bubble_chart Overview

Chronic catarrhal conjunctivitis is a chronic inflammation of the conjunctiva caused by various factors, and is a common eye disease that often affects both eyes.

bubble_chart Etiology

1. Infectious factors: It may result from incomplete cure of acute catarrhal conjunctivitis turning into chronic, or it could be due to the initial infection involving a small number of pathogenic bacteria with low virulence while the body's resistance is relatively strong, leading to a chronic and protracted state of the disease. Common pathogenic microorganisms causing this condition include Morax-Axenfeld diplobacillus, catarrhalis coccus, Escherichia coli, Proteus, Streptococcus, etc.

2. Non-infectious factors: Adverse environmental stimuli such as dust, wind and sand, smoke, strong light, harmful gases, etc.; ocular irritations like trichiasis, chronic dacryocystitis, lacrimal duct obstruction, eyelid margin inflammation, refractive errors, latent strabismus, etc.; poor lifestyle habits such as lack of sleep, excessive smoking or alcohol consumption; in addition, long-term use of certain eye drops, chronic allergic rhinitis, and other conditions can all contribute to the disease cause of chronic conjunctivitis.

bubble_chart Clinical Manifestations

The subjective symptoms of patients with this disease vary in severity from person to person. Some patients' subjective sensations often exceed the degree of pathological changes shown by clinical objective examinations, while others may not experience any discomfort. The main symptoms include itching, dryness, stabbing pain, foreign body sensation, eyelid heaviness, and visual fatigue in the affected eye, which are particularly aggravated in the evening or during reading.

Generally, those with mild lesions only exhibit slight congestion of the palpebral conjunctiva, without hypertrophy or hyperplasia, and with a small amount of secretion. However, those with long-term chronic inflammatory stimulation may present with congestion, hypertrophy, roughness, and papillary hyperplasia of the palpebral conjunctiva, giving it a velvety appearance. Sometimes, it may be accompanied by congestion and hypertrophy of the lacrimal caruncle, especially in cases of obstructive conjunctivitis of the lacrimal duct. The secretions are mostly mucoid, yellow or white foam-like, and relatively scant, often accumulating in the canthus. Palpebral conjunctivitis of the canthus caused by Morax-Axenfeld diplobacilli often manifests as congestion and erosion of the palpebral margin or corners of the mouth, with marked congestion and papillary hyperplasia of the upper palpebral conjunctiva and fornix (conjunctival congestion and surrounding skin eczema, maceration, and edema). Conjunctivitis caused by the irritation of decomposed products from meibomian gland secretions and eyelid inflammation may clinically present with congestion and swelling of the palpebral margin and tarsal conjunctiva.

bubble_chart Treatment Measures

First, the pathogenic causes should be eliminated by modifying the working and living environment, eliminating various bad habits, actively treating conditions such as entropion, chronic dacryocystitis, blepharitis, lacrimal duct obstruction, and correcting refractive errors and latent strabismus. For conjunctivitis caused by the decomposition products of eyelid margin secretions irritating the tarsal plate and conjunctiva, regular massage of the tarsal plate should be performed to facilitate the timely discharge of secretions from the tarsal glands.

Treatment primarily focuses on removing the disease cause. A 0.5% zinc sulfate solution is highly effective against Morax-Axenfeld diplobacillus. Additionally, instilling eye drops 2–3 times daily can relieve itching. Depending on the specific pathogenic bacteria, various antibiotic eye drops or 10% sulfacetamide sodium eye drops can be used.