Blepharoconjunctivitis

Blepharoconjunctivitis is an inflammatory eye disease, the essence of which is inflammation of the mucous membrane of the eye (conjunctiva) and eyelids. Typical symptoms are pain, inflammation, burning, dryness of the eye. The disease may have a different etiology, but the pathogenesis is based on the inflammatory process. The danger of this disease is that it can tend to progression and rapid development of complications. Most often, against the background of inflammation, an infectious process develops, which subsequently leads to the fact that the eye begins to pus, associated pathologies develop.

Epidemiology

Statistically, the inflammatory process in the eye region is almost always accompanied by infection. Bacteriologic studies conducted by a number of authors-researchers with the participation of patients with blepharoconjunctivitis allowed to establish the following etiologic structure of pathology: associations represented by 2 and 3 types of microorganisms prevail in patients (46%). Of them: S. Aureus + E. Coli - 12%; S. Aureus + C. Albicans - 8%; S. Aureus + S. Pneumoniae - 8%; S. Aureus + S. Pneumoniae - 8%.aureus + S.pneumoniae S.pyogenes - 8%; S. Aureus + S.pyogenes + Streptococcus spp. - 8%; S. Aureus + Streptococcus spp.+ Bacteroides spp. - In the group of patients with severe eye pathologies and complicated blepharoconjunctivitis, associations represented by 4 and 5 types of microorganisms prevail (55%). Of these: S. Aureus + E. Coli + Peptostreptococcus spp + Monococcus spp - 16.5%; S. Aureus + C.Albicans + E. Coli + S.epidermidis - S. Aureus + C. Albicans + E. Coli + S. Epidermidis - 16.5%.epidermidis - 16.5%; S. Aureus + E. Coli + Klebsiella pneumonia + C.Albicans + Enterococcus spp - 11%; S. Aureus + S.epidermidis + H.influenzae + S.pyogenes + E. Coli - 11%.

When analyzing age indicators, we found that in 30-35% of cases blepharoconjunctivitis is observed in children of the first year of life, in 25-30% of cases - in children from 1 to 12 years old. In persons from 12 to 35 years of age, pus in the eyes is observed much less frequently - no more than 5% of registered cases of pathology. The remaining 35-40% fall on persons over 35 years of age. After we analyzed the etiological factors underlying the development of blepharoconjunctivitis, we came to the conclusion that the cause of the development of this pathology in 95% of cases is an inflammatory process complicated by bacterial infection.

Causes of the blepharoconjunctivitis

There may be many causes: the development of inflammation, infection (bacterial, viral). Some types of blepharoconjunctivitis develop against the background of allergic reactions, fungal infection. The cause of blepharoconjunctivitis may be spasm, intoxication, as well as a violation of metabolic processes and local blood circulation, both in the mucous membranes of the eye, and at the level of the retina, brain. Blepharoconjunctivitis can be a consequence of a general somatic disease, or infectious disease. Often it develops with a cold, hypothermia, after surgery, especially in the eye, brain.

Risk factors

Different categories of people fall into the risk group. First of all, these are people who have a history of chronic, less often - acute eye diseases. Various traumas, surgical interventions, especially if they are accompanied by violation of the integrity of the eye, have a negative impact. Concomitant pathologies, in particular, various metabolic disorders such as atherosclerosis, diabetes mellitus, anorexia, obesity can be considered as risk factors. To the development of pathology of the organs of vision can lead to a violation of the metabolism of carbohydrates, proteins, fats, lack or excess of vitamins, minerals. Especially important for the visual sensory system are B vitamins, vitamin K, vitamin A, E, as well as minerals such as sulfur, zinc, copper, iron.

Risk factors include various foci of infection in the body, persistent viral infection, microflora disorders. There are known cases of blepharoconjunctivitis development against the background of parasites, in the presence of skin mites (demodex). This is associated with a high risk of penetration of these microorganisms into the eye. Accordingly, in the place of penetration of pathogens, an inflammatory and infectious process develops, which is often accompanied by the formation of pus. Contact lenses can also be considered as a risk factor, since the contact between the mucous membrane of the eye and the lens creates an oxygen-free environment. In this environment there are optimal conditions for reproduction of microorganisms (anaerobes), which can cause inflammation and pus formation.

