Conjunctivitis or Pinkeye
Conjunctivitis, also known as pinkeye, is one of the most common eye infections in the United States. It most often affects school age kids and is a major cause of school absences resulting in over 3 million missed school days every year. This article will give you helpful information about pinkeye and how it is treated.
What Is Conjunctivitis?
Conjunctivitis is an infection of the inner part of the eyelid, the conjunctiva. One or both eyes become red with drainage and crusting. If the infection starts out in one eye, it can spread to the other eye. It is also easily transmitted to others individuals by casual contact.
Symptoms of Conjunctivitis
The symptoms of conjunctivitis usually come on suddenly and include:
Crust on the eyelids and eyelashes
Whites of the eyes appear red
Swelling of the eyelid
Eyes sensitive to light
Foreign object type feeling
Discharge (Yellow, Green, or White)
Causes of Conjunctivitis
These include bacteria, viruses, irritants, and allergens. In more rare cases, conjunctivitis can be caused by a fungus or parasite. Even less common are cases that may be caused by a sexually transmitted disease such as gonorrhea or chlamydia.
If you have symptoms of pink eye or think you may have been exposed, see your doctor right away for evaluation. The earlier that treatment is started, the less chance there is for complications.
How Is Conjunctivitis Diagnosed?
Most cases of conjunctivitis will go away on their own. If you have symptoms for more than a few days, you need to see your doctor. Also, if you were exposed to someone who is being treated for conjunctivitis and are developing symptoms you should see your doctor.
The doctor will take a thorough history. You will be asked how long the symptoms have lasted and if you have been exposed to environmental irritants or anyone with conjunctivitis. The following exams may be performed:
Visual Acuity test to check your vision
Inspection of the eye and conjunctiva
Culture of eye discharge
Treatment for Conjunctivitis
Treatment for conjunctivitis depends on the type. The doctor will decide which type you most likely have and go from there. The doctor may decide to start you on antibiotics if your case is severe, while you await culture results. Here are the treatments for the main types:
Viral conjunctivitis will go away on its own in one to two weeks. Antibiotics will not help viral conjunctivitis.
The doctor may recommend using some plain saline eye drops (artificial tears). Ice packs can help with swelling and inflammation. If you have a very severe case, the doctor may put you on a short-course of anti-viral medication.
Bacterial conjunctivitis is treated with antibiotics. These are given with either an antibiotic ointment or eye drop that is placed directly in the eye. Once you start treatment, the infection should take around seven to ten days to clear. Your doctor may also recommend ice packs and saline eye drops to help relieve symptoms and swelling. If you have a mild case, the doctor may opt to watch and see if the infection gets better on its own without antibiotics.
Allergic conjunctivitis is an allergic reaction to pollen or animal dander. Treatment consists of removing the offending source and keeping the eyes rinsed to reduce irritation. The doctor may recommend both saline eye drops for clearing the irritant and topical allergy relief drops. You may also need to take an oral antihistamine.
If your conjunctivitis was caused by exposure to chemicals or other irritants, the doctor will most likely flush your eye to remove the offending agent. You may then be prescribed steroid eye drops to reduce inflammation. Understand that if you have redness in your eye after exposure, this is an emergency and you need to see a doctor right away. Especially if you suspect a chemical burn to the eye.
Sexually Transmitted Infections
Sexually transmitted diseases in the eye such as chlamydia or gonorrhea are treated most often with oral antibiotics because eye drops are usually not enough to clear the infection. The doctor will also recommend treatment for any sexual partners.
While rare, fungal conjunctivitis can be serious and usually requires aggressive treatment. More severe cases will need injections of anti-fungal medications directly into the eye. The doctor may also prescribe anti-fungal eye drops and possibly hospitalization in order for anti-fungal medications to be given intravenously.
Complications of Conjunctivitis
If conjunctivitis is left untreated, complications can develop. The inflammation due to the infection can cause the cornea to be damaged leading to loss of eyesight. If conjunctivitis lasts more than a few days, medical evaluation and treatment is strongly recommended.
Lifestyle Changes for Conjunctivitis
There are a few things you can do to reduce symptoms and increase your comfort. These include:
Use saline based eye drops. With your doctor’s okay, try some sterile saline eye drops. You can get these over-the-counter. Avoid using eye drops that reduce redness as this may cause irritation and burning.
Do not wear contact lenses. If you have conjunctivitis, do not use your contact lenses. If you have disposable lenses, throw any used lenses away and start with a fresh pair after being treated to avoid re-infection. If you have long-term lenses, ask your eye doctor what to do about either cleaning them or replacing them.
Use warm or cold compresses. You can wet a clean cloth in warm or cold water and hold it over your eyes. Warm water will help to loosen any crusting in the eyes, but cold water can help soothe and relieve inflammation. If you only have one infected eye, take care not to touch the uninfected eye with the cloth.
Keep hands away from eyes. Wash your hands often and avoid touching your face near your eyes. This can spread the infection to your other eye or to other people. This infection is highly contagious.
Throw out eye makeup and do not share. If you have conjunctivitis, throw out any makeup you have used.
Alternative Medicine for Conjunctivitis
Alternative and herbal medicine may be helpful for conjunctivitis, but the effects have not been proven. Just remember, if the infection does not clear within a few days, you need to see a physician. Some herbal remedies include:
Grated uncooked potato astringent
Herbal eyewashes (goldenseal)
Ginkgo biloba extract with hyaluronic acid
Conjunctivitis is avoidable if you practice the following:
Good Hand washing. Wash your hands or use a good hand sanitizer. Especially if you have been out in public.
If you wear contacts, keep them clean. Use the cleaning instructions for your contact lenses and replace them according to your doctor’s and manufacturer’s schedule. Old lenses lose their ability to protect from infections or eye injuries.
Clean well if someone is infected. If you have someone in your home infected with conjunctivitis, clean all bed linens and areas where they touch. Do not touch the eye dropper to the eye when giving them eye drops. Wash your own hands after treating or cleaning up after them.
Avoid touching your face or eyes. Keep your hands and fingers away from your hands and face unless you are washing your face or putting on makeup. During the day, touch your face as little as possible. Even if you are not at risk for pinkeye, touching your face increases your risk from outside sources.
Reduce exposure. If you will be around irritants, dust, or allergens. Take steps to protect your eyes. Wear utility goggles when there is risk of splashes or foreign objects. Ask your doctor about using allergy eye drops during peak allergy seasons.
American Optometric Association. (2014). American Optometric Association – Conjunctivitis. Retrieved from AOA: https://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/conjunctivitis?sso=y
Centers For Disease Control. (2014, January 9). CDC – Conjunctivitis. Retrieved from Centers For Disease Control: https://www.cdc.gov/conjunctivitis/about/index.html
Josephson, L. (2002). Homeopathic Handbook of Natural Remedies. In L. Josephson, Homeopathic Handbook of Natural Remedies (pp. 207-10). New York, NY: Random House.
Mayo Clinic. (2015, April 2). Complications of Conjunctivitis. Retrieved from Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/pink-eye/basics/complications/con-20022732
National Library of Medicine. (2000, October). Fungal and Parasitic Infections of the Eye. Retrieved from National Library of Medicine.
National Library of Medicine. (2012, November 7). PubMed Health. Retrieved from National Library of Medicine: https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072497/