Times of India
22 September 2010
By Sumitra Deb Roy
Mumbai, India

A senior researcher with a government lab thought his conjunctivitis had healed in a record time of 48 hours after his redness, itchiness and irritation disappeared soon after applying a steroid–based eye drop. But, as soon as he withdrew the drop, the infection returned with a vengeance affecting his vision and causing unbearable pain in his eyes.

He rushed to JJ Hospital where the steroid–based eye drop was immediately replaced with an antibiotic one. Professor of ophthalmology at the hospital Dr Ragini Parekh cautioned that it was not an isolated case. And, that there were many instances where abuse of steroid drops have led to deterioration in normal conjunctivitis infections. The hospital has treated over 100 conjunctivitis cases in the last three weeks.

Steroid–based drops, as Parekh explained, hide the infection, and give a feel good feeling to the patients. "But, the infection lies dormant and does not get killed by steroids. So as soon as the drop is discontinued, the actual infection comes out and takes a virulent form," she said. The duration of infection also gets prolonged as healing takes longer.

Steroid drops, say city ophthalmologists, are primarily meant for post–surgical comfort, and is mostly prescribed under the cover of antibiotics. Cornea surgeon Dr Tripti Mongia of Aryan Hospital in Kurla said that every one–two out of 20 conjunctivitis cases this year had some corneal infiltration. "Normal conjunctivitis does not affect the cornea but due to improper medication the infection moves to the secondary level requiring more aggressive management," she said. Plain antibiotics are more than enough to treat viral or bacterial conjunctivitis, she added.

Bacteria vs virus
Incidentally, the verdict is split over the issue if it is a virus or a bacteria that is responsible for the ‘pinkeye syndrome’ in the city. Some eyecare centres in the city like the Aditya Jyot Eye Hospital are seeing more of bacterial infections (60%), while several other centres including JJ Hospital is witnessing more of viral. Parekh said that conjunctival swabs had been sent to the hospital’s microbiology laboratory for investigation. "They will look into the nature and trend of the organism this year," she said adding that reports are expected within two days.

Red in the eye
Besides, ophthalmologists are also witnessing cases of sub–conjunctival haemorrhage where patients are left with a red clot in the eye even after the infection has subsided. Cornea surgeon Dr Kavita Rao of Aditya Jyot Eye Hospital said that those were cases of bleeding on the outer surface of the cornea. "Viral infection can make the blood vessels to rupture as they become fragile," she said. "But, it is a routine occurrence and is self–resolving," she said.

Not an epidemic
The good news though is that doctors say it is still not an epidemic like situation. "Cases are more and worse than normal but not that unusually high," said ophthalmologist Dr SS Bhatti. Head of epidemiology cell of BMC Dr Daksha Shah too said that numbers are normal so far and ample medicines have been made available to civic hospitals. Till last week, civic hospitals had treated over 850 cases.