Eye lesions in chickenpox, measles, rubella

The eye can also be involved in the process with other common viral diseases; in particular, chickenpox, measles, rubella.

The chickenpox virus belongs to the group of herpes viruses, being, as stated above, an analogue of the causative agent of shingles. Infection occurs from a sick person through the respiratory tract with the localization of the virus in the skin and mucous membranes. Against the background of a sharp increase in body temperature, a spotty-vesicular rash appears, in particular on the face and eyelids. This is accompanied by photophobia, lacrimation, hyperemia of the conjunctiva, on which bubbles can also appear. The discharge from the conjunctival cavity is mucous, subsequently with elements of pus. The resulting keratitis is often superficial point character, the infiltrates are stained with fluorescein. The process as a whole is benign. Treatment consists of administering gamma globulin injections, lubricating the rash with brilliant green, rinsing the eyes with tea infusion, followed by instillation of interferon, 20% sodium sulfacyl solution, and placing 1% erythromycin or tetracycline ointment behind the eyelids at night.

Measles conjunctivitis is caused by a pathogen belonging to paramyxoviruses, which are transmitted by airborne droplets through the lymphoid tissue of the nasopharyngeal ring, and then localize in the organs. Against the background of catarrh of the upper respiratory tract, an increase in body temperature on the mucous membrane of the cheeks, conjunctiva of the eyelids, areas of deteneration and necrosis of the epithelium may appear in the form of white spots surrounded by a red rim - Velsky-Filatov-Koplik spots, which are a harbinger of a small papular rash on the skin. The clinical picture of conjunctivitis, sometimes with severe photophobia, blepharospasm and eyelid edema, is supplemented by epithelial keratitis with the presence of corneal erosions. With a weakening of the body's defenses, a banal infection may join, as evidenced by purulent discharge from the conjunctival cavity. With proper treatment (gamma globulin in injections and drops, interferon and other virusostatic agents, vitamins, desensitizing drugs) the general and local processes end favorably. Otherwise, deep keratitis, corneal ulceration, iridocyclitis may develop with the outcome in gross corneal opacity with decreased vision.

Rubella, caused by rubella virus, is an acute infectious disease, mainly in children, transmitted by airborne droplets. Clinical manifestations consist of catarrh of the upper respiratory tract and, which is very typical, a generalized reaction of the lymph nodes (the occipital, posterior cervical and other lymph nodes swell and become painful). This is accompanied by a slight increase in body temperature, the appearance of a small rash in the form of pale pink spots, which disappear after a few days.

Along with the general clinical manifestations of the disease, catarrhal conjunctivitis and superficial keratitis occur, requiring only symptomatic treatment and interferon. Despite the favorable outcome of the disease, when it occurs in women in the first months of pregnancy, it can lead to infection of the fetus with the development of congenital rubella, which is a very common cause of malformations and congenital pathology of the organ of vision (microphthalmos, coloboma-vascular membrane, cataract, glaucoma).

Paratrachoma. Refers to borderline viral infections of the conjunctiva, the causative agents of which occupy an intermediate position between typical viruses and rickettsia. The disease is a urogenital infection that affects the population aged 17-35 years and gets on the conjunctiva through hands, water during swimming in the pool from patients with non-specific urethritis. Women suffering from cervical erosion, chronic cervicitis are more often ill. From such pregnant women, a child can become infected with paratrachoma during childbirth. From the above, it becomes clear why paratrachoma or conjunctivitis with inclusions is identified with bath conjunctivitis, ophthalmia of newborns with inclusions.

Conjunctivitis is often bilateral, accompanied by mucous and then purulent discharge, eyelid edema, hyperemia and infiltration of conjunctival tissue, formation of follicles on the lower transitional fold, hypertrophied papillae on the conjunctiva of the cartilage. The process is accompanied by adenopathy, which occurs on the 7th day of the disease. Superficial avascular keratitis often develops. The disease lasts 2-3 weeks. The diagnosis is confirmed by the presence of cytoplasmic inclusions and lymphoplasmatic cellular elements in the conjunctival scraping.

Correct diagnosis is facilitated by examination by a urologist and gynecologist. General treatment is reduced to the prescription of sulfadimiezine or tetracycline for 7 days, with local application of 1% erythromycin or tetracycline ointment.

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