjunctivitis is a type of conjunctivitis that is associated with inflammation of the eyelids (blepharitis).

Viral conjunctivitis is considered the most common ophthalmological disease; it affects the conjunctiva of the eye. Keratitis affects only the cornea, usually the condition is viral or bacterial in nature. Keratitis often occurs after an eye injury. Adenoviral keratitis is an acute infection of the mucous membrane of the eyeball. The disease is contagious and therefore requires immediate treatment.

Features of treatment of keratoconjunctivitis

Treatment for keratoconjunctivitis will depend on the cause of the inflammation. Any drugs can be used only after confirmation of the diagnosis and identification of the pathogen. To relieve symptoms, topical drops and ointments can be used. They give a short-term effect, but eliminate redness, burning and itching. Some of them are capable of destroying pathogens in the cornea and conjunctiva.

If inflammation progresses due to exposure to bacteria, it is necessary to include antibacterial drugs in therapy. Antiviral agents will help against viruses, and antifungals against fungi. It must be remembered that uncontrolled use of medications can lead to aggravation of the symptoms of keratoconjunctivitis.

If the cause of the progression of inflammation is a foreign body, surgical intervention is resorted to. In rare cases, conservative therapy for keratoconjunctivitis is completely ineffective. The ophthalmologist may suggest a corneal transplant to the patient.

Main medications for keratoconjunctivitis

Before using any drug, you should consult your doctor. It should be remembered that every medicine has contraindications.

Oftalmoferon is an anti-inflammatory, antiviral and immunomodulatory agent. For acute keratoconjunctivitis, 1-2 drops are prescribed 6-8 times a day into the affected eye. As you recover, the dose is reduced by 2-3 instillations per day. Treatment can be continued until complete recovery.

Tobramycin or Tobrex is a broad-spectrum antibiotic. It belongs to the group of aminoglycosides. For inflammation of the conjunctiva and cornea, 6-8 instillations per day, 1-2 drops into the conjunctival sac, are permissible. When symptoms subside, the dose is reduced to 4-5 instillations.

Ciprofloxacin is an antimicrobial drug from the fluoroquinolone series. Mild and moderate inflammations are treated by instilling 1-2 drops every 4 hours, and severe inflammations by instilling 2 drops every 2 hours. As you recover, the intensity and dosage are reduced.

If a bacterial ulcer occurs, Ciprofloxacin is recommended drop by drop every 15 minutes for 6 hours, and then drop by drop every half hour while awake. On the second day of treatment, a drop is instilled every hour of the day, on days 3-14, a drop is instilled every 4 hours (in the afternoon).

Preservation of the precorneal film helps protect the cornea from metaplasia. Trisol, Lakrisin, sodium bicarbonate solution (2%) are suitable for these purposes. You should also reduce the outflow of tears from the conjunctival sac by coagulation or blockade with silicone plugs.

To prevent secondary infection, a solution of chloramphenicol (0.25%) or sodium sulfacyl (30%) is recommended. Preservation of visual function is only possible if treatment is started at the first or second stage of inflammation, preferably before the development of filamentous keratitis.

Treatment methods for different types of keratoconjunctivitis

Allergic

Allergic keratoconjunctivitis should be treated quickly as complications can occur very quickly. Most often, allergic eye inflammation occurs in spring and summer, when there are a large number of allergens. The first step is to eliminate the irritant or limit contact with it. It is necessary to take antihistamines and vitamins to strengthen general immunity.

Herpetic

It is necessary to prescribe anti-inflammatory and antiviral drugs, eye and antiherpetic ointments (Bonafton, Virolex, Zovirax, Acyclovir). Orally Valtrex for herpes, immunomodulator Cycloferon or Polyoxidonium. Tobrex antibacterial eye drops with antibiotics or placing tetracycline, erythromycin ointment behind the lower eyelid.

Adenoviral

For uncomplicated keratoconjunctivitis, Poludan, Reaferon or Pyrogenal drops are prescribed. Depending on the complications, it is possible to take antiallergic and antiherpetic drugs. Glucocorticosteroids can eliminate signs of inflammation, but they are powerless against adenovirus, which quickly turns the disease into a chronic one (Tobradex, Dexamethasone, Sofradex).

Epidemic

Prescription of broad-spectrum antiviral drugs is required. Interferons and interferon inducers (Lokferon, Ophthalmoferon) are suitable for these purposes. In case of acute inflammation, therapy is supplemented with antiallergic drops (Allergoftal, Spersallerg) and oral antihistamines. The subacute form requires instillation of Lecrolin or Alamid.

If a film or rash appears on the cornea, corticosteroids are needed (Oftan-Dexamethasone, Dexapos, Maxidex). During a relapse, immunocorrective therapy (Taktivip) is performed. After epidemic keratoconjunctivitis, discomfort and decreased tear production may occur, which can be eliminated with Liquifilm and Poliglyukin.

Keratoconjunctivitis sicca

Treatment consists of eliminating symptoms. The ophthalmologist prescribes vitamins, artificial tears, Lacrisin and petroleum jelly. Keratoconjunctivitis sicca requires the use of moisturizing drops. They help restore the natural film of the eyeball. The best in this group are Actovegin and Taufon.

Chlamydial

This form of keratoconjunctivitis can be cured only with the help of antibiotics (macrolides, tetracyclines, fluoroquinolones). Instillations of antibacterial (Ofloxacin, ciprofloxacin solution) and anti-inflammatory drops (Indomethacin, dexamethasone solution), applications of tetracycline or erythromycin ointment are recommended. Systemic treatment for chlamydia is also required.

Tuberculosis-allergic

Therapy should be comprehensive, with the joint work of an ophthalmologist and a phthisiatrician. First of all, steroid instillations (Dexasone, Hydrocortisone) are prescribed. To carry out desensitization, instillation of Dexamethasone, Prednisolone (1%), calcium chloride solution (3%) and diphenhydramine (2%) is indicated.

Corneal defects are eliminated using keratoplasty. If inflammation affects the iris, mydriatics are required. To prevent secondary infection, antibiotics, sulfonamides and bactericidal agents are prescribed. In the presence of extraocular foci of tuberculosis, specific tuberculostatic drugs should be taken.

Prevention of keratoconjunctivitis

In most cases, the prognosis for inflammation of the cornea and conjunctiva is unfavorable. Only with timely detection of inflammation and proper treatment can complications be avoided (scarring of the mucous membrane, transition to a chronic form, otitis media, bacterial damage, blurred vision).

Since the causes of keratoconjunctivitis are varied, the best preventive measure would be general strengthening of the body, compliance with hygiene rules and timely treatment of any diseases. It is very important to control allergic reactions and fight helminthiasis.

Keratoconjunctivitis is a serious and dangerous condition that often results in severe deterioration of visual function. To preserve your vision and the ability to lead an active lifestyle, you need to monitor the condition of your eyes and respond to any changes in a timely manner.