Bacterial Conjunctivitis

Overview Of Bacterial Conjunctivitis

Bacterial conjunctivitis is an infection of the conjunctiva, the thin membrane that covers the white part of the eye and the inner surface of the eyelids. It is caused by various bacterial pathogens, most commonly *Staphylococcus aureus*, *Streptococcus pneumoniae*, and *Haemophilus influenzae*. The condition is characterized by redness, swelling, and discharge from the eyes, which can be purulent (pus-filled) or mucopurulent. Bacterial conjunctivitis is highly contagious and can spread through direct contact with infected individuals or contaminated surfaces. It can affect one or both eyes and is more common in children than adults. While most cases are mild and self-limiting, prompt treatment with antibiotics can reduce the duration of symptoms and prevent complications such as corneal ulcers or chronic conjunctivitis.

Causes of Bacterial Conjunctivitis

• Bacterial conjunctivitis is caused by infection with bacterial pathogens, most commonly *Staphylococcus aureus*, *Streptococcus pneumoniae*, and *Haemophilus influenzae*. Other causative agents include *Moraxella catarrhalis*, *Pseudomonas aeruginosa*, and *Neisseria gonorrhoeae* (particularly in neonates). The infection is typically transmitted through direct contact with infected eye secretions, contaminated hands, or objects such as towels or makeup. Risk factors include poor hygiene, contact lens use, and exposure to individuals with conjunctivitis. Neonatal conjunctivitis (ophthalmia neonatorum) can occur due to exposure to maternal genital infections during childbirth. Bacterial conjunctivitis can also result from secondary infection following viral conjunctivitis or trauma to the eye.

Risk Factors of Bacterial Conjunctivitis

• Several factors increase the risk of developing bacterial conjunctivitis. Poor hygiene practices, such as touching the eyes with unwashed hands or sharing towels or makeup, can facilitate the spread of bacteria. Contact lens wearers are at higher risk due to the potential for bacterial contamination of lenses or lens cases. Exposure to individuals with conjunctivitis, particularly in crowded settings like schools or daycare centers, increases the likelihood of transmission. Neonates are at risk of ophthalmia neonatorum if exposed to maternal genital infections during childbirth. Other risk factors include recent upper respiratory infections, which can predispose individuals to secondary bacterial conjunctivitis, and trauma to the eye, which can create an entry point for bacteria.

Prevention of Bacterial Conjunctivitis

• Preventing bacterial conjunctivitis involves adopting good hygiene practices and reducing exposure to risk factors. Frequent handwashing with soap and water, particularly before touching the eyes, can reduce the risk of transmission. Avoiding sharing towels, makeup, or other personal items that come into contact with the eyes is essential. Contact lens wearers should follow proper lens care guidelines, such as washing hands before handling lenses and replacing lens cases regularly. In neonatal settings, prophylactic antibiotic ointment (e.g., erythromycin) is routinely applied to the eyes of newborns to prevent ophthalmia neonatorum. Education and awareness about the contagious nature of conjunctivitis are key components of prevention efforts.

Prognosis of Bacterial Conjunctivitis

• The prognosis for bacterial conjunctivitis is generally excellent with appropriate treatment. Most patients experience significant improvement within 2–3 days of starting antibiotics, and symptoms typically resolve completely within a week. However, untreated or inadequately treated infections can lead to complications, such as chronic conjunctivitis, corneal ulcers, or keratitis (inflammation of the cornea). Recurrent infections may occur, particularly in individuals with underlying risk factors such as contact lens use or poor hygiene. Long-term outcomes are improved with early diagnosis, adherence to treatment, and addressing risk factors. Regular follow-up is usually unnecessary unless symptoms persist or complications arise.

Complications of Bacterial Conjunctivitis

• If left untreated, bacterial conjunctivitis can lead to several complications. Chronic conjunctivitis, characterized by persistent redness and discharge, can develop if the infection is not adequately treated. Corneal ulcers, which are open sores on the cornea, can occur in severe cases and may lead to scarring or vision loss. Keratitis, an inflammation of the cornea, can result from bacterial invasion and cause pain, photophobia, and blurred vision. In neonates, untreated conjunctivitis caused by *Neisseria gonorrhoeae* or *Chlamydia trachomatis* can lead to systemic infections, such as sepsis or pneumonia. Prompt treatment and follow-up are essential to prevent these complications and ensure complete resolution of the infection.

Related Diseases of Bacterial Conjunctivitis

• Bacterial conjunctivitis is closely associated with several other ocular and systemic conditions. Viral conjunctivitis, caused by pathogens like adenovirus or herpes simplex virus, can present with similar symptoms but requires different treatment. Allergic conjunctivitis, triggered by allergens such as pollen or pet dander, is characterized by itching and watery discharge rather than purulent discharge. Keratitis, an inflammation of the cornea, can result from bacterial invasion and cause pain, photophobia, and blurred vision. Neonatal conjunctivitis, caused by *Neisseria gonorrhoeae* or *Chlamydia trachomatis*, is a significant concern in newborns and requires prompt treatment to prevent systemic complications. Understanding these related diseases is essential for accurate diagnosis and effective management.

Treatment of Bacterial Conjunctivitis

The treatment of bacterial conjunctivitis typically involves topical antibiotic therapy to eradicate the causative bacteria and reduce symptoms. Commonly prescribed antibiotics include erythromycin ointment, polymyxin-trimethoprim drops, or fluoroquinolones (e.g., ciprofloxacin, ofloxacin). These medications are usually administered 3–4 times daily for 5–7 days. Warm compresses can help alleviate discomfort and remove crusts or discharge. Patients are advised to practice good hygiene, such as washing hands frequently and avoiding touching the eyes, to prevent spreading the infection. Contact lens wearers should discontinue use until the infection has resolved. In cases of neonatal conjunctivitis, systemic antibiotics may be required, particularly if caused by *Neisseria gonorrhoeae* or *Chlamydia trachomatis*.