Adenovirus conjunctivitis.

Adenoviral conjunctivitis is caused by adenoviruses of serotypes 3, 4, 7, 10. The eye disease is preceded or accompanied by damage to the upper respiratory tract (rhinitis, pharyngitis, nasopharyngitis, tonsillitis). Adenoviral conjunctivitis usually occurs in children's groups. Adenovirus is transmitted by airborne droplets, less often by contact. The incubation period is 3-10 days.

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Symptoms of adenoviral conjunctivitis

Adenoviral conjunctivitis begins acutely, usually in one eye, and the other eye may become ill within 1-3 days. The discharge along the edges of the eyelids and on the conjunctiva is scanty and mucous. The conjunctiva of the eyelids and transitional folds is hyperemic, edematous, with a greater or lesser follicular reaction and with the formation of easily removable films on the conjunctiva of the eyelids (usually in children). Depending on the severity of these symptoms, catarrhal, follicular and membranous forms of adenoviral conjunctivitis are distinguished. Corneal lesions are found in 13% of cases and have the character of superficial, small, point infiltrates stained with fluorescein. Keratitis symptoms usually completely disappear during recovery, which occurs within 2-4 weeks.

Adenoviral conjunctivitis is characterized by general symptoms: respiratory tract damage with fever and headache. Systemic damage may precede eye disease. Duration of adenoviral conjunctivitis is 2 weeks.

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Treatment of adenoviral conjunctivitis

Treatment of adenoviral conjunctivitis is complex. It should be noted that treatment can be difficult, since today there is no remedy that would selectively affect adenoviruses.

Treatment may vary and depends on possible ophthalmological complications, is a form of viral infection.

If one of the thirty known adenoviruses penetrates the mucous membrane of the nasopharynx, then after 3-5 days it also affects the conjunctiva of the eyes. Although pediatric ophthalmologists and pediatricians tend to believe that adenovirus gets into the eye through dirty hands, with which the child touches contaminated toys, dishes or common hygiene items - towels, handkerchiefs, and so on. As a rule, the conjunctiva of one eye suffers, the second eye "joins" after a few days. Symptoms of ophthalmologic adenovirus are clinically manifested in the form of burning and stinging in the eye, often children complain of an invisible speck, which is actually absent. The mucous membrane of the eye affected by the virus swells and turns red, increased lacrimation appears. Conjunctivitis of viral etiology can cause headaches, swelling of the parotid lymph nodes, and if it is not treated with adequate medications, the discharge is so abundant that the child cannot open his eyes in the morning, literally glued together with pus.

Many parents believe that adenoviral conjunctivitis can be treated at home, when the child's eyes are washed with weak tea or a solution of boric acid, especially well-read adults rush to the pharmacy to buy albucid to eliminate what seems to them an obvious eye infection. But antibiotics and corticosteroids do not have the desired effect on the virus, and viral conjunctivitis continues to develop, and sometimes gets complicated. Keratoconjunctivitis may develop, when the inflammatory process moves to the cornea of the eye, the eyelid swells greatly and closes the eye slit, photophobia develops. With a severe form of corneal damage, the child's vision can drop by almost 30%, which may require inpatient treatment and even surgery. To prevent such situations, parents should contact a pediatrician or pediatric ophthalmologist at the slightest sign of a viral eye infection.

Treatment of adenoviral conjunctivitis involves the use of drugs that act not only on the virus, but also do not damage the mucous membrane of the eye. The fact is that the virus has the ability to "hide" in tissue cells, in order to neutralize it, drops are needed that include leukocyte human interferon.

Before visiting a doctor, you should read and follow the following simple rules:

• It is necessary to allocate separate hygiene items for the sick child - a towel, a pillow, soap, and also dishes. The pipette for instilling drops should be intended only for the child, as well as other attributes of treatment - tampons, handkerchiefs, napkins.
• Those who care for a sick child need to regularly wash their hands with soap; this is enough to avoid transferring the virus to others and to themselves.
• The pipette, glass stick for applying the ointment, and the dishes must be treated by boiling. The virus cannot be neutralized with alcohol, but it dies at high temperatures.
• The room where the sick child is located should be ventilated and provide a normal level of humidity; it is advisable to darken (curtain) the windows for several days when the eye is irritated by light.

Adenoviral conjunctivitis, the treatment of which still does not have a single approved scheme, in a mild form does not require the use of complex eye drops. Interferon therapy, general tonic, immunomodulatory agents and compliance with hygiene rules are enough for the body to cope with the virus and its manifestations on its own within 10 days. However, there are also protracted forms of the disease, when drugs with a broad antiviral effect are used, for example, Laferon. Instillation is carried out quite often in the first seven days - up to 8 times a day, then the frequency is reduced to 2-3 times. If adenoviral conjunctivitis is accompanied by purulent discharge, antibacterial drops are indicated to reduce the risk of secondary infection. Antihistamines with vasoconstrictor properties are also effective. In case of photophobia syndrome and dry mucous membrane, artificial humidifiers are prescribed, such as Oftagel.

Adenoviral conjunctivitis is treated with instillations of interferons, DNAse or Poludan (6-10 times a day) and antiallergic eye drops, and if there is insufficient tear fluid, artificial tears or Oftagel.

To prevent the development of a secondary bacterial infection, it is necessary to instill antibacterial solutions (for example, eye drops Maxtrol). The duration of treatment is at least 2 weeks.

Recurrent adenoviral conjunctivitis is treated using immunocorrective methods. The therapy includes taktivin (6 injections at a dosage of 25 mcg), levamisole - 150 mg 1 time / week and cycloferon (10 injections of 2 ml).

In ophthalmological practice, the following drugs are considered effective in the treatment of adenoviral eye infections; they should only be selected by a doctor, taking into account the individual characteristics of the child's condition and the severity of the disease:

• Poludan is a drug, an interferon stimulator, intended for the treatment of adenoviral conjunctivitis, keratoconjunctivitis and keratitis.
• Florenal – neutralizes viruses, mainly of the Herpes simplex group.
• Interferon is an antiviral and immunostimulating agent, produced in the form of a powder from which a solution must be prepared.
• Tebrofen – in the form of drops or ointment, an antiviral drug.
• Floxal is an antimicrobial drop based on ofloxacin.
• Albucid is a broad-spectrum antimicrobial drop.
• Tobrex is an antimicrobial drops that can be prescribed from the first day of birth.
• Vitabact is a drug based on picloxidine hydrochloride, which has an aseptic effect. Drops are intended for the treatment of viral and microbial infections from the first day of birth.

Treatment of adenoviral conjunctivitis is carried out only under the supervision of a doctor, since an incorrectly selected drug can aggravate the course of the disease. The prognosis of ophthalmological forms of adenoviral diseases is usually favorable. Conjunctivitis in an uncomplicated form can go away on its own if personal hygiene, aseptic procedures and the use of immunomodulators are observed. More complex cases of the disease do not last more than a month, relapses are also extremely rare.

Adenoviral conjunctivitis has a favorable prognosis.