Infectious Conjunctivitis: Causes, Symptoms, and Treatment

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1. Background of the case study (Total: 5 marks)
1.1 What is infectious conjunctivitis?
Infectious conjunctivitis is defined as the inflammation of the conjunctiva of the eye that is
usually caused by bacteria and viruses. The common causal virus that causes the
infectious conjunctivitis are adenoviruses. The occurrence of bacterial infections is less
frequent comparatively (Perween, Bisht, & Aggarwal, 2016). Conjunctivitis caused by both
viruses and bacteria are contagious. The common symptoms of the disease includes
redness of the eye, tearing and discharge from the infected eye (Teweldemedhin et al.,
2017).
1.2 Of the four micro-organisms listed below, justify which one is more likely to be the cause
of John’s eye infection. Indicate why the other micro-organisms from the list are least likely
to cause the infection.
Legionella pneumophila
Yes or no, with reason:
Legionella pneumophila is not the causal organism for the conjunctivitis. Legionella
pneumophila is a causal organism for Legionnaires’ disease which is an intense form of
pneumonia characterised by the inflammation of the lungs due to the infection. This
bacteria is responsible for the cause of the disease.
Plasmodium ovale
Yes or no, with reason:
Plasmodium ovale is also not the causal organism for the conjunctivitis.
Plasmodium ovale causes tertian malaria in the humans. It is a parasitic protozoa.
Adenovirus
Yes or no, with reason:
Adenovirus is the causal organism for viral conjunctivitis. But the causal organism for the
conjunctivitis in John’s eye is not viral. This is because viral conjunctivitis is a familiar pink
eye disease that is usually accompanied by an upper respiratory tract infection like
measles, common cold or flu. Viral conjunctivitis usually is characterised by a watery
discharge but John had a thick, purulent and sticky. He had no complains of any other
discomfort (Perween, Bisht, & Aggarwal, 2016).
Staphylococcus aureus
Yes or no, with reason:
The causal organism for the conjunctivitis that occurred in John’s eyes is Staphylococcus
aureus. Staphylococcus aureus is the causal organism of the infectious conjunctivitis that
is acquired by John. This is one of the most common bacterial strains that causes acute
bacterial conjunctivitis. Bacterial conjunctivitis usually produces thick discharge and can
affect either eyes or a single eye only. Antibiotics including tropical antibiotic eye drops or
eye ointment are usually administered to combat the bacterial conjunctivitis (Perween,
Bisht, & Aggarwal, 2016) (Teweldemedhin et al., 2017).

2. Mechanism of action and adverse reactions (Total: 5 marks)
2.1 Describe the mechanism of action of gentamicin?
Gentamicin is a class of aminoglycoside antibiotics that is bactericidal in nature. It treats
the bacterial eye infections only. It binds to the 30S subunit of the bacterial ribosome thus
negatively impacts the protein synthesis intervening in the translational mechanisms
resulting in formation of non-functional, mistranslated proteins. These proteins aggregate
and lead to death of the bacteria (Bullock & Manias, 2013).
2.2 Name two adverse reactions of this drug?
The side effects of gentamicin includes severe burning and irritation that may result in
blurred vision. It can also lead to severe dizziness (Boustcha & Nicolle, 1995).
3. Physiological basis of signs (Total: 10 marks)
3.1 sign 1:
Painful eyes
Explanation of this phenomenon:
The pain in the eye is caused by the inflammation of the conjunctiva which is a thin clear
tissue that lies on top of the white part of the eyes and lines the inner side of the eyelid
(Marieb & Hoehn, 2007).
3.2 sign 2:
Red and swollen eyes
Explanation of this phenomenon:
The redness of the eye is caused due to the dilation of the blood vessels and capillaries
that are present between the white surface of the eye and the overlying conjunctiva (Craft
et al., 2015).
3.3 sign 3:
Purulent sticky discharge
Explanation of this phenomenon:
The bacterial conjunctivitis causes eye discharge that are thick and purulent in nature in
comparison to the viral conjunctivitis (Marieb & Hoehn, 2007). This thin, watery mucus is
produced by mucin and meibum which is an oily substance that is secreted by the
meibomian glands that keeps the eye moist and lubricated (Craft et al., 2015).
4. Infection control issues (Total: 5 marks)
4.1 Issue 1:
Personal hygiene
Discussion as to why this is an issue:
Personal hygiene is considered as the most important aspect of the personal hygiene.
Elderly people have the fear of falling or slipping that interferes in the process of
maintaining the personal hygiene (Norris & Lalchandani, 2018). Dementia among the
elderly adults also pose to be a reason for lack of personal hygiene. Individual with
dementia does not have the concept of good hygiene and appearance despite being
aware that it should be maintained.
4.2 Issue 2:

Physical impairment in the elderly adults
Discussion as to why this is an issue:
Physical impairment in the elderly adults is another cause that poses a hindrance for the
maintenance of personal hygiene. Personal hygiene indeed plays an important role in the
prevention of infectious conjunctivitis. The physical impairment imparts hindrance to
perform the daily activities that includes changing clothes, bathing and similar hygiene
activities. Physical impairment can be the result of various health complications like
arthritis as well as other joint disorders. Others may include nerve and muscle disorder,
paralysis, reduced muscle strength and decreased joint flexibility and coordination.
5. Transmission of infection (Total: 5 marks)
5.1 Describe transmission from John to Mary:
The bacteria and the viruses that causes conjunctivitis can be contagious in nature. The
disease can spread from person to person in several ways. The different ways by which
this infectious conjunctivitis gets transmitted includes:
Close and direct contact with the infected individual like shaking of hands, touching.
The microbes can be spread through air by coughing and sneezing. The discharge from
the upper respiratory tract and the conjunctivae of the infected patient are the main source
of the pathogen and are the common modes of transmission of the same (Cleary, Barsam
& Tuft, 2016).
Touching an infected surface that is already contaminated with the causal organism for
conjunctivitis and then touching the eyes directly before washing the hands. These
surfaces might have been contaminated by the person already infected by the disease
(Bauer, 2015).
6. Breaking the chain of infection (Total: 5 marks)
6.1 Identify procedure 1:
Personal hygiene and clothing
Describe how this effectively breaks the chain of infection:
The individuals who have acquired infection should not have direct contact with other
uninfected people in the family. Maintaining the personal hygiene plays a very crucial role
in prevention of the disease. The clothing of the patient should be changed daily. Clothes
are the main source of bacterial infection based on the literature studies. Avoid the use of
jewellery like wristwatches and fingernails should be kept short and clean. Care givers
should wear required facemasks that should cover the nose, mouth and chin completely
(Burchum & Rosenthal, 2014).
6.2 Identify procedure 2:
Hand washing
Describe how this effectively breaks the chain of infection:
Hands are the most vital organs and another main source for spreading infection. It is
considered as the principle source of cross-infection in patients. Hence, washing of hands
is considered as the most important of controlling measures for spreading of infections.
Care givers are advised to use gloves if possible to reduce the tendency of spreading of
the infection. Washing of hands with soap or relevant disinfectants remove germs from the
hands. People usually have the tendency to touch their eyes, nose and mouth
unintentionally and this increases the probability of individual to acquire contagious
diseases (Norris & Lalchandani, 2018).
7. Presentation (Total: 5 marks)