Congiuntivite
Definizione
La congiuntivite è un’infiammazione a carico della congiuntiva, la membrana mucosa, sottile, trasparente, che riveste internamente le palpebre e, ripiegandosi, ricopre la parte anteriore del globo oculare. Il segno più caratteristico è l’arrossamento della congiuntiva palpebrale e bulbare. Ipersecrezione acquosa, che incolla le palpebre, purulenta e pseudomembranosa.
Eziologia
La congiuntivite è una delle malattie oculari più comuni e può manifestarsi in forma acuta o cronica, può interessare un solo occhio o entrambi gli occhi. Può essere causata da un’infezione batterica, virale o da altri microorganismi o parassiti (congiuntivite infettiva). Può derivare da inquinamento dell’aria (fumi, polveri), luce intensa (saldatura, alta montagna, mare), allergeni (soprattutto pollini), batteri, virus, micoti (“leptothrix” trasmessa dal gatto).
Diagnosi differenziale
In presenza di una iperemia oculare, bisogna escludere una irite, un glaucoma acuto, un’ulcera o un traumatismo corneale.
Esami di laboratorio
Striscio congiuntivale e coltura della secrezione congiuntivale.
Complicazioni
Cheratite, perforazione corneale e panoftalmia in caso di ulcera della cornea.
Congiuntivite allergica
Frequente nelle riniti allergiche; si manifesta con prurito e arrossamento oculare, lacrimazione bilaterale. La congiuntivite allergica tende a recidivare e viene trattata con colliri contenenti antistaminici e cortisonici per qualche giorno (non prolungare la terapia).
Congiuntivite batterica
I germi più spesso in causa sono il pneumococco, lo stafilococco aureo, bacillo di Koch-Weeks , Morax-Axenfeld. La secrezione congiuntivale è spesso purulenta ma non vi è dolore. Senza terapia dura 10-15 giorni. Terapia: instillazione di collirio o uso di una pomata contenente un sulfamidico o un antibiotico secondo il germe in causa. Non associare mai corticosteroidi.
Congiuntivite virale
Un adenovirus è spesso in causa. La congiuntivite è di tipo follicolare, accompagnata da febbre, faringite e adenopatia pre o retroauricolare. La secrezione congiuntivale è acquosa, abbondante, la congiuntiva palpebrale è iperemica. L’infezione può essere contratta nelle piscine. La guarigione si verifica abitualmente in due settimane. L’enterovirus 70 può essere responsabile della congiuntivite emorragica epidemica. Terapia: sintomatica (lavaggi con soluzione fisiologica isotonica).
Vedi anche:
- Congiuntivite da inclusioni nel neonato e nell’adulto
- Rinite allergica
- Occhi che lacrimano troppo (Epifora)
- Uveite: infiamazione dell’uvea
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