The gritty, itchy sensation in my right eye could mean only one thing. It was a long time since I’d had conjunctivitis, but I knew the drill and carefully bathed my eye in cooled boiled water to soothe the irritation and keep the eye clean.
Conjunctivitis is a familiar little complaint - in fact, it’s the most common eye problem for which people see their GP. The term ‘conjunctivitis is the medical name for the infection of the mucous membranes, the covering over the white part of the eye, including the bit that runs under the eyelids.
But by day three, this supposedly innocuous irritation hadn’t cleared up and my eye was feeling increasingly sore, so I bought some antibiotic eye drops from a chemist - after all, everyone knows conjunctivitis is caused by bacteria.Yet surprisingly, in the days that followed, it became much worse.
My eye stung - the same sensation as when soap gets in your eye, but more intense and continuous.
The eye itself was now bright red and bloodshot, and the upper lid very swollen, attracting sideways glances as I did the school run.
Friends were more direct - ‘What on earth has happened?’ asked one.
By day six, I was in my GP’s surgery. He was concerned that my eye wasn’t responding to the antibiotic drops, and advised that if there was no improvement within 24 hours, I must go straight to the emergency unit at the regional eye service.
And there, at Birmingham Midland Eye Centre the following day, I was diagnosed with viral conjunctivitis and learnt that this form of the condition is very different to the conjunctivitis I thought I knew.
I was not alone in my diagnosis. Specialists explained that this winter’s record levels of the adenovirus (a group of viruses which affect the respiratory system, causing sore throats, breathing difficulties and the common cold) had resulted in record levels of viral conjunctivitis.
Approximately one in ten people with the adenovirus will develop viral conjunctivitis.
‘We are commonly seeing ten to 15 people per morning clinic, compared to the usual one or two, or none,’ says Anil Aralikatti, consultant ophthalmic surgeon at the service, which provides emergency eye care for the West Midlands.
‘The people we see here tend to have the more severe forms of viral conjunctivitis, which can lead to eyesight impairment.’
And this is the key difference between bacterial and viral conjunctivitis.
The bacterial form will clear up in a few days, certainly within a week. It is easily treatable with antibiotic eye drops.
But when conjunctivitis is caused by a virus, there is no effective treatment. This means it tends to last much longer - up to six to eight weeks, although it can last for more than a year.
There is a risk that the infection may spread to the cornea; the transparent outer layer covering the iris (the coloured part of the eye) and the pupil. Infection and scarring of the cornea can mean permanent sight impairment.
That’s why the nurse who assessed me warned that if I had any problems with my vision, such as a sensitivity to light or seeing ‘halos’ (a faint ring) around lights, I must come into the eye centre immediately - these are signs the cornea might be affected.
As Mr Aralikatti explains, “When the infection spreads to the cornea, this can lead to small swelling spots on the surface.”
‘Over time, these spots can scar. We’ve seen patients whose vision has become impaired after viral conjunctivitis to such an extent that they’re now unable to drive.
‘We also see some patients who develop scar tissue in the part of their membrane (white of the eyes) under the eyelids.
‘If this happens, it restricts movement of the eyeball in the socket and we have to carry out a procedure to peel off this scar tissue.’
These complications are not uncommon - between a quarter and half of those with viral conjunctivitis seen at the Birmingham Midland Eye Centre will experience some of these problems.
But how did I catch an adenovirus in my eye? In the days just before my eye problem started, I’d had a sore throat, a cold and a slightly raised temperature.
I hadn’t paid this much attention - it just seemed a part of the usual rounds of winter bugs. Almost everyone will catch a form of adenovirus every winter.
There are more than 50 types of adenovirus, but some strains pose a particular risk to the eyes, says Mr Aralikatti.
“We know the adenovirus type eight is most likely to cause infection in the eyes and particularly to involve the cornea. “But we don’t know what type of virus each patient has - that is only possible with a laboratory test. “Once you arrive at an eye clinic, we need to focus on reducing the risk of damage to the eye.”
The virus can reach the eye from the nose by travelling up the tear duct. Lax hygiene when you’re ill is another risk factor - for example, blowing your nose, then not washing your hands, and rubbing your eyes.
‘The message is simple: you should never, ever, place your fingers anywhere near your eyes,’ says Mr Aralikatti. ‘If they itch or are sore, use eye drops.’My other main risk factor, apart from having a virus, is wearing contact lenses.
In the three days immediately before my eye infection, I had worn my lenses for longer than normal, having travelled to visit family and forgotten my glasses.‘Over-use of contact lenses reduces oxygen in the eye and causes dryness. ‘These are part of the eye’s natural defences against infection,’ says Mr Aralikatti.
‘The cornea needs oxygen to work effectively - contact lenses are a barrier between the eye and the amount of oxygen the eye needs. ‘Moisture helps to wash away viruses and bacteria, and reduces irritation.’ Although there is no treatment for viral conjunctivitis, in very severe cases steroid eye drops may be given to reduce the pain and inflammation in the eye.
The problem is you may feel much better, but because the drugs suppress the body’s natural responses to fight the virus, they can make things worse in the longer term, causing the virus to grow stronger and persist for longer. Steroids should only be used cautiously by specialists.
-- Dailymail London
February 14, 2016, 01:00:29 PM