Concomitant general diseases can also be considered as risk factors. Especially negatively affect such diseases in which a person takes antibiotics, antiviral or anti-inflammatory drugs. This is due to the fact that these drugs disrupt local immunity, violate the colonization resistance of mucous membranes, which leads to an increased risk of contamination of the eye with pathogens.

Blepharoconjunctivitis is often diagnosed in newborns, children of the first year of life, especially those born prematurely or with low body weight. This is due to the fact that children at this age are not yet fully formed microflora, the eye is at the stage of adaptation to new conditions. Accordingly, environmental factors have a detrimental effect on both the eye itself and its mucous membrane. Potential risk factors, against the background of which a pathological process in the visual system may develop, include overwork, violation of visual hygiene, increased eye strain.

The risk increases also if a person undergoes age-related changes, biochemical and hormonal background is disturbed, immunity decreases.

Pathogenesis

The pathogenesis is based primarily on the inflammatory process in the mucous membrane of the eye (conjunctiva) and eyelid. Pathogenesis is largely determined by the cause and trigger factors that trigger the inflammatory process itself. Gradually, a bacterial infection may join, since aseptic (non-inflammatory) process in the body is rarely observed. Gradually, pus may appear, which is often seen as a sign of bacterial infection. All this leads to further disruption of the microflora, reduction of defense and compensatory mechanisms, disruption of the hormonal background.

The inflammatory process develops in a standard way: leukocytes, lymphocytes, neutrophils arrive at the focus of infection. All these cells actively produce inflammatory factors. They also produce mediators, interleukins, cytokines, and other mediators that quite quickly activate local immunity, various compensatory and protective reactions develop. They are often accompanied by burning, tearing.

Symptoms of the blepharoconjunctivitis

Symptoms depend on the nature of the course of pathology. So, the symptoms of blepharoconjunctivitis can be both acute and chronic manifestations. First, there are signs of mucous membrane disorders, which manifest themselves in the form of friability, redness of mucous membranes. Against this background, pain, burning develops, dryness of the eye appears. Gradually, the symptoms intensify, there is lacrimation, sometimes - heavy purulent discharge. Secondly, the functional capabilities of the eye are significantly impaired. In particular, there are signs of fatigue, vision may be impaired, photophobia appears.

The first signs of blepharoconjunctivitis are complaints of a feeling of blockage in the eye, itching, burning, tearing, pain, increased fatigue and watery eyes. All of these symptoms tend to increase significantly towards evening. Often, on the surface of the eye or on the eyelid, a film is formed, through which it is impossible to see the image clearly. It seems that the eye is covered with a white veil. Visual acuity decreases, all silhouettes are perceived blurred.

The first sign may be the appearance of pus, with which all the main symptomatology of the pathology begins. Especially noticeable is the formation of pus in the morning. This is due to the fact that at night the lacrimal apparatus is not active, pus is not washed away by tears. Accordingly, in the morning, its intense accumulation is manifested. It should be taken into account that pus accumulates directly on the surface of the mucous membrane, under the eyelid, which supports inflammation of the mucous membrane itself and the eyelid. During this period, it is usually quite difficult to open the eye, because the eyelids are stuck together, and often develop edema.

Blepharoconjunctivitis in children

One of the most common diseases in children is blepharoconjunctivitis, which is due to a number of factors. Thus, in newborns and children of the first year of life, the pathology is observed most often, and proceeds most severely. This is due to the immaturity of the eye and its functional unpreparedness for active functioning, resistance to infectious factors. In children of early preschool age, pathology is associated mainly with a high level of activity, with non-compliance with sanitary and hygienic norms. Thus, children at this age are characterized by curiosity, high desire to learn and study everything new. Children often play in the sandbox, the ground, get dirty hands in the face, eyes. The ingress of foreign bodies, contaminants, can cause a corresponding reaction, which is accompanied by the development of inflammatory and infectious process.

In children of primary school age blepharoconjunctivitis is mainly associated with increasing eye strain, adaptation of the eye to new and high loads. Thus, the leading activity of the child becomes educational, and not play. This is associated with an increase in the load on the visual system, its overstrain, increased adaptation.

In adolescence, children often have blepharoconjunctivitis, developing against the background of increased sensitization of the body, against the background of frequent infectious and somatic diseases. During this period, children, as a rule, have reduced adaptive capabilities of the body, the state of immunity, microflora, there are active hormonal changes. Also in adolescents are often observed allergic, autoimmune reactions, increased sensitization.

