SPARSH Speciality Clinic

Conjunctivitis
Conjunctivitis, which is also known as ‘Pinkeye’, is an irritation on the outmost layer of the white portion of the eye and the inner layer of the eyelid. This makes the eye appear reddish or pink. There might be scratchiness, itchiness, or pain. The eye, which is affected, may be ‘stuck shut’ or have tears in the morning. Also, white portion of the eye can have swelling. Itching is very common in such cases because of allergies. Conjunctivitis can affect either both the eyes, or even one eye.

Anyone can get a pink eye, but schoolchildren, pre-schoolers, college student, day-care workers, and teachers are particularly at risk for the transmissible types of pinkeye because they closely work closely with others.

The very common contagious causes are viral followed by a bacterial infection. The viral infection might occur with other symptoms of common cold. Both the bacterial and viral cases are simply spread between the people. Allergies to animal hair or pollen are amongst the common causes. Diagnosis often depends on its signs and symptoms.

Conjunctivitis is also called neonatal conjunctivitis.

Few Facts on Conjunctivitis:
Here are a few facts about conjunctivitis. They are as follows:

-  Pinkeye can result from an infection, an irritation, or an allergy.

-  Bacteria or a virus can cause infection. Sometimes it is associated to a Sexually Transmitted Infection (STI).

-  Antibiotics are used often, but these does not work if the cause if virus.

-  The symptoms usually last up to two or three weeks, but they can continue for longer.

-  It is vital to wash hands with care and not to share personal belongings, like towels, as this can spread the disease.

Types of Conjunctivitis:
There can be different types of Pinkeye. They are as follows:

Bacterial Conjunctivitis:
Bacterial conjunctivitis is the most common type of pinkeye. It is caused by bacteria, which infects the eye via several sources of contamination. The bacteria can spread contact with exposure to contaminated surface, an infected person, or via other means like ear infection or sinus.

The common kinds of bacteria, which case bacterial conjunctivitis, are Streptococcus pneumonia, Pseudomonas aeruginosa, Haemophilus influenza and Staphylococcus aureus. A thick eye pus or discharge is usually produced in Bacterial conjunctivitis and one or both the eyes can get affected.

Viral Conjunctivitis:
 This type of conjunctivitis is another common form of pinkeye, which is highly infectious, as coughing and sneezing can spread airborne viruses. This form of pinkeye can also accompany common viral respiratory infections like the flu, the common cold, or measles.

Usually, a watery discharge is produced during viral conjunctivitis. Normally, the infection begins in one eye and rapidly spreads to the other eye.

Unlike with the bacterial infections, antibiotics do not work against virus. No ointments or eye drops affect against the common virus, which cause viral conjunctivitis. However, it is self-limited that means it will cure by itself after a short span of time.

Chlamydial and Gonococcal Conjunctivitis:
 These bacterial forms are related to contamination from Sexually Transmitted Diseases (STDs) including Chlamydia and gonorrhoea. Newborn babies might be infected while passing through the birth canal of the infected mother. A form of Chlamydia infection called Trachoma causes scarring on the surface of the eye. Trachoma is the leading cause of avertable blindness of the world.

Neonatal Conjunctivitis:
Neonatal Conjunctivitis, also called Ophthalmia neonatorum, is a type of pinkeye contracted by newborn babies during delivery. The eyes of the baby are infected during the passage via birth canal from an infected mother with either Chlamydia Trachomatis or Neisseria Gonorrhoeae. If left untreated, it can lead to blindness. It may be contagious or non-contagious.

Allergic Conjunctivitis:
Eye allergies cause this form of conjunctivitis. Allergens including dust mites, animal dander, and pollen trigger eye allergies.

The most common indicator of allergic pinkeye is itchy eyes that can be relieved with a special type of eye drop consisting of antihistamines to monitor allergic reactions. These drops are available over both at medical counters and by prescription.

It is also imperative to avoid the allergen in treatment of this type of pinkeye. Allergic pinkeye can be perennial (year-round) or seasonal, based on the allergen that causes the reaction.

