Introduction
The conjunctiva is a membrane that lines the outer surface of the eye and the inner surface of the eyelids. Chronic conjunctivitis refers to long lasting inflammation of this membrane. Chronic conjunctivitis can be associated with a variety of etiologies and should be evaluated an eyecare specialist.
Background
Chronic conjunctivitis, or chronic inflammation of the conjunctiva, can occur for variety of reasons. A common etiology of chronic conjunctivitis is of bacterial and viral origin. A few organisms that can cause chronic inflammation of the conjunctiva includes, but is not limited to, is S. aureus, C. trachomatis, adenovirus and N. gonorrhoeae.
Another possible cause of chronic conjunctivitis is inflammation of the meibomian glands. The meibomian glands are small glands around the eyelashes that secrete an oily film that prevent the tears in our eyes from evaporating. This helps maintain the moisture in our eye. This condition can cause chronic inflammation of both the conjunctiva and the eyelids. It can also predispose an individual towards the formation of a chalazia (a small bulge on the eyelid from the blockage of a meibomian gland).
Some other causes of chronic conjunctivitis include wearing contact lens, use of particular medications and recurrent styes. Any chronic inflammation should be seen by an eye specialist.
Signs & Symptoms
The signs and symptoms will differ from person to person depending on what the cause is for the chronic conjunctivitis. The following are the signs/symptoms associated with the most common causes.
Chronic bacterial conjunctivitis - ""itching, burning, foreign-body sensation, morning eye crusting,"" warmth and redness around the eyelids; these patients can also have recurrent styes or chalazia (a small bulge on the eyelid from the blockage of a gland).
Meibomianitis - warmth and redness of the edges of the eyelid and conjunctiva; dry eye syndrome is also common
Patients that present with chronic conjunctivits may also have a history of acne rosacea. This is a skin disorder that causes episodic facial redness following alcohol or particular food consumption.
Conjunctival pain, sensitivity to light and vision that remains blurred after blinking several times are rarely seen in association with primary conjunctivitis and are indicative of a serious underlying cause. Patients with these symptoms should be seen by an ophthalmologist.
Diagnosis
Testing for chronic conjunctivitis varies depending on the etiology.
If bacterial origins are suspected, an eye specialist will collect bacteria from the area and perform different stains (ie Gram stains) and different tests (such as a culture) to ascertain what bacteria it is. A similar method will be followed with different stains and tests for chronic conjunctivitis believed to be viral in origin.
A thorough history of contact lens use, current medications along with history of the conjunctival inflammation should be taken by your physician; this will be the strongest method of determining the cause of the chronic conjunctivitis.
Treatment
Treatment of chronic conjunctivitis varies depending on the etiology.
If the cause is determined to be bacterial or viral in origin, treatment will include the appropriate topic antimicrobials; systemic medications may be required should the situation permit. Medications will vary depending on the organism cultured. Treatment can also include the use of artificial tears to restore hydration to the eye.
The establishment of good hygiene with regards to the eyelid is of utmost importance for someone with chronic conjunctivitis. This would include the use of warm compresses along the eye alongside with scrubs directed towards the edge of the eyelids. This would assist in the healing process and serve as prevention for further episodes.
Follow-up
The establishment of good hygiene with regards to the eyelid is of utmost importance. This would include the use of warm compresses along the eye alongside with scrubs directed towards the edge of the eyelids. Washing hands before handling contact lens is also a great preventative technique.
Prognosis for chronic conjunctivitis can vary according to the etiology. For the prognosis of one's specific condition, an ophthalmologist should be consulted.