As the first alarming symptoms indicating the development of blepharoconjunctivitis in children may be eye pain, burning, increased lacrimation, increased fatigue.

Self-treatment should never be practiced, as it can significantly disrupt the homeostasis of the entire visual system, cause serious complications.

Forms

Depending on the criteria underlying the classification, there are several types of blepharoconjunctivitis. Thus, according to the nature of the manifestation of the disease, acute and chronic blepharoconjunctivitis are distinguished. With acute pathology develops acute visual impairment, symptoms increase sharply, there is pain, burning, increased lacrimation. Chronic blepharoconjunctivitis is characterized by such signs as latent, latent course, gradual increase in the symptoms of pathology. Depending on the etiological factor that provoked the development of pathology, you can distinguish allergic, demodectic, viral, herpetic, meibomian and purulent blepharoconjunctivitis.

Acute blepharoconjunctivitis.

It is an inflammation affecting the eyelids and conjunctiva of the eye, causing redness, itching, swelling, and sometimes discharge of mucus or pus from the eye. This condition can be caused by a variety of factors including bacterial, viral infections, allergic reactions, or exposure to external irritants.

Characteristic signs and symptoms of acute blepharoconjunctivitis include:

• Redness and swelling of the eyelids and conjunctiva. The conjunctiva is the clear membrane that covers the white of the eye and the inside of the eyelids. Inflammation makes it red and swollen.
• Itching and burning. Common sensations that can be quite irritating.
• Discharge from the eyes, which may be mucous or purulent depending on the cause of the inflammation. In the morning, the eyelids may be sticky due to drying of discharge during sleep.
• Foreign body sensation in the eye and increased tear production.
• Light sensitivity, or photophobia, can also be seen, especially if the inflammation is severe.

Treatment of acute blepharoconjunctivitis depends on the cause. Bacterial infections may require antibiotics in the form of drops or eye ointments. Viral infections, such as herpes virus, may be treated with antiviral medications. Allergic reactions are often controlled with antihistamines and avoiding contact with allergens.

Chronic blepharoconjunctivitis.

Chronic blepharoconjunctivitis is a long-term and recurrent inflammatory condition of the eyelid margins and conjunctiva of the eye. This condition is characterized by a prolonged inflammatory process that can last for months or even years, with periods of exacerbation and reduction of symptoms.

Here are a few characteristics of chronic blepharoconjunctivitis:

1. Recurrent symptoms: Patients with chronic blepharoconjunctivitis may experience periodic exacerbations of symptoms such as itching, burning, sandy eyes, heavy eyelids, and increased lacrimation.
2. Eyelid marginal changes: Inflammation of the eyelid margins can lead to various changes such as redness, swelling, crusting, thickening of the margins and eyelash loss.
3. Appearance of Caviar and Camedones: Yellowish caviar (oily discharge from the meibomian glands) and comedones (blockage of the meibomian tubules) may form on the eyelid margins, which can lead to discomfort and worsen inflammation.
4. Development of chronic conjunctivitis: Inflammation of the conjunctiva of the eye can also become chronic, which is manifested by redness, swelling, and hyperplasia of blood vessels on the surface of the eyeball.
5. Associated Conditions: Chronic blepharoconjunctivitis may be associated with other conditions such as rosacea, seborrheic dermatitis, demodecosis, and allergic reactions.
6. Long-term treatment required: Treatment of chronic blepharoconjunctivitis often requires a long-term and systematic approach, including regular eyelid hygiene, application of topical medications (e.g., drops or ointments), and treatment of associated conditions.

Chronic blepharoconjunctivitis can significantly reduce a patient's quality of life, so it is important to have regular checkups with an ophthalmologist and follow treatment recommendations to manage symptoms and prevent exacerbations.

Allergic blepharoconjunctivitis.

It is an allergic inflammation of the eyelids and conjunctiva that can occur due to exposure of the body to various allergens. It is one of the most common allergic eye diseases.

