Conjunctivitis

What is conjunctivitis?

Conjunctivitis is one of the most common eye infections in children and adults. Often called pink eye, it is an inflammation (swelling) of the conjunctiva, the tissue that lines the inside surface of the eyelid and outer coating of the eye. This tissue helps keep the eyelid and eyeball moist.

Conjunctivitis can be caused by a virus, bacteria, irritating substances (shampoos, dirt, smoke, and especially pool chlorine), allergens (substances that cause allergies) or sexually transmitted infections. Pink eye caused by bacteria, viruses, and sexually transmitted infections can spread easily from person to person, but is not a serious health risk if diagnosed promptly.

What are the symptoms of conjunctivitis?

The symptoms of conjunctivitis include the following:

• Redness in the white of the eye or inner eyelid
• Greater amount of tears
• Thick yellow discharge that crusts over the eyelashes, especially after sleep (in conjunctivitis caused by bacteria)
• Other discharge from your eye (green or white)
• Itchy eyes (especially in conjunctivitis caused by allergies)
• Burning eyes (especially in conjunctivitis caused by chemicals and irritants)
• Blurred vision
• Increased sensitivity to light

See your ophthalmologist (a doctor trained to treat eye conditions) or family doctor if you have any of these persistent 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 and cells from the eyelid with a cotton swab. Bacteria or viruses that may have caused conjunctivitis can then be seen through a microscope or grown in culture for identification.

How is conjunctivitis treated?

• Bacteria: 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 eye three to four times a day for five to seven days. It may be difficult to apply ointments in 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.
• Virus: Medicine cannot treat conjunctivitis caused by a virus. This type of conjunctivitis often results from a common cold. Just as a cold must run its course, so must this form of conjunctivitis, which will last from four to seven days. You can help relieve symptoms by applying a cold compress and using artificial tears as recommended by your doctor.
• Irritating substance: To treat this type of conjunctivitis, use warm water for five minutes to wash the irritating substance from the eye. You should also avoid further exposure to the irritating substances. Your eyes should begin to improve within four hours after washing away the substance. If they do not, call your doctor.
• Allergies: Allergy-associated conjunctivitis should be checked out by your ophthalmologist and an allergist. It may disappear completely when the allergy is treated with antihistamines or when the allergen is removed. You can relieve symptoms temporarily by applying a cold compress on closed eyes.
• Ophthalmia neonatorum and sexually transmitted infections : The same bacteria that causes the sexually transmitted infections chlamydia and gonorrhea can also infect the conjunctiva. The infant form is called ophthalmia neonatorum and is most commonly spread during birth as the infant passes through the birth canal of an infected mother. Newborns are usually given eye drops immediately after birth to treat any possible infection. Adult conjunctivitis related to the sexually-transmitted disease can be spread through hand contact when rubbing the eyes or touching contact lenses after touching infected genitals. Oral antibiotics (pills, eye drops, or ointment) are usually prescribed for treatment. It is important that any sexual contacts be tested and treated for these sexually-transmitted diseases to avoid re-infection.

Being around a person who has conjunctivitis and wearing contact lenses may increase your risk of getting conjunctivitis, but the outcome is usually very good with treatment. Washing your hands thoroughly can help prevent the spread of infectious conjunctivitis.

Please note that eyes can become re-infected. Call your doctor if symptoms return or if vision decreases after being treated.

What can I do to help relieve symptoms of conjunctivitis?

Take these measures to relieve the symptoms of conjunctivitis:

• Protect your eyes from irritating substances
• Remove contact lenses, if you wear them
• Place cold compresses on your eyes and do not share washcloths or towels with others
• Wash your face and eyelids with mild soap or baby shampoo and rinse with water to remove irritating substances

Non-prescription artificial tears, a type of eye drops, may help relieve itching and burning from irritating substances. (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't touch or rub the infected eye(s).
• Wash your hands often with soap and warm water.
• Wash any discharge from your eyes twice a day using a fresh cotton ball or paper towel. Afterwards, discard the cotton ball and wash your hands with soap and warm water.
• Wash your bed linens, pillowcases, and towels in hot water and detergent.
• Avoid wearing eye makeup.
• Don't share eye makeup with anyone else.
• Never wear another person's contact lens.
• Wear glasses instead of contact lenses. Throw away disposable lenses or be sure to clean extended wear lenses and all eyewear cases.
• Avoid sharing common articles such as unwashed towels, cups, and glasses.
• Wash your hands after applying eye drops or ointment to your eye or your child's eye.
• Do not use eye drops that were for an infected eye in a non-infected eye.

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.