The document discusses visual disorders and conjunctivitis. It defines conjunctivitis as an inflammation of the conjunctiva that can be caused by infection, allergies, or physical agents. Conjunctivitis is classified as viral, bacterial, or allergic. Viral conjunctivitis spreads easily between eyes and is associated with upper respiratory infections. Bacterial conjunctivitis causes redness, swelling, and a sticky discharge in one eye that often spreads to the other. Treatment involves topical antibiotics or erythromycin for bacterial infections. Nursing care includes teaching hand washing, eye hygiene, isolation, and medication administration to prevent spread.

1. Visual Disorder
Conjunctivitis
By
Mr. Ravi Rai Dangi
Assistant Professor
Fellowship in Neonatal Nursing
MSc. Child Health Nursing

2. Visual Disorder
 The important diseases recognized as responsible for
visual impairment and blindness in India are cataract,
refraction errors, glaucoma, conjunctivitis.
 Mal nutrition and systemic disease are also important
contributing factors.
 Other causes include are eye injury, congenital disorders,
retinal detachment, tumors, leprosy etc.

3. The visual disorder can be found as the following problems.
 Amblyopia or subnormal vision in one or both eyes in
spite of correction of significant refractive error.
 Night blindness – it means inability to well at night or in
faint light. It may occur in retinitis, choroidoretinistis, Vit A
deficiency, retina toxic drugs.
 Double Vision – It is found in squint, ptosis. It may be
warning sign of increase IOP, brain tumor, orbital or
myasthenia gravis.

4.  Color blindness – It is a genetically determine condition
in which color perception is defective or absent. Red and
green color deficiency is the usual found. It can be detected
at the age of 5 to 6 years’ age.
It is found in about 8% of the male population and is
inherited as sex linked recessive trait. Color blindness
may be total or partial there is no specific treatment.

5. Some main responsible disease for visual impairments in
India :-
 Conjunctivitis
 Cataract
 Refractory errors
 Glaucoma
 Retinopathy of Prematurity

6. Conjunctivitis
Conjunctivitis is an inflammation resulting in redness of
the lining of the white part of the eye and the underside of
the eyelid (conjunctiva) that can be caused by infection,
allergic reaction, or physical agents like infrared or
ultraviolet light.

7. Classification of Conjunctivitis
Viral Conjunctivitis –
 Adenovirus (enterovirus, HSV)
 Occurs in community epidemics (schools, workplaces,
physicians’ offices)
 Usual modes of transmission: contaminated fingers,
medical instruments, swimming pool water

8.  Viral conjunctivitis is often associated with an infection of
the upper respiratory tract, a common cold, or a sore throat.
Its symptoms include excessive watering and itching. The
infection usually begins in one eye, but may spread easily
to the other eye.
 Viral conjunctivitis manifests as a fine, diffuse pinkness of
the conjunctiva, which is easily mistaken for a ciliary
infection of the iris (iritis), but there are usually
corroborative signs on microscopy, particularly numerous
lymphoid follicles on the tarsal conjunctiva, and sometimes
a punctate keratitis.

9. Acute Bacterial Conjunctivitis
 Common causes in neonates: Chlamydia trachomatis,
Neisseria gonorrhoeae
 In children: Haemophilus influenza (80%), Streptococcus
pneumoniae (20%),
 In adults: Staphylococcus aureus.
 Bacterial conjunctivitis causes the rapid onset of
conjunctival redness, swelling of the eyelid, and a sticky
discharge. Typically, symptoms develop first in one eye,
but may spread to the other eye within 2–5 days.

10.  Conjunctivitis due to common pus-producing bacteria
causes marked grittiness or irritation and a stringy,
opaque, greyish or yellowish discharge that may cause
the lids to stick together, especially after sleep.
 Severe crusting of the infected eye and the surrounding
skin may also occur. The gritty or scratchy feeling is
sometimes localized enough that patients may insist
that they have a foreign body in the eye.

11. • Ophthalmia neonatorum (neonatal conjunctivitis)
results from a maternal gonococcal and/or chlamydial
infection. Neonatal conjunctivitis occurs in 20 to 40%
of neonates delivered through an infected birth canal.

12. Presentation:
• Unilateral or bilateral, red eye, mucopurulent or
purulent discharge continuously throughout the day,
burning, irritation, mild chemosis
• Neonates: symptoms appear 5-14 day after birth
(inclusion conjunctivitis of the newborn)
• Highly contagious: spread by direct contact or by
contaminated objects

13. Symptoms and signs:

14. • Photophobia
• Periorbital cellulitis
• Burning sensation
• Foreign body sensation
• Pain in eye
• Fever

15. Diagnosis of Conjunctivitis
• Clinical diagnosis of physical examination
• Morning crusting of eye unreliable for determining
etiology
• Culture of drainage from eye

16. Treatment
Viral
• Topical antibiotics not necessary because secondary
bacterial infection is uncommon
• Some relief from cold compresses and topical
antihistamines/decongestants
• Do not use topical corticosteroids due to risk of sight-
threatening complications (scarring, corneal melting,
perforation), especially if etiology is herpes
simplex virus or bacterial keratitis

17. Acute Bacterial Conjunctivitis
• Topical broad-spectrum antibiotics: erythromycin
ointment, bacitracin-polymyxin B ointment (Polysporin),
trimethropim-polymyxin B (Polytrim), sulfa drops
• Sulfa drops (Bleph-10): less effective and rare side effect
of Stevens-Johnson syndrome
• Inclusion Conjunctivitis of the Newborn: treat with 2
week course of erythromycin (50mg/kg/d po divided
QID) or sulfisoxazole (150mg/kg/d po divided QID),
topical unnecessary with systemic

18. Nursing Management
Teach proper hand washing technique and instruct keep
hand away of eyes to relatives.
Use disinfected for eye examination.
Apply warm compression over eye and drop and ointment
as order.
Encourage avoid sharing personal cloths with other.
Instruct relatives to clean eye discharge with tissue and
dispose carefully.
Replace eye cosmetics and do not share.

19. Teach the relative to install eye drops and ointments
correctly without touching tip of container with eye or
lashes.
Encourage patient to stay away of school for at least 7
days.
Instruct to use dark black eye glass to avoid bright light
and contamination.
Use and care of contact lenses correctly.
Avoid rubbing eyes.

20. In hospitalized patients with viral conjunctivitis, isolation
is recommended for 10 to 14 days or as long eye looks
red.
Strict instrument disinfection.
Teach the relative to install eye drops and ointments
correctly without touching tip of container with eye or
lashes.
Encourage patient to stay away of school for at least 7
days.

21. Instruct to use dark black eye glass to avoid bright light
and contamination.
Use and care of contact lenses correctly.
Avoid rubbing eyes.
In hospitalized patients with viral conjunctivitis, isolation
is recommended for 10 to 14 days or as long eye looks
red.
Strict instrument disinfection.