conjunctivitis is an eye disorder .this is all so known as pink eye .in the India south side people it is called as madras eye ..in this slide mentioned about .definition, review anatomy and physiology, types including causes , pathophysiology, signs and symptoms, treatment, nursing management, and prevention are there. the client who is affected with this use separate towels, wash your hands daily, eat eye healthy foods like vitamin a , e,omega 3 fatty acid, this will help the eyes verywell.eye exercise very helpful for eye health.if eye sensitive is there use sun glass that is very help full for the eye , eye staraning should be avioded.if the school student is affected means student should not go to the school for one week.

2. INTRODUCTION
Conjunctivitis is most common eye disease. It is otherwise called pink eye
.mostly found in the school age children. It Is mostly affected 6 million people
in America .some seasonal occurrence is happening in the
conjunctivitis.Bactereal conjunctivitis arising from dec to April, viral
conjunctivitis is coming in the summer season.Alergic conjunctivitis is peak in
the spring and summer through .This is called madras eye in India.

3. DEFINITION
• Inflammation of the conjunctiva is called conjunctivitis.

4. ANOTOMY OF CONJUNCTIVA

5. The conjunctiva can be divided into three regions: the palpebral or tarsal conjunctiva, the
bulbar or ocular conjunctiva, and the conjunctival fornices. The palpebral conjunctiva is
further divided into the marginal, tarsal, and orbital regions. The bulbar conjunctiva is
divided into scleral and limbal parts. Finally, the conjunctival fornices are divided into the
superior, inferior, lateral, and medial regions.
The conjunctiva of the eye consists of an epithelial layer composed of stratified squamous
and stratified columnar epithelium. It is non-keratinized with interspersed goblet cells.
There are also present within this epithelial layer blood vessels, fibrous tissue, lymphatic
channels, melanocytes, T- and B-cell lymphocytes, Langerhans cells, and accessory
lacrimal glands.
The conjunctiva covers the anterior, non-corneal portions of the globe, as well as the fornices
and the palpebrae. The conjunctival epithelium has multiple functions. In addition to serving
as a physical barrier, the conjunctiva’s goblet cells secrete mucin, which forms a part of the
tear film of the eye. This allows for the ocular surface to maintain its healthy moisture layer.
The conjunctiva also has some immune cells which aid in defense of the ocular surface

6. TYPES INCLUDING CAUSES AND
RISK FACTOR
•According to American ophthalmic association it is divided three types1.allergic
conjunctivitis 2.infeccious conjunctivitis 3.chemical conjunctivitis.
1.Allergic conjunctivitis
I. Allergic conjunctivitis occurs more commonly among people who
already have seasonal allergies. They develop it when they come into
contact with a substance that triggers an allergic reaction in their eyes.
II. Giant papillary conjunctivitis is a type of allergic conjunctivitis
caused by the chronic presence of a foreign body in the eye. People
who wear hard or rigid contact lenses, wear soft contact lenses that
are not replaced frequently, have an exposed suture on the surface of
the eye or have a prosthetic eye are more likely to develop this form of
conjunctivitis.

7. 2.Infectious conjunctivitis
I. Bacterial conjunctivitis is an infection most often caused by staphylococcal or streptococcal
bacteria from your own skin or respiratory system. Insects, physical contact with other people, poor
hygiene (touching the eye with unclean hands), or using contaminated eye makeup and facial
lotions can also cause the infection. Sharing makeup and wearing contact lenses that are not your
own or are improperly cleaned can also cause bacterial conjunctivitis.
II. Viral conjunctivitis is most commonly caused by contagious viruses associated with the common
cold. It can develop through exposure to the coughing or sneezing of someone with an upper
respiratory tract infection. Viral conjunctivitis can also occur as the virus spreads along the body's
own mucous membranes, which connect the lungs, throat, nose, tear ducts and conjunctiva. Since
the tears drain into the nasal passageway, forceful nose blowing can cause a virus to move from
your respiratory system to your eyes.
III. Ophthalmia neonatorum is a severe form of bacterial conjunctivitis that occurs in newborn babies.
This is a serious condition that could lead to permanent eye damage if it is not treated immediately.
Ophthalmia neonatorum occurs when an infant is exposed to chlamydia or gonorrhea while passing
through the birth canal. For several years, U.S. delivery rooms have applied antibiotic ointment to
babies' eyes as a standard prophylactic treatment.
3.Chemical conjunctivitis
Chemical Conjunctivitis can be caused by irritants like air pollution, chlorine in swimming pools, and
exposure to noxious chemicals.

