Diseases of the conjunctiva

"It is important not to self-medicate conjunctivitis, since some frequently used treatments can have harmful effects for certain types of conjunctivitis or for other inflammatory conditions that simulate conjunctivitis (herpetic keratitis, etc.)".

DR. ÁNGEL SALINAS ALAMÁN
SPECIALIST. OPHTHALMOLOGY DEPARTMENT

The conjunctiva is an almost transparent membrane that covers the white part of the eye, the sclera, and also the eyelids on the inside.

Its function is to protect the eyeball from external agents, although it also intervenes in the formation of tear components and in the immunological defense of the eye.

Conjunctivitis is the most frequent pathology and has some characteristics common to all its origins, such as: red eye and increased secretions, different for each type of conjunctivitis.

The most frequent are those of viral origin, with a very variable clinic but usually very flowery, with unilateral onset, often becoming bilateral after 3 to 7 days.

It is sometimes accompanied by significant edema of the eyelid. The secretion in this case is watery but can subsequently become somewhat thicker. The treatment is symptomatic because its evolution cannot be avoided, which can last from one week to one month depending on the aggressiveness of the virus.

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What are the symptoms of conjunctival problems?

Some pictures that at first sight seem like conjunctivitis, may actually be other more important eye diseases.

It is necessary to consider if the visual sharpness is diminished or if an intense pain appears, which indicates to go to a specialist in Ophthalmology. 

The most common symptoms are:

  • Ocular pain.
  • Eye redness.
  • Eye itching.
  • Ocular secretion.
  • Blurred vision.

Do you have any of these symptoms?

You may have a conjunctive disease

Types of conjunctive diseases and their treatment

Generally, it occurs in people with other types of allergies (rhinitis, asthma, dermatitis, etc.) and is associated with volatile allergens (pollen, dust mites, etc.). Its onset is usually abrupt and bilateral with a main symptom being intense itching, especially at the inner end (towards the nose) of the conjunctiva, itching that increases when rubbing. The secretion is watery or mucous depending on the intensity.

The treatment consists of the administration of antihistamine and/or corticoid eye drops.

The secretion is mucopurulent and the beginning is somewhat more insidious. Treatment is usually effective with antibiotic eye drops.

In conjunctivitis of difficult resolution or recurrent, it is necessary to think about a disorder of the lacrimal duct or infectious pathology of the eyelids (blepharoconjunctivitis).

The conjunctiva is sensitive to a multitude of external agents and can become inflamed by exposure to them.

Inflammations of the conjunctiva related to exposure, for example, to chlorine in swimming pools, to air conditioning, to work with computers, to eye drops with preservatives, accompanying dry eye, etc. are very typical.

The treatment in these cases consists of avoiding the toxic agents associated with the administration of lubricating eye drops (artificial tears).

This frequent lesion can form in the bulbar conjunctiva adjacent to the limbus on the nasal side, or later on the temporal side. Upon exploration we can find elevated and yellowish deposits, which gradually increase in size, until they border the cornea, although they do not invade it.

From the histological point of view, they are formed by an elastic degeneration of collagen in the fundamental substance, thinning of the epithelium and, sometimes, calcification.

Surgical excision is rarely necessary.

This injury is more frequent in warm and sunny climates and can represent a response to chronic dryness and sun exposure. In these areas, the lesion progresses and can represent a threat to vision.

On exploration we find a raised triangular area of bulbar conjunctiva, which actively invades the cornea to produce visual symptoms if the pupillary area is affected or if it generates astigmatism. It is usually bilateral, affecting more frequently the nasal side of the interpalpebral area.

The examination of the leading edge and body of the pterygium shows if there is activity in the lesion, according to the degree of vascular dilation in the center of it.

Surgical removal is indicated if the lesion progresses towards the visual axis, or if it produces significant discomfort.

The rate of recurrence is high, especially in countries with a high level of sun exposure.

Tumors of the conjunctiva are quite rare and can pose diagnostic problems when they appear. Clinical differentiation between benign and neoplastic conditions can be difficult based on a simple examination.

Repeated observations over a period of time with the aid of serial photographs may be helpful in determining the evolution of the lesions.

In many cases it will be necessary to perform a biopsy to reach a diagnosis.

Where do we treat them?

IN NAVARRE AND MADRID

The Department of Ophthalmology
of the Clínica Universidad de Navarra

Equipped with the latest technology, the Department of Ophthalmology has the necessary equipment, both technical and human, to offer comprehensive and specific assistance to each patient.

We are one of the few centers that have a microsurgery laboratory for the improvement of clinical practice.

Organized in specialized units

  • Cornea and eye surface
  • Retina
  • General Ophthalmology
  • Refraction defects
  • Oculoplastic
  • Pediatric ophthalmology
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Why at the Clinica?

  • More than 25 years of experience.
  • Experts in the diagnosis and treatment of ocular pathologies.
  • With the security and guarantee of a prestigious hospital.

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