24 August 2004

--- What To Do About It

"SORE EYES DOWNS WORLD'S 9th MOST POWERFUL WOMAN" was the title of the Philippine Star's news feature last August 22, obviously referring to how conjuctivitis has affected President Gloria Arroyo (GMA), who has recently been named by Forbes magazine as the world's 9th most powerful woman. GMA got the sore eyes after she came back from Cebu City visiting the newly painted Malacanang Palace of the South.

Sore eyes, which is also known as "pinkeye" and conjuctivitis has just made a comeback lately.

Conjunctivitis is defined as infection of the conjunctiva, which is the thin, translucent, relatively elastic tissue membrane lining of the white of the eye and the inside of the eyelids. I will enumerate now the 3 common types and their respective symptoms so you will be forwarned:
  1. Viral - reddish, with watery discharge, and infection usually begins with one eye, but may spread easily to the fellow eye. This is also more often associated with an upper respiratory tract infection (URTI), cold, or sore throat. This is explained by its causative organism --- the adenovirus --- which is the most common cause of viral conjunctivitis, although it can also be caused by other viruses. This type is the MORE contagious type, and is seen as the culprit in most community epidemics, with the virus transmitted in schools, workplaces and yes, even in doctors' clinics. The usual modes of transmission are contaminated fingers, medical instruments and swimming pool water.

  2. Bacterial - reddish also, but this time the discharge is stringy, parang pisi pag tinatanggal mo, and causes the lids to stick together, especially after sleeping, parang sinemento o nilagyan ng glue, making it difficult for you to open them. Most patients with this condition often report that their eyelids are matted together on awakening. Conjunctival and mild eyelid swelling may also be complained. There is also notable increased tear production, a "gritty feeling" when you blink, parang me buhangin (feels like there is sand inside when you blink), and just like the viral type, it may also initially affect only one eye, but may spread easily to the fellow eye. Bacterial conjunctivitis is also often caused by bacteria such as staphylococcus and streptococcus. Infections with Streptococcus pneumoniae and Haemophilus influenzae are more common in children, while Staphylococcus aureus most frequently affects adults.

  3. Allergic - less redness, but distinct complaints are the excessive "ITCHY FEELING" in the eyes and eyelids portion. The eyelids are also notably swollen. This condition is usually, although not invariably, seasonal. More often than not, there is personal or family history for other atopic conditions, such like allergic rhinitis, asthma or eczema.

Well, the first thing to do is see your ophthalmologist. The eyes are delicate and very important structures of your body and they necessitate proper care and attention by the RIGHT people.

Often, the usual habit in cases of infection is just to get the advice of a friend who had it before, or to borrow whatever "effective eyedrop" worked for your friend. I'd like to tell you that you may not be helping yourselves when you do that. Since the condition is contagious, bacteria or viruses might have contaminated the tips of the containers of any "borrowed medicine eye drops," and instead of getting better, you might be re-infecting yourself with more harmful organisms.

I would like to offer some TIPS you can do if ever you contract sore eyes. The management is usually dependent on the type of conjunctivitis you have:
  1. For Viral Conjuctivitis - since this is a viral condition like your common cold, there is NO CURE, but don't fret. Management here is usually supportive, and symptoms can be relieved with cold compresses and placing artificial tears (buy from your favorite drugstore). In worst cases, your ophthalmologist may prescribe topical steroid drops to reduce the discomfort. A period of 3 weeks is usually necessary for viral conjunctivitis to resolve.

  2. For Bacterial Conjunctivitis - depending on the type of bacterial organism that infected your eye, your ophthalmologist will usually prescribe an eye antibiotic that you need to apply 3-6 times per 24-hour period based on the severity of the infection. It is unfortunate that there is still no single broad-spectrum antibiotic that covers ALL potential conjunctival bacterial pathogens. In choosing an appropriate topical antibiotic, you should ask your doctor to consider the cost of your eye medicine (one of the most expensive medicines around!), the effectivity, and you should also demand from them an explanation of the possible side effects of each medication. Based on practice, when it comes to eye medicine preparations, solutions are preferred by most adults and adolescents, while ointments are better tolerated by young children, who are less apt to complain about associated blurring of vision.

  3. For Allergic Conjunctivitis - here, the primary mode of treatment rests on the proper identification and avoidance of the causative allergen. Cold compresses can also help alleviate the symptoms. Your ophthalmologist will most likely prescribe vasoconstrictors, antihistamine drops, topical nonsteroidal anti-inflammatory agents (to relieve the pain) and mast-cell stabilizers (mast cells produce histamine which causes the allergic reactions) like cromolyn sodium or lodoxamide. He may also prescribe oral antihistamines.

My favorite advice to prevent most infectious diseases from spreading: WASH YOUR HANDS OFTEN and THOROUGHLY!

There is a PROPER way to wash your hands thoroughly: click here for the CDC link I want you to read.

Additionally, you can do the following:
  • avoid touching or shaking hands with infected people

  • if you shook hands and touched them, avoid touching your face

  • wash your hands, wash your hands, wash your hands!

  • do not share or reuse your handkerchiefs, towels, or washclothes; using a disposable tissue is best

  • do not swim in infected swimming pools

  • regularly disinfect surfaces like your working areas, tables, doorknobs, etc., with a diluted bleach solution

  • if you know someone with sore eyes, advise that person to stay home until he gets better
Now, that President GMA has finally admitted that we are indeed in the MIDDLE OF A FINANCIAL CRISIS (I congratulate her! this is a positive move for me), the last thing she needs while perusing the financial books and analyzing how to remedy it --- is the pesky conjunctivitis. I pray she gets well soon so we can all get out of this mess at the soonest possible time!

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