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Spring is a coming, and with it the gentle hum of lawn mowers. I love the smell of fresh cut grass; however my eyes don't! Spring and summer is tainted for thousands by a condition that leads to irritation and poor sight in the form of conjunctivitus. But here in the UK we consider “conjunctivitus” as an all or nothing term. Were you aware there are different types of the condition? For the most part I have always considered it to be the same wherever you are and triggered always by the same things, eg. pollen. grass etc, and we can easily self -remedy using over the counter drugs.
Ever heard of these?
- Acute Hemorrhagic Conjunctivitis
- Atopic Keratocomjunctivitis
- Bacterial Conjunctivitis
- Emergent Treatment of Acute Conjunctivitis
- Epidemic Keratoconjunctivitis
- Giant Papillary Conjunctivitis
- Keratoconjunctivitis Sicca
- Neonatal Conjunctivitis
- Superior Limbic Keratoconjunctivitis
- Viral Conjunctivitis
Some of these variants are fairly new on the scale of discovery. Acute Hemorrhagic Conjunctivitis (AHC ) was first described in 1969. Since the first reports from Ghana, the infection has been described in numerous other countries, including China, India, Egypt, Cuba, Singapore, Taiwan, Japan, Pakistan, Thailand, and the United States. There was an epidemic of the strain involving more than 200,000 people reported as occurring in Brazil in 2006.
We humans are the sole host for the enteroviruses. It is spread easily through fecal-oral channels. So we see the highest of AHC infection typically where hygiene is deficient. Maybe why I had not come across it in the UK. Sexually transmitted infections can also be a cause of the strain, in neonatal conjunctivitis. This presents during the first month of life. It may be aseptic or septic. Bacterial and viral infections are major causes of septic neonatal conjunctivitis, with chlamydia being the most common infectious agent. Infants may acquire these infective agents as they pass through the birth canal during the birth process. Not an association I would have ever made with my eye health.
Several studies demonstrate that acute conjunctivitis occurs with almost equal frequency between bacterial and viral causes. Fitch et al noted that viral conjunctivitis occurs more frequently in the summer, and bacterial conjunctivitis occurs more often in the winter and spring. Most causes of conjunctivitis are benign, with a self-limited process; however, depending on the immune status of the patient and the etiology, conjunctivitis can progress to increasingly severe and sight-threatening infections. The role of the emergency physician is to separate those few conditions requiring more vigorous treatment from the majority that can be handled satisfactorily in the clinics.