Characteristics of allergic blepharoconjunctivitis include:

1. Itchingand irritation: Patients often complain of severe itching and discomfort in the eyelids and conjunctiva.
2. Redness of the eyes and eyelids: The eyes may be red, and the skin around the eyelids may also be inflamed and red.
3. Tear production: Increased tear production is one of the typical signs of allergic eye inflammation.
4. Swelling of the eyelids and surrounding tissues: Under the influence of the allergic process, the eyelids may swell and become thicker.
5. Photoreaction: Sensitivity to light may be increased, which can cause soreness and discomfort in bright light conditions.
6. Mucopurulent secretion: In some cases, patients have a mucopurulent secretion from the eyes.
7. Sensation of sand in the eyes: Patients may feel that they have something in their eyes, like sand or a foreign body.
8. Visual impairment: Temporary visual impairment due to swelling and irritation of the eyes may occur.

Treatment for allergic blepharoconjunctivitis usually includes the use of antihistamine eye drops or ointments, anti-inflammatory drops, and the application of cold compresses to relieve symptoms. In cases of severe allergic response, systemic antihistamines or corticosteroids may be required under medical supervision.

Demodectic blepharoconjunctivitis

Caused by the reproduction of demodexes, which are microscopic mites that usually live in the meibomian glands in the eyelid margins in humans. Here are the main characteristics of this disease:

1. Cause: Demodecosis blepharoconjunctivitis is caused by parasitization of demodexes in the meibomian glands, which is where these mites feed and reproduce.
2. Symptoms: Characteristic symptoms of demodectic blepharoconjunctivitis include redness of the eyelid margins, itching, burning, a feeling of sand in the eye, discharge from the eye, often in the morning after sleep, and possible crusting at the base of the eyelashes.
3. Diagnosis: To diagnose demodectic blepharoconjunctivitis, it is common to scrape the surface of the eyelid margins to examine the contents under a microscope for the presence of demodexes.
4. Treatment: Treatment of demodectic blepharoconjunctivitis includes the use of anti-demodectic drugs, such as permethrin or ivermectin, which can be applied as topical drops or ointments. Masking and eyelid massage may also be recommended to clear the glands of mites and avoid their reappearance.
5. Prevention: Preventionof demodectic blepharoconjunctivitis involves regular eyelid and eye hygiene, including cleaning the eyelids of makeup and other contaminants, and avoiding contact with contaminated surfaces.
6. Associated Conditions: Demodecosis blepharoconjunctivitis may be associated with other skin conditions such as rosacea or seborrheic dermatitis, so treatment sometimes requires a comprehensive approach to managing these conditions.

Viral blepharoconjunctivitis.

It is an inflammatory condition caused by viruses that affect the conjunctiva (the mucous membrane of the eye) and the edges of the eyelid. This condition can be caused by a variety of viruses, including adenoviruses, herpesviruses, and others. Here are the main characteristics of viral blepharoconjunctivitis:

1. Infectious nature: Viral blepharoconjunctivitis is an infectious disease transmitted by contact. It can occur through touching contaminated surfaces or carriers of the virus, as well as through aerosol transmission.
2. Symptoms: Characteristic symptoms of viral blepharoconjunctivitis include redness of the conjunctiva and eyelid margin, swelling, burning, itching, a feeling of sand in the eye, sensitivity to light, lacrimation and copious tear production. Patients may also have discharge from the eye that may be cloudy or contain pus.
3. Incubation period: The incubation period for viral blepharoconjunctivitis can vary depending on the type of virus, but usually ranges from a few days to a week.
4. Spread: Viral blepharoconjunctivitis can easily spread from person to person, especially in close contact settings such as children's groups, family interaction, and public places.
5. Viral agents: Viral blepharoconjunctivitis can be caused by a variety of viruses, but the most common are adenoviruses (especially types 3, 4, and 8) and herpesviruses (HSV-1 and HSV-2).
6. Treatment: Treatment of viral blepharoconjunctivitis usually involves the use of symptomatic measures such as cold compresses to relieve swelling and irritation, and the use of topical antiviral drops or ointments to shorten the period of illness and reduce the risk of spreading the virus.
7. Prevention: Important measures to prevent viral blepharoconjunctivitis include regular hand washing, avoiding contact with contaminated surfaces, and preventing transmission to others.

Herpetic blepharoconjunctivitis.

