Conjunctivitis

What is conjunctivitis?

Conjunctivitis is one of the most common and treatable eye infections in both children and adults, thought it is most common in children . Often called “pink eye,” it is an inflammation and/or infection of the conjunctiva, the transparent tissue that lines the inside of the eyelid and covers the white part of the eye. This tissue normally helps keep the eyelid and eyeball moist. Conjunctivitis can happen in just one eye, or it can affect both eyes at the same time, or one shortly after the other. Most cases of conjunctivitis are easily treated and resolve without complications. If it is not treated, however, some types of conjunctivitis can become dangerous.

What causes conjunctivitis?

Conjunctivitis has many causes. It can be caused by a virus, bacteria, foreign body, allergens, irritating substances (shampoos, dirt, smoke, and especially pool chlorine), and even sexually transmitted infections (STIs). Conjunctivitis caused by bacteria, and viruses can spread easily from person to person, but it is not a serious health risk if diagnosed early.

What are the symptoms of conjunctivitis?

• Redness of the white of the eye or inner eyelid
• Watery discharge, or excessive tearing
• Thick yellow discharge
• Itchy eyes (especially in conjunctivitis caused by allergies)
• Burning eyes (especially in conjunctivitis caused by chemicals and irritants)
• Crusty eyelids (especially after sleeping)
• Blurred vision
• Red and swollen eyelids
• Increased sensitivity to light

See your ophthalmologist if you have any of these symptoms. Ear infections also commonly occur in children who have bacterial conjunctivitis. The ophthalmologist will examine your eyes and possibly take a sample of fluid from the eyelid with a cotton swab. Bacteria or viruses that may have caused conjunctivitis can then be seen through a microscope.

How is conjunctivitis treated?

The type of conjunctivitis determines its treatment:

• Bacterial Conjunctivitis

  Conjunctivitis caused by bacteria is treated with antibiotics, a type of medicine prescribed by your doctor. The antibiotic can be given as eye drops, ointments, or pills. Eye drops or ointments may need to be applied to the inside of the eyelid three to four times a day for five to seven days. It may be difficult to apply ointments inside of a child’s eye. If the ointment gets as far as the eyelashes, it will most likely melt and enter the eye. Pills may need to be taken for several days. The infection should improve within a week. Take the medicine as instructed by your doctor, even if the symptoms go away.

• Viral Conjunctivitis

  Medicine cannot treat the many viruses that cause conjunctivitis, but there are drops that can help relieve the symptoms. This type of conjunctivitis is often caused by the common cold. Just as a cold must run its course, so must viral conjunctivitis, which will last from 4 to 7 days. Cold compresses and artificial tears may help the symptoms, and frequent hand-washing will keep the virus from spreading. See your ophthalmologist for medications that may lessen the symptoms.

• Irritating substances / Chemical conjunctivitis

  To treat this type of conjunctivitis the eye must be flushed, or irrigated, to remove the offending material. You should avoid further exposure to the irritating substance as well. Your eyes should begin to improve within a few hours after irrigation. If they do not, call your doctor.

• Allergic Conjunctivitis

  Allergy-associated conjunctivitis should be evaluated by your ophthalmologist. It may disappear completely when the allergy is treated with antihistamines or the when the allergen is removed, and symptoms may be present only seasonally. Relieve symptoms temporarily by applying a cold compress on closed eyes and applying artificial tears or over the counter allergy drops. Prescription medication may be necessary to control your allergic conjunctivitis.

Ophthalmia neonatorum and STIs

The same bacteria that cause the sexually transmitted infections chlamydia and gonorrhea can also infect the conjunctiva. This is called ophthalmia neonatorum and is usually spread during birth as the infant passes through the birth canal of an infected mother. Newborns are typically given eye drops immediately after birth to treat any possible infection. This type of conjunctivitis can also be spread through contact with hands when rubbing the eyes or touching contacts. Antibiotics in the form of pills, eye drops, or ointment are prescribed for treatment. Washing hands thoroughly can help prevent the spread of this type of conjunctivitis.

What can I do to help relieve symptoms?

• Protect your eyes from dirt and other irritating substances.
• Remove contact lenses and dispose of any contacts that have been worn.
• Place cold compresses on your eyes.
• Wash your face and eyelids with mild soap or baby shampoo and rinse well with water to remove any irritating substances.
• Non-prescription artificial tears, which are available over the counter, may help relieve itching and burning. (Note: Other types of eye drops may irritate the eyes and should not be used.) Do not use the same bottle of drops in the other eye if it is not infected.

How can I prevent spreading the infection?

• Don not touch or rub the infected eye(s).
• Wash your hands frequently with soap and water.
• Wash any discharge from your eyes as often as needed using clean washcloth or cotton ball. Afterwards, wash your hands with soap and warm water. Make sure to use a clean towel or fresh cotton ball.
• Wash your bed linens, especially pillow cases, and towels in hot water and detergent.
• Do not wear eye makeup.
• Do not share eye makeup with anyone else.
• Never wear another person’s contact lens.
• Wear glasses instead of your contact lenses. Throw away used disposable lenses or be sure to clean extended wear lenses and all eyewear cases thoroughly.
• Avoid sharing common items such as unwashed towels, cups, and glasses.
• Wipe down frequently touched items such as door knobs and telephones with Clorox wipes or rubbing alcohol.
• Wash your hands after applying the eye drops or ointment to your eye or your child’s eye.
• Do not use eye drops in a non-infected eye that were used for an infected one.
• If your child has bacterial or viral conjunctivitis, keep him or her home from school or day care until he or she is no longer contagious.

Other causes of conjunctivitis

One kind of conjunctivitis happens in a few people who wear contact lenses or who have stitches in their eyes. This is called giant papillary conjunctivitis and it makes the underside of the eyelids very irritated and swollen. If you are diagnosed with this type of conjunctivitis, the doctor may recommend a different kind of contact lens, a different way to clean the contact lenses, or not wearing contact lenses for some time.