This is a severe epidemic form of catarrh of the eye, which is caused by a special germ known as the “Koch Weeks bacillus.” The treatment of this is the same as that outlined below. The germ of pneumonia and that of grippe also often cause conjunctivitis, and “catching cold,” chronic nasal catarrh, exposure to foul vapors and gases, or tobacco smoke, and the other causes enumerated, as leading to congestion of the lids, are also responsible for catarrhal inflammation of the eye.

Treatment. In the milder attacks of conjunctivitis the treatment should be that recommended above for congestion of the lids. The swelling and inflammation, in the severer types, are greatly relieved by the application of the cold water compresses, advised under the section on “black eye,” for an hour at a time, thrice daily. Confinement in a dark room, or the use of dark glasses, and drops of zinc sulphate (one grain in an ounce of water) three times a day, with hourly dropping of boric acid (ten grains to the ounce of water) constitute the ordinary treatment.

In inflammations with copious discharge of creamy pus, and great swelling of the lids, the eyes should be washed out with the boric acid solution every half hour, and a solution of silver nitrate (two grains to the ounce of water) dropped into the eye, once daily, followed immediately by a weak solution of common salt in water to neutralize the nitrate of silver, after its action has been secured. The constant use of ice cloths, already mentioned, forms a necessary adjunct to treatment. The sound eye must be protected from the chance of contagion, arising from a possible infection from the pus discharging from its mate. This may be secured by bandaging the well eye, or, better, by covering it with a watch crystal kept in place by surgeon’s plaster.

In treating sore eyes with discharge, in babies, the infant should be held in the lap with its head backward and inclined toward the side of the sore eye, so that in washing the eye no discharge will flow into the sound eye. The boric acid may then be dropped from a medicine dropper, or applied upon a little wad of absorbent cotton, to the inner corner of the eye, while the eyelids are held apart.

Hemorrhages occurring under the conjunctiva (or membrane lining the inner surface of the lids and covering the front surface of the eyeball) may be caused by blows or other injury to the eye, by violent coughing, by straining, etc. Dark red spots may appear in the white of the eyeball, slightly raised above the surface, which are little blood clots under the conjunctival membrane. No special trouble results and there is nothing to be done except to wait till the blood is absorbed, which will happen in time. If the eyes water, solution of zinc sulphate (one grain to the ounce of water) may be dropped into the eye, twice daily. Hot applications are beneficial here to promote absorption of the clot.