Conjunctivitis

The conjunctiva is a clear membrane covering the white of the eyes. Conjunctivitis, also known as pinkeye occurs when the conjunctiva in the eye gets inflamed. This common eye infection is not serious but is highly contagious and causes discomfort. Conjunctivitis can occur due to an infection, allergy or chemical reaction. Commonly infectious conjunctivitis happens due to viral or bacterial infection such as Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus. Allergic conjunctivitis occurs as a result of allergy to pollen, animal dander, dust mites or cosmetics or even hay fever. Chemical reaction can lead to conjunctivitis due to irritation. This happens due to chlorine in swimming pools or smoke and fumes.

Children suffering from conjunctivitis may have ear infection or sore throat. The infection can pass through coughing, sneezing and direct contact with tissues, clothes or towels used by an infected person. Conjunctivitis caused by allergy or chemicals however are not contagious. Typical symptoms of conjunctivitis range from redness and discomfort in the eyes to swelling and tearing. There is itchiness and sensitivity to bright light. Eyes affected by conjunctivitis tend to water and exude sticky discharge, especially on waking up. There might be pink or reddish blots on the eye due to inflammation.

Broad spectrum antibiotic ointment or solution is prescribed for bacterial infection. antihistamines are used for allergic conjunctivitis. Corticosteroid drops are prescribed in cases of severe allergic conjunctivitis. It is essential to identify the allergen and take precautions against exposure to it. Do not share tissues, makeup, towels or eye drops. Wash your hands after touching your eyes.

Slit Lamp Test

Slit lamp test is used to examine the eyes from a three dimensional view. Different parts of the eyes like the anterior and the posterior segments are viewed during the test. The front part of the eye including the clear, cornea (outer covering), the lens, iris, and the vitreous gel (front section of the gel-like fluid) in the middle of the eye are studied. The slit lamp is a low power microscope combined with a high intensity light source that is focused into a thin beam to shine. The binocular slit lamp provides a magnified view of the eye structures in detail. An additional hand-held lens is used to examine the retina.

Special lenses are placed in between the slit lamp and cornea to view the deeper structure of the eye which includes the retina, optic nerve and the drainage angle (area from where the fluid drains out of the eye). A camera attached to the slit lamp may be helpful in capturing pictures of the eye. To detect foreign bodies in the eye, a special dye (Fluorescein) is used. The eyes are dilated before the test is done so as to widen the pupil for examination.

Various methods are used to conduct the test namely observation by optical section, direct diffuse illumination, retro illumination, indirect illumination, etc.

Slit lamp test diagnosis

Slit lamp tests are used to identify eye problems at an early stage. The test is usually done:

• As a part of routine eye examination.
  
• To examine structures at the back of the eye like the retina and the optic nerve.
  
• Help detect glaucoma, macular degeneration, etc.
  
• To examine structures at the front of the eye.
  
• To detect cataract, conjunctivitis, injury to cornea, etc.
  
• To detect presence of foreign bodies in the eye.
  
• Monitoring injuries/bleeding from injuries, etc.
  
• Detect eye problems that may show up due to diabetes, rheumatoid arthritis
  

Slit Lamp Test Procedure

Slit lamp test is performed by an ophthalmologist or optometrist. The test takes about 5-10 minutes. The following steps are followed:

• Eyes are dilated to widen the pupil for examining the structure of the eye clearly.
  
• Anesthetic eye drops (to numb the eyes) are used in case of removing a foreign body.
  
• Patient is made to sit placing the chin and forehead against the bars on the slit lamp.
  
• The slit lamp is placed in front of the eyes in line with the doctor's eyes. The patient is asked to focus the eyes without blinking in the direction as requested by the doctor.
  
• A narrow beam of light is directed into the eye as the doctor examines through the microscope. A camera attached to the instrument may be used to capture images of different parts of the eyes.
  
• To check for ulcers, scratches or burns, the doctor may use a Fluorescein drop. This dye dissolves in the tears and coats the cornea thus covering the area of scratches, ulcer, etc. This will enable the doctor to examine the injury better.

Stevens Johnson Syndrome

Stevens Johnson Syndrome or SJS is a potentially deadly skin condition with symptoms similar to erythema multiforme but in a much more severe and extensive manner.

SJS, depending upon the severity is also known as Toxic Epidermal Necrolysis (TEN) - a violent reaction that comes after exposure to some drugs like allopurinol, sulfonamide antibiotics, lamotrigine, carbamazepine, nevirapine and phenytoin.

SJS can affect any age group, particularly older people. It can be caused by a drug hypersensitivity. A patient with impaired immune system like HIV, or one who is undergoing radiation therapy has higher chances of SJS. Stevens Johnson syndrome symptoms include flu-like symptoms in addition to the rashes. There is blistering on the skin and mucus membranes. Infection that enters through the blistered and affected areas can be deadly and life-threatening. The patient may develop red eyes and joint pains. The skin lesions are often referred to as target lesions since they are characterized by concentric rings of red, white and red. Conjunctivitis is sometimes noticed. Treatment for Stevens-Johnson syndrome include topical anesthetics, corticosteroids and antibiotics. Usually the patients suffering from this condition are hospitalized. It may take a few weeks for a patient to recover from SJS.