Conjunctivitis: Nursing process (ADPIE)

Leilani Flores is a 3-year-old client who was brought to the primary care clinic by her father, Alvin. Yesterday, Leilani’s older sister was diagnosed with bacterial conjunctivitis, and was started on antibiotic eye drops.

Today, Alvin is concerned that the infection has spread to Leilani. He reports that she woke up with her right eye crusted shut with yellow drainage and she has been rubbing the eye frequently.

Conjunctivitis, commonly known as pink eye, refers to the inflammation of the conjunctiva, which is the clear membrane that covers the sclera and the inner surface of the eyelids, in response to an infection, allergen, or irritant.

As a result there’s dilation of conjunctival blood vessels, which typically causes the eye to look pink or red. So, there are two main causes of conjunctivitis, infectious and non-infectious.

Infectious conjunctivitis can be further divided into viral and bacterial conjunctivitis. Viral conjunctivitis is the most common one and is typically caused by adenovirus, but can be also due to herpes simplex virus or varicella-zoster virus.

On the other hand, bacterial conjunctivitis is most often caused by Staphylococcus Aureus, Streptococcus pneumoniae, or Haemophilus influenzae, but less commonly, it can also be caused by Neisseria gonorrhoeae, or Chlamydia trachomatis.

Both viral and bacterial conjunctivitis are highly contagious, and spread through direct hand-to-eye contact with contaminated objects, or with an infected person’s secretions like tears or eye discharge.

So, the main risk factors include close contact with someone who has conjunctivitis, as well as attending crowded places like schools or daycare.

Other factors that increase the risk of conjunctivitis include poor hand hygiene and improper use of contact lenses. There’s also non-infectious conjunctivitis, which includes allergic and irritant conjunctivitis.

Allergic conjunctivitis is usually caused by airborne allergens, like pollen, grass, or dust, and an important risk factor is the season, especially during spring.

On the other hand, irritant conjunctivitis can be caused by a mechanical irritant, such as a foreign body or chemical irritants found in smoke, fumes, powders, and liquids like chlorine or alcohol.