Herpetic blepharoconjunctivitis is a form of inflammatory disease caused by the herpes virus that affects the eyelid margin and conjunctiva of the eye. This condition can be caused by either herpes type 1 (HSV-1), which is commonly associated with lip and facial herpes, or herpes type 2 (HSV-2), which is more commonly associated with genital herpes. Here are the main characteristics of herpetic blepharoconjunctivitis:

1. Viral involvement: Herpetic blepharoconjunctivitis is caused by the herpes virus, which can infect the eyelid margin and conjunctiva of the eye, causing inflammation and various clinical manifestations.
2. SymptomFeatures: Symptoms of herpetic blepharoconjunctivitis may include redness of the eyelid and/or conjunctiva, swelling, itching, burning, a feeling of sand in the eye, sensitivity to light, and blistering or ulceration of the eyelid margin and conjunctival surface.
3. Recurrences: Herpetic blepharoconjunctivitis is usually characterized by periodic exacerbations, which can occur against the background of weakened immunity, stress or other provoking factors.
4. Spread of the virus: Herpes virus canspread to neighboring areas of the eye and facial skin, causing other forms of viral lesions such as herpetic keratitis (inflammation of the cornea) or herpetic dermatitis (inflammation of the skin).
5. Treatment: Treatment for herpetic blepharoconjunctivitis includes the use of antiviral medications in the form of topical drops or eye ointments to help reduce inflammation and control recurrences. Severe or recurrent cases may require systemic antiviral treatment under the guidance of a doctor.
6. Prevention of transmission: Because herpes is a contagious virus, it is important to take precautions to prevent transmission to others, including avoiding eye and skin contact during an exacerbation and practicing good hygiene.
7. Regular Examination: Patients with herpetic blepharoconjunctivitis should be examined regularly by an ophthalmologist for evaluation of the eye and recommendations for further treatment and care.

Purulent blepharoconjunctivitis.

It is a form of inflammatory disease that is characterized by the presence of purulent discharge in the area of the eyelid margin and/or on the surface of the conjunctiva. Here are the main characteristics of purulent blepharoconjunctivitis:

1. Purulent discharge: One of the main signs of purulent blepharoconjunctivitis is the presence of purulent discharge at the eyelid margin and/or on the surface of the eye. This may appear as a yellowish or greenish discharge.
2. Redness and swelling: The inflammation that accompanies purulent blepharoconjunctivitis can lead to redness and swelling of the eyelid margins and conjunctiva.
3. Soreness and discomfort: Patients with purulent blepharoconjunctivitis may experience soreness, burning sensation or itching in the area of the eyelid margin and eye.
4. Formation of a winged international bulla (brush): In some cases of purulent blepharoconjunctivitis, a winged international bubble formation may occur, which is an abscess that forms at the edge of the eyelid. It is usually filled with pus and may require drainage.
5. Possible visual impairment: In cases of severe and prolonged purulent blepharoconjunctivitis, especially in the absence of adequate treatment, visual impairment due to complications or corneal root infection may occur.
6. Treatment: Treatment of purulent blepharoconjunctivitis usually includes the use of antibiotic topical medications in the form of eye drops or ointments, application of warm compresses to relieve swelling and reduce inflammation, and hygienic procedures to clean the eyelids and remove purulent discharge.

Meibomian blepharoconjunctivitis.

It is an inflammatory condition that affects the meibomian (sebaceous) glands in the margins of the upper and lower eyelid, as well as the conjunctiva. This condition is often accompanied by conditions such as seborrheic dermatitis, rosacea, or chronic blepharitis. Here are the main characteristics of meibomian blepharoconjunctivitis:

1. Meibomian gland disease: Meibomian blepharoconjunctivitis is characterized by inflammation of the meibomian glands, which secrete an oily secretion needed to protect and moisturize the eye.
2. Cysts and comedones: Inflammation of the meibomian glands can lead to the formation of cysts and comedones (blockage of the exit ducts of the meibomian glands). This can cause blockage of the flow of secretion and reduced secretion.
3. Symptoms: Symptoms of meibomian blepharoconjunctivitis may include a feeling of sand or a foreign body in the eye, burning, itching, redness of the eyelid margins, and swelling. In some cases, increased tear production or symptoms of eye irritation may occur.
4. Recurrent exacerbations: Meibomian blepharoconjunctivitis is often a chronic condition with periods of exacerbations and symptom reduction.
5. Comprehensive treatment: Treatment for meibomian blepharoconjunctivitis often includes applying warm compresses to soften and liquefy the oil in the meibomian glands, massaging the eyelid margins to relieve blockages and stimulate the release of oily secretion, applying topical medications (such as drops or ointments) to reduce inflammation and fight infection, and regular eyelid hygiene.
6. Associated Conditions: Meibomian blepharoconjunctivitis is often associated with otherconditions such as seborrheic dermatitis, rosacea, or demodecosis.
7. Doctor's advice: If meibomian blepharoconjunctivitis is suspected, it is important to see an ophthalmologist or ophthalmic specialist for evaluation and effective treatment.

