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Conjunctivitis: Diagnosis, Risk Factors, Symptoms, Treatment, Prevention E-mail
Written by Jeff Behar, MS, MBA   

 

Defined

Conjunctivitis (aka pink eye) is an inflammation or infection of the transparent membrane that lines your eyelid and part of your eyeball, and may make you feel as if you've got something in your eye that you just can't remove.

Causes

Conjunctivitis is most often caused by a virus but can also be caused by bacteria. Conjunctivitis (pink eye) can also result from an allergic reaction or - in newborns - an incompletely opened tear duct. 

Viral 

Conjunctivitis also can be caused by some viral infections, such as adenovirus, and can occur in someone battling a cold or the flu.

Bacterial

Many different bacteria and viruses can cause pinkeye. The organisms that cause the sexually transmitted diseases (STDs) gonorrhea and chlamydia can also infect the eyes and cause conjunctivitis. This can occur in sexually active people and in newborns who acquire the infection at birth from their mothers.

Allergic

Allergic conjunctivitis occurs more frequently among kids with allergic conditions such as hay fever. It's typically seen only at certain times of the year, especially when caused by allergens such as grass or ragweed pollen. Other allergy -causing substances like animal dander or dust mites can cause year-round symptoms of conjunctivitis. Chemicals such as those in chlorine and soaps or air pollutants such as smoke and fumes also can lead to pink eye.

Risk Factors

Exposure is the common risk factor for viral, bacterial and allergic conjunctivitis.

Viral and bacterial conjunctivitis are common among children and are very contagious.

Someone with conjunctivitis may be contagious for seven to 14 days after signs and symptoms first appear.

How the Eye Becomes "Pink" or "Red"

Inflammation causes small blood vessels in the conjunctiva to become more prominent, resulting in a pink or red cast to the whites of your eyes, hence the name "pink eye" or "red eye"; commonly used terms to refer to all types of conjunctivitis.

Symptoms 

Symptoms may include:

  • Eye irritation. Conjunctivitis (pink eye) may make you feel as if you've got something in one or both of your eyes that you just can't remove.
  • Eye redness.The whites of your eyes may begin to have a pink discoloration, and you may not see as clearly as you did before.
  • Eyelid swelling
  • Eye itchiness
  • Yellow or white discharge coming from your eyes, especially in the morning
  • Excessive tearing
  • In some types of conjunctivitis, there may be blurred vision, pain, headache, low-grade fever, and tiredness. 

Symptoms Suggesting a More Severe Eye Infection
  • Severe eye pain
  • Change in vision
  • Extreme sensitivity to light
  • Marked heat & swelling of eyelids

In these cases an appointment should be made with an eye doctor immediately.

Diagnosis

Your doctor may take a sample of eye secretions from the conjunctiva for laboratory analysis to determine which form of infection (viral or bacterial) you have and how best to treat it.

If you with recurrent pink eye or persistent eye tearing, you may have a blocked tear duct. In  this case your doctor may refer you to an eye specialist (ophthalmologist) for further evaluation and treatment.

But because pink eye can be contagious, it should be diagnosed and treated early.

Home Treatment for All Forms of  Conjunctivitis

Applying warm compresses to your affected eye or eyes may ease some of the symptoms. To make a compress, soak a clean, lint-free cloth in warm water and wring it out before applying it gently to your closed eyelids. It is very important that a clean compress is used each time to prevent infections.

For allergic conjunctivitis, avoid rubbing your eyes so that you don't release more histamines. Instead, use cool clean compresses to soothe your eyes.

For allergic conjunctivitis specially formulated over-the-counter eyedrops such as Naphcon-A or Opcon-A, which contain an antihistamine and an agent that constricts blood vessels may also prove helpful.

Treatment (bacterial conjunctivitis)

Your doctor may prescribe antibiotic eye drops if the infection is bacterial. The infection should clear within several days of starting treatment.

Note: Antibiotic eye ointment, in place of eye drops, is sometimes prescribed for treating bacterial pink eye in children because an ointment is often easier to administer to an infant or young child than are eye drops.

With either form of medicine, you should notice a marked improvement in signs and symptoms within one to two days.

Treatment (viral conjunctivitis)

Viral conjunctivitis can't be treated with antibiotic eye drops or ointment. Like a common cold, you can use an over-the-counter remedy to relieve some symptoms, but the virus just has to run its course.

With viral conjunctivitis you may notice a worsening of symptoms in the first three to five days. After that, your signs and symptoms should gradually clear on their own. It may take up to two to three weeks from the time you were infected for the virus to go away.

Allergic Conjunctivitis

 

If the irritation is allergic conjunctivitis, your doctor may prescribe one of many different types of eye drops. These may include;

  • antihistamines
  • anti-inflammatory drops
  • decongestants
  • mast cell stabilizers
  • steroids
Prevention

Avoiding allergens is the best way to prevent allergic pink eye.

Practicing good hygiene is the best way to control the spread of viral and bacterial conjunctivitis (pink eye). If you have viral or bacterial conjunctivitis: 

  • Don't touch your eyes with your hands.
  • Wash your hands thoroughly and frequently.
  • Discard eye cosmetics, particularly mascara.
  • Throw away or carefully wash items that touch their eyes.
  • Do not share eye makeup or other items used on their eyes (for example, eye drops, wash clothes, towels, or tissues).
  • Cover mouth and nose when coughing or sneezing.
  • Follow your eye doctor's instructions on proper contact lens care.
  • Change your towel and washcloth daily, and don't share them with others.
  • Change your bedding often, specifically your pillow.

Note: if viral, the virus might also be on the infected person's fingers, therefore it is important in such cases to consider what objects, items someone who has been infected might have touched in order to avoid catching the condition.

Special Issues (Newborns and Infants)

Newborns' eyes are susceptible to bacteria normally present in the mother's birth canal. These bacteria cause no symptoms in the mother however it is possible that such bacteria can cause infants to develop a serious form of conjunctivitis known as ophthalmia neonatorum, which needs treatment without delay to preserve sight. For this reason, shortly after birth, every newborn's eyes are protected with a preventative application of an antibiotic, such as erythromycin ointment.

Prognosis

Though the inflammation of pink eye makes it an irritating condition, it rarely affects your sight. If you suspect pink eye, you can take steps to ease your discomfort.

 

 


 
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