American Medical Association Family Medical Guide - American Medical Association [734]
Diagnosis and Treatment
diagnosis of conjunctivitis is based on the symptoms and an examination of the affected eye. If the doctor suspects bacterial conjunctivitis, he or she may take a sample of fluid or discharge from the eye for laboratory analysis.
To treat bacterial conjunctivitis, the doctor will recommend gently washing away any discharge with warm water and applying prescription antibiotic eyedrops or ointment to the eyes. The condition should clear up after 1 week. Viral conjunctivitis usually goes away on its own within 7 to 10 days. To treat allergic conjunctivitis, a doctor may recommend using nonprescription or prescription eyedrops to reduce the allergy symptoms. You will also need to identify and avoid exposure to the allergen to prevent future episodes of allergic conjunctivitis. To treat neonatal ophthalmia, a doctor may cleanse the baby’s eyes and eyelids of any discharge, apply antibiotic eyedrops to the eyes, and give antibiotics intravenously (through a vein).
To help prevent conjunctivitis from spreading, wash your hands frequently, and keep them away from your eyes. Use your own towels and washcloths and change them daily, and wash your towels, washcloths, sheets, and pillowcases in hot water.
Subconjunctival Hemorrhage
A subconjunctival hemorrhage is leaking of blood from a small blood vessel in the eye into the area between the conjunctiva and the sclera (the white of the eye). A subconjunctival hemorrhage may be caused by an eye injury or infection, or may develop as a result of coughing, sneezing, straining, or any other activity that increases the pressure in the blood vessels in the head and neck. A subconjunctival hemorrhage also may be associated with taking blood thinners. Sometimes a subconjunctival hemorrhage occurs suddenly, for no obvious reason.
Symptoms, Diagnosis, and Treatment
The main symptom of a subconjunctival hemorrhage is a bright red patch on the sclera. A diagnosis of subconjunctival hemorrhage is based on the symptoms and an examination of the eye.
In most cases, a subconjunctival hemorrhage is harmless and the red patch goes away on its own after about a week. However, if the patch results from an injury or is painful, call your doctor right away. You may have a serious eye injury or an underlying disorder that needs treatment. If you are taking anticoagulant drugs (blood thinners), talk to your doctor as soon as possible. He or she may need to reduce the dosage of the drug or prescribe another anticoagulant.
Scleritis
Scleritis is inflammation of the sclera (the white of the eye). The condition is rare and sometimes occurs along with rheumatoid arthritis (see page 918) or a digestive disorder such as Crohn’s disease (see page 764). Scleritis usually affects people between ages 30 and 60. If the condition is not treated, the inflamed tissue could become perforated. Scleritis can affect one or both eyes.
Symptoms
The symptoms of scleritis include one or more dark red patches, widespread inflammation and redness in the white of the eye, and dull, aching pain in the eye. If the inflammation occurs at the back of the eye, vision may be impaired.
Diagnosis and Treatment
A diagnosis of scleritis is based on the symptoms and an examination of the eye. Mild or moderate cases of scleritis are usually treated with anti-inflammatory medications such as corticosteroids, taken in eyedrops or in tablets. In severe cases, doctors may prescribe immune-suppressing drugs, which dampen the abnormal immune response and relieve inflammation. If the sclera is perforated, surgery is necessary to repair the damage.
Uveitis
Uveitis is inflammation of the uvea, which consists of the iris (the colored part of the eye), the ciliary body (the ring of muscles that focus the lens), and the choroid (the layer of blood vessels beneath the retina). The condition is called iritis when the inflammation is confined to the iris, cyclitis when it is confined to the ciliary