Meibomite

It is an inflammatory disease of the meibomian glands, which are located in the eyelids of the eye. These glands secrete an oily secretion that helps to lubricate the surface of the eye and prevent tear fluid from evaporating. Inflammation of the meibomian glands can be caused by a variety of factors, including infection, blockage of the glands' exit ducts, and anatomical features.

Characteristics of meibomite include:

1. Swelling and redness of the eyelid: The disease is usually accompanied by swelling and redness in the eyelid area, especially in the basal margin.
2. Soreness: Inflamed meibomian glands may be painful when touched or pressed.
3. Redness of the eyelid margin: Inflammation can lead to redness of the eyelid margin, which sometimes causes discomfort and itching.
4. Secretion: Sometimes a yellowish or whitish secretion may be secreted from the meibomian glands, especially when the eyelid is pressed.
5. Chalazion formation: In cases of prolonged and inadequately treated meibomitis, a chalazion, a larger cyst that forms from the meibomian gland, may develop.
6. Discomfort when blinking: Some patients may experience discomfort or pain when blinking due to inflammation of the meibomian glands.

Treatment for meibomitis usually involves hygienic procedures such as applying warm compresses and eyelid massage, as well as taking anti-inflammatory or antibiotic drops or ointments.

Chalazion

A chalazion is an inflammatory disease of the meibomian gland, which is manifested by the formation of a cyst in the upper or lower eyelid. Here are the main characteristics of a chalazion:

1. Cyst formation: A chalazion usually begins with the formation of a small mass or lump at the edge of the upper or lower eyelid. It may be painful or uncomfortable to touch.
2. Slow development: A chalazion can develop slowly over time. The cyst may be small and painless at first, but as it grows, it may become more palpable.
3. Redness and swelling: There may be redness and swelling around a formed cyst, especially if inflammation increases.
4. Secretion: Fat may accumulate inside the cyst, which may sometimes come out as an oily secretion.
5. Migration discomfort: Depending on the size and location of the cyst, it may cause discomfort when the upper or lower eyelid migrates, especially when massaged or pressed.
6. Possible scar formation: If a chalazion persists for a long period of time or if it recurs, scar tissue may develop in the eyelid area.
7. Rarely infected: A chalazion does not usually become infected, but in rare cases it can become a source of infection, especially if it is opened or damaged on its own.

A chalazion may resolve on its own, but if it is long-lasting, recurring, or significantly uncomfortable, it is recommended to see an ophthalmologist for evaluation and treatment. Treatment may include application of warm compresses, eyelid massage, application of topical medications or, in some cases, surgical removal of the cyst.

Complications and consequences

Blepharoconjunctivitis can be accompanied by unfavorable consequences and complications, especially in the absence of adequate treatment, or if incompletely treated. As the main complications should be considered keratitis, which is a disease in which the inflammation of the cornea of the eye develops. In the absence of treatment, the vision gradually decreases, there is a clouding of the cornea. Among the most dangerous complications, angular conjunctivitis should be attributed. This disease, the specific sign of which is inflammation of the mucous membrane of the eye, the vascular layer located under the conjunctiva. In rare cases, tumors of the eye, vascular layer may develop. The eye nerve may be affected, which often ends in tissue necrosis and blindness.

Diagnostics of the blepharoconjunctivitis

The basis for diagnosing any eye disease is an ophthalmologic examination. It is carried out in the office of an ophthalmologist, using special equipment and instruments. In the process of examination, visually assess the condition of the mucous membranes of the eye, its visible structures, the condition of the eyelids, vasculature, note inflammatory, traumatic, dystrophic processes, other changes. It is obligatory to examine the eye fundus with the help of special equipment (equipment, dark room, magnifying glasses, lenses are necessary). It may be necessary to check the vision using standard methods. There are many other methods of eye examination, which are used in the conditions of specialized clinics and departments in case of indications for additional examination.

