CHRONIC CATARRHAL CONJUNCTIVITIS

Chronic catarrhal conjunctivitis’ also known as
‘simple chronic conjunctivitis’ is characterised by
mild catarrhal inflammation of the conjunctiva.

Etiology
A. Predisposing factors
1. Chronic exposure to dust, smoke, and chemical
irritants.
2. Local cause of irritation such as trichiasis,
concretions, foreign body and seborrhoeic scales.
3. Eye strain due to 
refractive errors, phorias or
convergence insufficiency.
4. Abuse of alcohol, insomnia and metabolic
disorders.

B. Causative organisms

• Staphylococcus aureus is the commonest cause of chronic bacterial conjunctivitis.
• Gram negative rods such as Proteus mirabilis, Klebsiella pneumoniae, Escherichia coli and Moraxella lacunata are other rare causes.

C. Source and mode of infection. Chronic
conjunctivitis may occur:
1. As continuation of acute mucopurulent
conjunctivitis when untreated or partially treated.
2. As chronic infection from associated chronic
dacryocystitis, chronic rhinitis or chronic upper
respiratory catarrh.
3. As a mild exogenous infection which results from
direct contact, air-borne or material transfer of infection.

Clinical picture
Symptoms of simple chronic conjunctivitis include:

• Burning and grittiness in the eyes, especially in the evening.
• Mild chronic redness in the eyes.
• Feeling of heat and dryness on the lid margins.
• Difficulty in keeping the eyes open.
• Mild mucoid discharge especially in the canthi.
• Off and on lacrimation.
• Feeling of sleepiness and tiredness in the eyes.

Signs. Grossly the eyes look normal but careful
examination may reveal following signs:

• Congestion of posterior conjunctival vessels.
• Mild papillary hypertrophy of the palpebral conjunctiva.
• Surface of the conjunctiva looks sticky.
• Lid margins may be congested.

Treatment
1. Predisposing factors when associated should be treated and eliminated.
2. Topical antibiotics such as chloramphenicol or
gentamycin should be instilled 3-4 times a day for
about 2 weeks to eliminate the mild chronic
infection.
3. Astringent eye drops such as zinc-boric acid
drops provide symptomatic relief.