Angular conjunctivitis is an inflammation of the mucous membrane of the eyes, provoked by pathogenic microflora. Visually, this disease can be determined by its localization - in the corners of the palpebral fissures. Usually the pathology is chronic and is accompanied by regular periods of exacerbations. Having suffered this form of conjunctivitis once, the body does not produce specific immune cells, so recurrence is not ruled out.
When symptoms are detected and treated early, angular conjunctivitis resolves fairly quickly. But a late diagnosed pathology, especially after numerous attempts at self-treatment, can take a long time and regularly bring discomfort to the patient for several years.
Short description
Angular conjunctivitis appears as a result of reproduction directly on the mucous membrane of the eye of pathogenic microorganisms- specific sticks of Morax-Axenfeld. In the normal state, the lacrimal fluid, constantly produced by the conjunctiva, contains antiseptic substances, due to which the pathogenic microflora penetrating the eyes is quickly disinfected and does not cause pathological processes. But with a weakened immune system and the influence of various harmful conditions, pathogenic microorganisms can provoke the occurrence of local inflammation.
Angular conjunctivitis is found in about 6-7 people out of 100 with an inflammatory lesion of the mucous membrane of the eyes. But the acute forms of this defect are extremely rare - approximately 4/5 of all people with this disease suffer from its chronic course.
A person at any age can face such a violation, but still much more often the disease is diagnosed in people of middle and advanced years. The incidence rate increases many times among those who have crossed the forty-year milestone. Various complications are also much more common among elderly patients, when involutive tissue remodeling occurs.
Women and men are equally affected by this disease - this pattern applies to both young and old people.
Pathogenesis
The causative agent of angular conjunctivitis - diplobacillus Morax-Axenfeld - is a small sticks arranged in a chain of two. It is a Gram-negative bacterium that does not stain when tested by the Gram method.
Diplobacillus belongs to the category of strict aerobes - bacteria that fordevelopment requires being in an environment with free air access. It is necessary for microorganisms to release the energy needed for the activity of pathogens.
It is noteworthy that this bacterium is immobile - due to its specific structure, it is not able to move independently.
It should also be said that diplobacillus belongs to the group of opportunistic pathogens. And this means that it can get on the mucous membranes of a strong, he althy person, while not causing him any harm. However, under the influence of certain factors, the bacterium becomes more aggressive and leads to the appearance of a pathology - angular conjunctivitis.
Why appears
Infection can occur under various circumstances. The most common causes of angular conjunctivitis are:
- sharing eye makeup or towels containing pathogens;
- visiting the bathhouse, sauna and swimming pool;
- mechanical damage and eye injuries;
- washing with dirty water;
- use of insufficiently sterilized devices in a beauty parlor.
There are several other factors that can trigger the development of the disease. These include recent pathologies of an infectious nature, severe hypothermia, respiratory ailments and advanced age.
In addition, Morax-Axenfeld diplobacilli can be transferred from one pathological focus tothe other, for example, at the moment of sneezing from the throat - into the eyes. The main feature of these sticks lies in the fact that they can provoke inflammation only on the conjunctiva, but for the rest of the mucous membranes they are relatively safe.
Symptoms and treatment of angular conjunctivitis
In the photo you can see the main symptom of this pathology - redness and damage to the skin in the corners of the eyes. It is for this symptom that the ophthalmologist during the examination may suspect the presence of a pathogenic bacillus on the mucous membrane. Due to the fact that peculiar crusts can form on the affected conjunctiva, in some cases, patients experience visual impairment. However, in reality, there is no need to worry - this is usually a temporary condition that disappears on its own almost immediately after recovery.
The incubation phase of the disease can last a maximum of 4 days from the moment the pathogenic microflora penetrates the mucous membrane. At first, a person is disturbed by slight pain at the moment of blinking and itching in the eyes, gradually these signs intensify.
Typical symptoms of angular conjunctivitis are:
- pain and burning sensation in the eye area;
- friability and severe redness of the conjunctiva;
- feeling of the presence of a foreign object in the eye;
- damage to the integrity, cracking of the skin of the eyelids;
- pain and itching in the area of the inner or outer corners of the eyes;
- a small amount of thick discharge from the eyes.
When determining the diagnosis, among other things, differential diagnosis with other types of conjunctivitis is required. After all, the treatment of various types of disease can vary significantly.
Features
It is noteworthy that in fact the symptoms of angular conjunctivitis can be erased, in some cases they do not cause severe discomfort to the patient at all. A slight reddening of the eyes after a hard day's work can be mistaken for banal fatigue, and scant discharge is sometimes not given any importance at all.
Under such circumstances, the pathology often flows into a chronic sluggish form, which often leads to a long and extremely difficult treatment. That is why it is so important to pay attention to the photo of angular conjunctivitis and, if such signs appear, immediately contact an ophthalmologist. The doctor will conduct a physical examination, after which he will prescribe additional examinations and a course of treatment.
How to detect vice
As already mentioned, the diagnosis of angular conjunctivitis begins with an examination by a specialist and the collection of the necessary anamnesis. Then the doctor usually performs biomicroscopy - a detailed examination of the cornea, lens, mucous membrane, anterior chamber and iris using a special lamp. Due to the use of this device, it is possible to objectively determine the degree of damage to various structures of the eye and detect many other defects.
To identify the causes of conjunctivitis, sometimesThe ophthalmologist sends the patient for auxiliary examinations:
- bacterial culture of discharge from the eye to determine the type of pathogen and select the most effective antibiotic;
- cytological examination of scraping from the mucous membrane.
Diagnostic features
Due to the fact that sowing is done for quite a long time, about a week, most often an ophthalmologist, based on the symptoms found and his own observations, makes a preliminary diagnosis and prescribes broad-spectrum antibacterial drugs.
If the patient has specific signs of pathology, he can be prescribed a narrowly focused therapy immediately after examination and questioning. The doctor makes such a decision in order not to waste time and improve the patient's condition as quickly as possible. If the need arises, therapy will be adjusted based on new information after culture results are available.
Treatment
With such a disease, in no case should you use all sorts of solutions or gauze bandages, as this can provoke the development of keratitis. This is a rather dangerous complication that can lead to the penetration of the infection much deeper, which will cause the appearance of a cataract or even blindness.
The doctor may advise the patient to wash the eyes with antiseptic solutions to mechanically eliminate pathogenic bacteria, cleanse the conjunctiva and suppress the further development of microflora.
For this, usuallythe following drugs are used:
- zinc sulfate;
- nitrofural;
- potassium permanganate;
- boric acid.
Throughout the treatment of angular conjunctivitis, the patient should touch the eyes as little as possible so as not to spread the bacteria. At the same time, a person should have his own towel and separate hygiene items until complete recovery. In addition, he needs to wash his hands every time before contact with other people.
Drug therapy
Conservative treatment of angular conjunctivitis involves the use of several groups of drugs:
- non-steroidal anti-inflammatory drugs;
- fortifying medicines, including vitamins;
- desensitizing drugs - reduce the body's susceptibility to toxins;
- immunostimulating drugs - biologically active peptides produced from thymus extract, interleukins and interferons;
- antibiotics - most often "Tetracycline", "Tobramycin", "Gentamicin", "Ofloxacin" in the form of ointment or drops.
Prevention of angular conjunctivitis
Measures aimed at preventing the development of such an unpleasant pathology include the following rules:
- Using separate hygiene items - gloves, cosmetics, towels, scarves.
- Compliance with the banal rules of hygiene - regular hand washing.
- Avoiding contact of dirty hands with eyes.
- General strengthening of immunity.
- Elimination of chronic infectious foci.