Laboratory diagnostics

In ophthalmology mainly microbiological (bacteriological, virological), immunological, serological, immunohistochemical methods are used. They are used when there are indications and suspicion of bacterial, viral, immunologic pathologies, development of oncologic process in the eye area. As for standard methods, such as clinical blood tests, urinalysis, fecal analysis, biochemical and immunological studies, they are also often needed. But they are effective and informative mainly in inflammatory and bacterial processes, with a decrease in immunity, including local immunity. These analyses allow you to assess the overall picture of pathology, to assess what exactly is disturbed in the body, allows you to assume the cause of the pathological process, its severity, allows you to assess the effectiveness of treatment, processes in dynamics, to predict the duration and results of treatment. For example, a shift of leukocytic formula indicating the development of viral, bacterial infection, suggests that the inflammatory process in the eyes is a consequence of general disorders in the body, arising against the background of activation of viral, bacterial microflora. Then highly specific ophthalmologic examination may be required to clarify the data.

Specific analyses used in ophthalmology include the study of eye secretions, scrapes and smears from the mucous membrane of the eye, eyelid, the study of tears, flush water, eyelashes, purulent secretions, exudate, histologic studies of tissue samples.

Instrumental diagnostics

Various types of equipment are used to assess the state of the eye fundus, structure of tissues, mucous membranes of the eye, to examine the vasculature of the eye, to detect the reaction to a particular stimulus. With the help of special reagents create this or that effect, in particular, dilate pupils, contrast vessels, visualize the lens or other individual structures of the eye. Methods are used to measure intraocular and intracranial pressure.

Instrumental methods include methods that allow to obtain an image and assess the state of the eye, or its individual structures in statics, or in dynamics. Certain methods make it possible to register changes occurring in the eye in a normal state, at rest, when performing certain actions. You can analyze eye movements, muscle contraction, pupil reaction to light, darkness, introduction of chemicals, contrast. There are also numerous methods to assess the functional activity of not only the visual sensory system, but also the conductive elements, including the optic nerve, the reflex arc, as well as the relevant parts of the brain responsible for processing visual signals.

Differential diagnosis

The basis of differential diagnosis is the need to differentiate between different conditions and diseases that develop similar symptoms. First of all, it is necessary to differentiate blepharoconjunctivitis from other bacterial and viral diseases. It is important to exclude malignant, degenerative, dystrophic changes in the basic structures of the eye. It is important to differentiate blepharoconjunctivitis from blepharitis proper, conjunctivitis, keratitis, keratoconjunctivitis, angular pathologies. If necessary, the doctor will prescribe additional specialist consultations, as well as auxiliary methods of research (laboratory, instrumental).

A popular procedure is the examination of the eye discharge, it will show the nature of the inflammatory process, which largely determines further treatment. For the study, under special sterile conditions, a small amount of mucous membrane detachment (swab from the conjunctival surface) is taken. Then the material is sterile packed, and in compliance with all the necessary conditions of transportation, delivered for further study in the laboratory, where it is evaluated.

Further bacteriological, virological examination is carried out, which allows to identify the cause of blepharoconjunctivitis. Thus, in the inflammatory process of bacterial origin, the corresponding bacterium, which is the causative agent of the disease, will be isolated and identified. With a viral process, the virus is isolated, its quantitative and qualitative characteristics are given. Additionally, it is possible to select an effective antiseptic drug, select its dose, concentration, which will have the desired effect.

The differential diagnosis between blepharoconjunctivitis and other eye conditions involves considering the various clinical signs and characteristics of each condition. Here's how you can make a differential diagnosis between blepharoconjunctivitis and these conditions:

1. Iridocyclitis:

   • Iridocyclitis is an inflammation of the iris and ciliary body.
   • The main symptoms include eye pain, photophobia, redness of the eye, and blurred vision.
   • Differentiation is made by ophthalmoscopy and evaluation of inflammatory changes within the eye.

2. Keratoconjunctivitis:

   • Keratoconjunctivitis is an inflammation of the cornea and conjunctiva, often caused by an allergic reaction.
   • Symptoms include redness, itching, tearing, and a sensation of sand in the eyes.
   • Differentiation is done by evaluating the cornea using specialized techniques such as scanning laser tomography (OCT) or fluorescein angiography.