Giant papillary conjunctivitis (GPC): 
Giant papillary conjunctivitis, generally involves both the eye. Also, contact lens wearers, often, are affected by GPC. This state can cause itching, contact lens intolerance, red bumps inside the eyelids, tearing and a heavy discharge. The person who suffers from this type of pinkeye needs to stop wearing contact lenses. The doctor may recommend to switch different type of contact lends, to trim down the chances of pinkeye coming back.

Non-infectious conjunctivitis: Diesel exhaust, certain chemicals, smoke and perfumes cause non-infectious conjunctivitis. Some types of conjunctivitis are resultant of sensitivity to certain consumed substances including herbs like turmeric and eyebright.

The immune responses of eye like a reaction to wearing ocular prosthetics (artificial eye) or contact lenses can cause certain types of conjunctivitis including the Giant Papillary Conjunctivitis. Toxic conjunctivitis can be caused by a reaction to preservatives in ointments or eye drops.

Conjunctivitis Symptoms:
The most prevalent conjunctivitis symptoms include the following:

-  Itchiness in one or both the eyes

-  Redness in one or both the eyes

-  Tearing

-  A pus or discharge in one or both the eyes forming a crust during night that may not allow one to open eye in the morning.

-  Gritty feeling in one or both the eyes

Viral Conjunctivitis: Sensitivity to light, itchy and watery eyes, are the common symptoms of viral conjunctivitis. This type of pinkeye can affect one or both the eyes.

Bacterial Conjunctivitis: The eye discharges a sticky, greenish-yellow or yellow discharge or pus in the eye’s corner. In a few cases, this pus can be stern enough to cause one’s eyelids to be stuck when s/he wakes up. It can affect one or both the eyes. Bacterial pinkeye is contagious, usually by a direct contact with contaminated items or hands that have been in contact with eyes.

Allergic Conjunctivitis: Itchy, burning, watery eyes; often accompanied by a runny nose, light sensitivity, and stuffiness. Both the eyes are affected by allergic conjunctivitis. This type is not contagious.

Causes of Conjunctivitis:
A virus, most commonly, causes contagious conjunctivitis. Allergies, bacterial infections, dryness and other irritants are also the common causes. Both the viral infections and bacterial infections are infectious, passing from one to another through contaminated water or objects.

Viral: The most common cause of the viral conjunctivitis (adenoviral keratoconjunctivitis) is adenoviruses. Herpes simplex viruses can cause herpetic keratoconjunctivitis. This can be a serious problem and require treatment with acyclovir. Coxsackievirus A24 and Enterovirus 70, two types of enteroviruses can cause a highly contagious ailment called acute hemorrhagic conjunctivitis. These two enteroviruses were first identified in an outburst in Ghana in 1969. Since then, the viruses have spread across the world causing various epidemics.

Bacterial: Haemophilus influenza, streptococcus pneumonia, and staphylococcus are the most causes of acute bacteria conjunctivitis. Neisseria meningitides or Neisseria gonorrhoea usually cause hypercute cases (through very rare). Staphylococcus aureus, gram-negative enteric flora, or moraxella lacunata are the typical causes of chronic cases of the bacterial conjunctivitis, which lasts longer than 3 weeks.

Allergic: Allergens like perfumes, dust mites, pollens, cosmetics can cause allergic conjunctivitis.

Causes of Conjunctivitis in newborns:
Blocked tear duct, irritation, or infection can cause conjunctivitis in newborn babies. One cannot find it difficult to determine the cause as each form of pinkeye produces similar symptoms.

Sometimes, virus or bacteria are passed on from mother during her delivery, even though she has no symptoms of conjunctivitis. The virus or bacteria may be associated to STI.

 If the infant has bacterial pinkeye due to Chlamydia, the symptoms usually, appear 5 to 12 days after delivery. The symptoms seem to appear 2 to 4 days if the infection is due to gonorrhoea.

 The virus causing genital and oral can be transmitted at birth and emerge as conjunctivitis.

In a few cases, conjunctivitis arises as a reaction of the eye drops given to the infant at the time of birth, to prevent contamination. In such cases, the symptoms usually pass after 24 -36 hours.

