Conjunctivitis

Eye

Conjunctivitis, or pink eye, 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 in one eye it can easily spread to the other eye. It is also easily transmitted to other individuals by casual contact.
Conjunctivitis 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. Read on for more information about pinkeye and how it is treated.

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Symptoms

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
  • Itching
  • Burning
  • Eyes sensitive to light
  • Foreign object type feeling
  • Excessive tears
  • Discharge (yellow, green, or white)
  • Blurred vision
  • Eye pain
  • Headache
  • Nausea

Diagnosis

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

Treatments

Treatment for conjunctivitis depends on the type. The doctor will decide which type you have and go from there. If your case is severe, the doctor may decide to start you on antibiotics while you await culture results. Here are the treatments for the main types of conjunctivitis:

Viral conjunctivitis. 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 antiviral medication.

Bacterial conjunctivitis. Bacterial conjunctivitis is treated with antibiotics. These are given with either an antibiotic ointment or an 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. 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 saline eye drops for clearing the irritant, and topical allergy relief drops. You may also need to take an oral antihistamine.

Chemical/irritants. 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.

Fungal conjunctivitis. While rare, fungal conjunctivitis can be serious and usually requires aggressive treatment. More severe cases will need injections of antifungal medications directly into the eye. The doctor may also prescribe antifungal eye drops and possibly hospitalization for antifungal medications to be given intravenously.

Alternative Treatments and Home Remedies

Alternative and herbal medicine may be helpful for conjunctivitis. Just remember, if the infection does not clear within a few days, you need to see a physician. Some herbal remedies include:

  • Chamomile
  • Grated uncooked potato astringent
  • Herbal eyewashes (goldenseal)
  • Ginkgo biloba extract with hyaluronic acid
  • Marigold
  • Fennel seed
  • Eyebright

Prevention

Conjunctivitis is avoidable if you practice the following:

Good hygiene. 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 you 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 eyedropper 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 a risk of splashes or foreign objects. Ask your doctor about using allergy eye drops during peak allergy seasons.

References

American Optometric Association. (2014). Conjunctivitis. Retrieved from American Optometric Association: 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). 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.

Klotz, S. A., Penn C. C.& Negvesky, S. I. B. (2000, October). Fungal and parasitic infections of the eye. Retrieved from National Library of Medicine: https://pubmed.ncbi.nlm.nih.gov/11023963/

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. (2012, November 7). PubMed Health. Retrieved from National Library of Medicine: https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072497/

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