3. Angular conjunctivitis:

   • Angular conjunctivitis is characterized by inflammation in the corners of the eyes, often caused by bacterial infection or seborrheic dermatitis.
   • The main symptoms include redness, swelling, and muco-purulent discharge from the corners of the eyes.
   • Differentiation may be based on the nature of the discharge and the result of bacteriologic analysis.

4. Blepharitis:

   • Blepharitis is an inflammation of the eyelid margin, usually caused by a bacterial infection or demodectosis.
   • Symptoms include redness, itching, irritation, and oily separating scales at the basal margin of the eyelids.
   • Differentiation may include evaluation of the eyelid margin, type of secretion, and response to treatment.

5. Keratitis:

   • Keratitis is an inflammation of the cornea that can be caused by infection, trauma, allergies, or other causes.
   • The main symptoms include eye pain, blurred vision, photophobia, and corneal redness.
   • Differentiation includes evaluation of the nature of corneal inflammation, bacteriologic and virologic test results, and response to antibiotic treatment.

If there is doubt or uncertainty about the diagnosis, it is important to see an experienced ophthalmologist for further evaluation and treatment.

Treatment of the blepharoconjunctivitis

Treatment for blepharoconjunctivitis can involve several methods and steps that vary depending on the cause and severity of the condition. Here are the general treatment principles and steps that can be applied:

1. Cleansingand hygiene: The first step in treatment is to cleanse the eyelids and eye lids. This may include using warm compresses to soften the crusts and separate them from the edges of the eyelids, and using hygienic products to remove oil, makeup, and other contaminants from the eyelid skin.
2. Application of compresses: Warm compresses can help relieve inflammation, reduce swelling and improve smear flow. This can be done with a warm, damp washcloth or special heat eye masks.
3. Treatment of infection: If blepharoconjunctivitis is caused by a bacterial infection, your doctor may prescribe antibiotics in the form of topical drops or ointments that are applied to the edges of the eyelids.
4. Use of anti-infective and anti-inflammatory drops: In addition to antibiotics, drops containing antiseptics and/or anti-inflammatory components may be recommended to relieve inflammation and itching.
5. Removal of mechanical irritants: If blepharoconjunctivitis is caused by allergies or irritation, it is important to identify and avoid contact with allergens or irritants.
6. Treatment of Associated Conditions: If blepharoconjunctivitis is a symptom of another condition such as seborrheic dermatitis or rosacea, treating the underlying condition can also help improve eye health.
7. Correction of hormonal balance: In case blepharoconjunctivitis is associated with hormonal imbalance, as may be the case with rosacea, the use of hormonal remedies may also be recommended.
8. Regular check-ups: Once treatment has begun, it is important to monitor your eyes regularly and have check-ups with your ophthalmologist or general practitioner.

Effective treatment for blepharoconjunctivitis may require a combination of different methods depending on your specific circumstances. It is important to discuss with your doctor the best treatment options for your particular case.

Prevention

The basis of prevention is the maintenance of normal immunity, the normal state of mucous membranes, microflora, to stop foci of infection. It is important to observe the rules of hygiene. It is not allowed to get into the eye dirty water, sweat, should not get into the eye with dirty hands, objects, even if something got there. To maintain the normal state of the body, requires a nutritious diet, compliance with the regime of the day, work and rest, sufficient consumption of vitamins, especially vitamin A. It is important to give your eyes rest, especially if the work is associated with constant eye strain (drivers, work at a computer, with a microscope). It is necessary to relax the eyes periodically throughout the day. To do this, there are special exercises, gymnastic complexes for the eyes. It is also necessary to simply perform relaxing exercises, including Trataka, meditation, contemplation, concentration, staring into the darkness, concentrating on a stationary or luminous object. These are all specialized techniques to keep the eyes healthy. In addition, it is necessary that food should be rich in caratinoids (vitamin A). It is important to consume enough fluids.

Forecast

If you see a doctor in time, take the necessary measures - the prognosis can be favorable. In other cases, if you do not follow the doctor's recommendations, do not treat, or treat incorrectly - blepharoconjunctivitis is severe, and can end up with various complications, up to sepsis, and complete loss of vision, and even the eye itself.