Other causes of Pinkeye:
Red eyes can be symptoms of the following:

Acute Glaucoma:
Acute Glaucoma is one of rarest forms of glaucoma. In this pressure is build up in eyes. Symptoms appear quickly including red eyes, pain, and loss of vision, which may be permanent, if not treated on time.

Keratitis:
The cornea possible becomes ulcerated and inflamed. If the cornea is blemished, it can lead to perpetual vision loss.

Blepharitis:
Blepharitis, common inflammation of eyelids, causes irritation, itching, and redness. The patient will also have dandruff – like scales on eyelashes. This is not contagious.

Diagnosis of Conjunctivitis:
In many cases, the doctor can diagnose conjunctivitis by asking a few questions about the symptoms one experiences in recent past and perform a physical examination of the patient’s eye.

Not often, the doctor may also ask the patient to take a sample of the pus, which drains from his/her eye for lab analysis (culture). The doctor may require culture if s/he find the symptoms severe or suspects a high-risk cause like a serious bacterial contamination, sexually transmitted infection, or foreign body in the patient’s eye.

Conjunctivitis Treatment:
Treatment of red eye is based on the type of pinkeye.

Bacterial Conjunctivitis: The eye-specialist normally will prescribe an antibiotic ointment or eye-drop for the treatment of bacterial conjunctivitis.

Viral Conjunctivitis: In many cases, this form of conjunctivitis will run for several days, and no medical treatment is indicated or required. One can try a home remedy like applying a wet washcloth, or cold water to the eyes many times in a day can relieve conjunctivitis symptoms.

Allergic Redeye: Allergic pinkeye can be prevented by allergy medications or this can even shorten the bouts of this form of conjunctivitis. Sometimes the medication should be started before allergy flare-ups or allergy season begins. Consult the doctor for details.

Prevention from Conjunctivitis:
The following remedies can reduce the risk of passing or catching an infective conjunctivitis:

-  Avoid rubbing and touching the affected eye.

-  Wash hands frequently with warm water and soap, or use sanitizer.

-  Keep eyeglasses clean

-  Use goggles in swimming pool, and do not swim if infectious.

-  Always remove contact lens at night, and follow instructions about lens hygiene.

-  Avoid sharing personal stuff such as pillows and towels, contact lenses and make up with other people.

-  It is better to throw away any make-up or contact lens solution, after the contagion is gone.

-  One can reduce the risk of allergic and irritant pinkeye by avoiding known or potential allergens and irritants.

-  This includes ensuring air conditioning units are maintained and clean, rooms are well ventilated, and avoiding misty or smoky atmosphere.

Myths Related to Conjunctivitis:
Following are the most common myths about pinkeye:

Myth #1: All types of conjunctivitis are contagious:

One of the most harmful and common misconception about red eye is that there is only one, highly infectious form. Red eye actually has various causes, including advanced dry eye, allergies, infections, and exposure to chemical fumes.

Myth #2: Any pinkness points to Conjunctivitis:

Many people believe that any red or pink colouration in the eye indicate the presence of conjunctivitis. However, ‘pink eye’ applies to colouration changes of the eyeball itself.

One can be infected at first sight: This is the most persistent myths about conjunctivitis is that the infected person can transmit the ailment at a single glance. Nevertheless, there is no transmission of diseases through eye contact, including conjunctivitis.

Loss or impairment of hearing can happen due to a variety of causes and may be temporary or permanent in nature, depending on the type and severity of the condition. One of the most common causes of hearing impairment is age. The degeneration of one's vital organs and senses becomes a reality for many people as the advancement of age happens, and the delicate insides of the ears are no different. Noise pollution, injury to the ear drum or any other part of the ear, as well as the movement of particles inside are only a few of the many reasons for loss of hearing. One of the many ways of dealing with long term hearing impairment is by using a hearing aid.