9. SYMPTOMS OF CONJUCTIVITIS
•Redness in the white of the eye or inner eyelid
•Swollen conjunctiva
•More tears than usual
•Thick yellow discharge that crusts over the eyelashes, especially
after sleep. It can make your eyelids stick shut when you wake up.
•Green or white discharge from the eye
•Itchy eyes
•Burning eyes
•More sensitive to light
•Swollen lymph nodes (often from a viral infection)

10. DIFFERENTS OF CONJUCTIVITIS

11. DIAGNOSTIC TEST
•Patient history to determine the symptoms, when the symptoms began,
and whether any general health or environmental conditions are
contributing to the problem.
•Visual acuity measurements to determine whether vision has been
affected.
•Evaluation of the conjunctiva and external eye tissue using bright light and
magnification.
•Evaluation of the inner structures of the eye to ensure that no other
tissues are affected by the condition.
•Supplemental testing, which may include taking cultures or smears of
conjunctival tissue. This is particularly important in cases of chronic
conjunctivitis or when the condition is not responding to treatment.

12. TREATMENT
1.Allergic conjunctivitis
The first step is to remove or avoid the irritant, if possible. Cool compresses and
artificial tears sometimes relieve discomfort in mild cases. In more severe cases,
nonsteroidal anti-inflammatory medications and antihistamines may be prescribed.
People with persistent allergic conjunctivitis may also require topical steroid eye
drops. Oral antihistamines may also be prescribed.
2.Infectious conjunctivitis
This type of conjunctivitis is usually treated with antibiotic eye drops or ointments.
Bacterial conjunctivitis may improve after three or four days of treatment, but
patients need to take the entire course of antibiotics to prevent a recurrence. Viral
conjunctivitis. No drops or ointments can treat viral conjunctivitis. Antibiotics will not
cure a viral infection. Like a common cold, the virus has to run its course, which
may take up to two or three weeks. Symptoms can often be relieved with cool
compresses and artificial tear solutions. For the worst cases, topical steroid drops
may be prescribed to reduce the discomfort from inflammation.

13. 3.Chemical conjunctivitis
Careful flushing of the eyes with saline is a standard treatment for
chemical conjunctivitis. People with chemical conjunctivitis also may
need to use topical steroids. Severe chemical injuries, particularly
alkali burns, are medical emergencies and can lead to scarring,
damage to the eye or the sight, or even loss of the eye. If a chemical
spills in your eye, flush the eye for several minutes with a lot of water
before seeing your medical provider.
Contact lens wearers may need to temporarily stop wearing their
lenses while the condition is active. If conjunctivitis is due to wearing
contact lenses, a doctor of optometry may recommend switching to a
different type of contact lens or disinfection solution. A doctor of
optometry might need to change the contact lens prescription to a lens
that is replaced more frequently. This can help prevent conjunctivitis

14. PREVENTION
1.Don't touch your eyes with your hands.
2.Wash your hands often.
3.Use a clean towel and washcloth daily.
4.Don't share towels or washcloths.
5.Change your pillowcases often.
6.Throw away your eye cosmetics, such as mascara.
7.Don't share eye cosmetics or personal eye care items.

15. NURSING MANAGEMENT•Teach proper hand washing technique and instruct patient to keep hands away of eyes
•Use disinfected equipment for eye examination
•Encourage patient to avoid sharing personal cloths with others
•Apply warm compress over eye and instill eye drops/ointment as ordered. Some eye
drops contain antihistamines or other medications that can be helpful for people with
allergic conjunctivitis.
•If pink eye affects only one eye, don’t touch both eyes with the same cloth. This reduces
the risk of spreading an infection from one eye to the other.
•Instruct patient to clean eye discharge with tissue and dispose carefully.
•Replace eye cosmetics and do not share
•Teach the patient to install eye drops and ointments correctly without touching tip of
container with eye or lashes
•Encourage patient to stay away from school for at least 7 days
•Instruct to use dark black eye glasses to avoid bright light and contamination
•Advise patient to use and take care of contact lenses correctly
•Advise patient to avoid rubbing eyes
•Administer antihistamines and mast cell stabilizers (for allergic conjunctivitis) as ordered.
•Administer decongestants, steroids and anti-inflammatory eye drops as ordered.