ACUTE HAEMORRHAGIC CONJUNCTIVITIS

Acute Haemorrhagic Conjunctivitis (AHC) is a new form of infectious eye disease that first appeared in epidemic form in 1969.
Conjunctivitis is an inflammation of the conjunctiva. The conjunctiva is the thin clear tissue that lies over the white part of the eye and lines the inside of the eyelid.
The disease typically has a sudden onset and is characterized by painfully swollen and red eyes, superficial keratitis, sub-conjunctival haemorrhage, palpebral follicles and excessive lachrymation. The disease usually lasts for 1-2 weeks with rapid recovery usually without complication. Secondary bacterial infection may occur in a small number of cases when the course of disease may be prolonged.
AHC has been given variety of names like “Apollo 11 disease” “Epidemic haemorrhagic conjunctivitis”, “Acute Conjunctivitis”, “Joy Bangla Epidemic Conjunctivitis”, ‘Picorna Epidemic Conjunctivitis” and “Singapore Epidemic Conjunctivitis (SEC)”.
The disease was given the name of Acute Haemorrhagic Conjunctivitis (AHC) by Kono and colleagues in 1972 . The term AHC is well established and remains an appropriate designation for the disease.

What causes conjunctivitis?
Conjunctivitis has a number of different causes including:
Viruses
Bacteria (such as gonorrhoea or chlamydia)
Irritants such as shampoos, dirt, smoke and
swimming -pool chlorine
Allergies such as dust and pollen, or a special type of allergy that affects some contact lens wearers
caused by some bacteria and viruses – called infective conjunctivitis – can spread easily from person to person, but it is not usually a serious health risk.

What are the symptoms of conjunctivitis?
The symptoms of conjunctivitis differ depending on the cause of the inflammation, but can include:
Redness in the white of the eye or inner eyelid
Increased amount of tears
Thick yellow discharge that crusts over the
eyelashes , especially after sleep
Green or white discharge from the eye
Itchy eyes
Burning eyes
Blurred vision
Increased sensitivity to light

Seek medical advice if you have any of these symptoms of conjunctivitis. You may be advised to attend for an examination of your
eyes and a sample of fluid from the eyelid using a cotton swab may be taken to be analysed in a laboratory. Bacteria or viruses that may have caused conjunctivitis, including a sexually transmitted infection (STI), can then be identified and appropriate treatment prescribed.

How is conjunctivitis treated?
The treatment for conjunctivitis depends on the cause:
Bacteria. Conjunctivitis caused by bacteria usually does not need treatment with
antibiotics as the infection usually clears up by itself. When antibiotics are required they are usually in the form of eye drops .
Viruses. This type of conjunctivitis often results from the viruses that cause a common cold . Just as a cold must run its course, so must this form of conjunctivitis, which usually clears within one to two weeks.
Irritants.

For conjunctivitis caused by an irritating substance use water to wash the substance from the eye for five minutes. Your eyes should begin to improve within four hours after washing away the substance. If the conjunctivitis is caused by an acid or alkaline material such as bleach, seek urgent medical advice.

Allergies.
Allergy-associated conjunctivitis should improve once the allergy is treated and the allergen removed. Seek medical advice if you have conjunctivitis that is linked to an allergy.
Traditionally, home remedies are sufficient for soothing conjunctivitis associated with uncomplicated colds, minor infections, or
allergies. Treatment consists primarily of cleansing the eyes and preventing the condition from spreading.
To relieve the discomfort of conjunctivitis, apply a warm compress for five to 10 minutes, three to four times a day. Preservative-free artificial tears (lubricant eye drops) can be applied frequently. Never use steroid eye drops without a doctor’s prescription.

Pages with reference to book, From 61 To 62
Abdul Ghafoor, M.I. Burney
( National Institute of Health, Islamabad. )

REFERENCES
1. Parrott, W.F. An epidemic called Appollo – An outbreak of conjunctivitis in Nigeria. Practationer, 1971; 206:253.
2. Kono, R., Sasagawa, A., lshii, K., Sugiura, S., Ochi, M., Matsuiniaya, H., Uchida, Y., Kameyama, K., Kaneko, M. and Sakurai, N. Pandemic of a new type of conjunctivitis. Lancet, 1972; 1:762.
3. Kono, R., Sasagawa, A., Miyamura, K. and Tajiri, E. Seriologic characterization and sero.epidemiologic studies on acute haemorrhagic conjunctivitis (AHC) virus. Am. J. Epidemiol., 1975; 101 :444.
4. Kono, R. Appolo 11 disease acute haemorrhagic conjunctivitis; a pandemic of a new enterovirus infection of the eyes. Am. J. Epidemiol., 1975; 101 :383.
5. Kono, R. and Uchida, Y. Acute haemorrhagic conjunctivitis. Ophthalmology Digest, 1975; 39:14.
6. Mirkovic, R.R., Kono, R., Murphy, M. Y., Sohier, R., Schoridt, NJ. and Melnick, J.L. Enterovirus type 70; the etiologic agent of pandemic acute haemorrhagic conjunctivitis. Bull. WHO., 1973; 49 :341.
7. Mirkovic, R.R., et al. “enterovirus Etiology of the 1970 Singapore Epidemic of A cute Conjunctivitis”. Intervirology A., 1974; 119-127.
8. Line, K.H. and Yin -Murphy, M. “An Epidemic of Conjunctivitis in Singapore in 1970”. Singapore Med. J., 1971; 12:247.
9. WHO Wkly Epidemio Rec., 1981; 5 6:393.
10. Ghafoor, A., Bumey, M.I., Iqbal, J. and Khan, Z. Acute haemorrhagic conjunctivitis (AHC) epidemic    of 1981. JPMA., 1984; 34:245.

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