Read on to know how you can regain your hearing with hearing aids:

1. Long Forgotten Sound: A hearing aid will help you reacquaint yourself with long forgotten and subtle sounds that you may not have been able to hear for a long time. Many times, this kind of impairment also makes us forget to notice the fact that we do not hear so many normal sounds in our everyday lives - sounds that we probably did not notice even earlier. This may include the whirring of a fan, the whoosh of the air, the pitter patter of pets' feet and so much more. A hearing aid will help in bringing about an adjustment to these sounds that you will actually end up discovering again.
2. Technicalities: The hearing aid basically works by letting your hearing and ears readjust to the various volumes, intensity and vibrations that one feels when different sounds reach the ears. This helps in hearing better.
3. Amplification: A hearing aid is basically an electroacoustic device that fits in neatly behind your ear where it is tucked away from plain sight. This device helps in amplifying sounds so that you can catch them and hear them more clearly.
4. Modulation: The Audiologist, who are specalized in hearing assessment and diagnosis, will prescribe the type and detail of hearing aid based on your individual condition in terms of volume, size, power and circulation. These factors help in modulating the sounds in a certain way so that they reach the nerve pathways from the inner ear and travel to the brain in a proper and effective way. This is usually done in a customised way to cater to the specific type and cause of your hearing loss.

Using a hearing aid is a matter of retraining your hearing rather than restoring it completely. These aids will be helpful in regaining a better sense of hearing within the condition you are going through, rather than reversing the condition completely.

Child nutrition from age 6 months to 5 years Growth and development of a child depends on the nourishment received by the child right from birth. Healthy diet and proper eating habits are essential to be inculcated in a child as early as possible. A balanced diet given to the child at the earliest provides all nutrients required for adequate growth and development. Nutritional value of every food item introduced in the child’s diet should be gauged prior and then given to the child.

Nutritional requirement of children varies in accordance to the age group. It is necessary that the parents should have knowledge about the age-specific requirements of the diet, which will benefit the child in their growing years.

Following is the ideal child nutrition ranging from the age group of 6 months to 5 years.

1. 6 months to 12 months

A. Right from the birth of a newborn child, it is necessary to begin breastfeeding for the baby. It should begin within an hour of the child’s birth. It is the ideal way of providing proper nutrition to the child.

B. Breastfeeding is beneficial by providing nourishment and also by improving the immunity of the baby.

C. From birth to 6 months, only breastfeeding is advised. It is a critical source of nutrition for the child even during illness.

D. After the baby turns 6 months old, solid food can be introduced in the child’s diet.

E. Breastfeeding can be continued and supplemented with other food items.

F. Usually, fruit juices are introduced first in the diet.

G. Feeding bottle should be avoided and the child should be fed with a spoon and cup. Proper hygiene and good handling of the food is required.

H. It is necessary to wipe the gums and developing teeth clean with a wet gauge to prevent any decay that can be caused by sticking of the food on the teeth surfaces fed to the child.

2. 1 year to 3 years

A. Children in this age group can tell when they feel full after feeding. It is necessary to listen to their demand for food and also avoid overfeeding children.

B. This age group requires children to eat all types of nutrients, so parents should focus on providing a variety of food items to replenish their child’s nutritional requirements.

C. Children in this age group require fat-rich foods and should be given dairy products for calcium requirements.

D. Processed foods should not be given to children in this age. Calories intake should be monitored to the optimum level.

E. Since children at this age are involved in activities like walking, running around and playing it is essential to keep feeding them at regular intervals to maintain the energy levels of their bodies.

3. 3 years to 5 years.

A. Children belonging to this age group require to eat a well-balanced, nutrient rich diet.

B. Grains should be included on a routine basis. They provide the child with carbohydrates, fibers and minerals. All these nutrients provide energy to the child’s body.

C. Inclusion of whole wheat grains provides fibers in adequate quantity.

D. Refined foods should be avoided, whole grain breads should be included in the diet.

E. Fruit intake should be increased, as they are an important source of various vitamins. Fresh fruit should always be preferred over juices for growing children.

F. Sugar intake should be kept to a minimum quantity, since refined sugars do more harm to the child’s health than any good.

G. Vegetables should form a considerably greater part of the child’s daily diet, with the inclusion of a variety of vegetables.

H. Protein sources of food include meat, poultry, pulses, beans and nuts. Along with protein, these food items also provide iron, zinc and minerals to the body.

Apart from the above specified food items, daily intake of milk is necessary for children of growing age. It provides the body with sufficient calcium to facilitate bone growth in growing children. Also, nuts like walnuts, almonds, cashews are advised to be given to the children daily.