"Pink Eye" (conjunctivitis)

Conjunctivitis is an infection of the conjunctiva - the thin, protective membrane that covers the surface of the eyeball and inner surface of the eyelids. When the conjunctiva becomes inflamed, it gives the eye a reddish tinge, hence the common name of "pink eye." It is caused by bacteria, viruses and other germs that are transmitted to the eye through contaminated hands, towels, eye makeup, contact lenses, etc. It can also result from exposure to irritants such as chemicals, smoke or dust, pollen and other allergens. It is not uncommon for conjunctivitis to occur in conjunction with a cold or flu.

Conjunctivitis is highly contagious and tends to be prevalent in crowded work spaces, daycare centers and schools. It easily spreads by direct person-to-person contact, in airborne droplets that are coughed or sneezed. It also spreads from sharing makeup, towels and washcloths. Although usually a minor eye infection that improves within two weeks, some types can develop into serious corneal inflammation and vision loss, if not treated quickly.

Signs and Symptoms

The primary sign is redness and inflammation of the white part of the eye. In addition, you may experience the following symptoms:

• Swelling, burning and/or itching in one or both eyes
• Excessive tearing or watering
• Thick yellow discharge that crusts over the eyelashes, especially after sleep
• Blurred vision or sensitivity to light
• A gritty feeling in your eye

Types of Conjunctivitis

• Bacterial conjunctivitis symptoms are: red eye(s), sticky discharge, gritty or foreign-body sensation and the eyelids may be stuck shut in the morning. Vision is usually not affected. The most common types of bacteria causing the infection are staphylococcus (staph) or streptococcus (strep). If the discharge is severe, gonococcal (gonorrhea) conjunctivitis must be considered. Bacterial conjunctivitis is not related to the common cold or flu.
  
  Treatment - Bacterial conjunctivitis is usually treated with antibiotic eye drops or ointments that cover a broad range of bacteria. Warm compresses may be prescribed to help soothe the eye, and artificial tears prescribed to help clear discharges and dilute the bacterial toxins. Your eye doctor may also recommend eyelid scrubs.
  
  
• Viral conjunctivitis is often associated with an upper respiratory tract infection, cold, or sore throat. It is usually caused by an adenovirus, the family responsible for upper-respiratory illnesses. Although viral conjunctivitis often clears spontaneously within a week, you should still see your eye doctor to ensure it doesn't lead to a more serious infection involving the cornea.
  
  Treatment - Antibiotics are ineffective against viruses. A warm compress may relieve some of the discomfort. Artificial tears may also provide symptomatic relief. For the worst cases, topical steroid drops may be prescribed to reduce the discomfort from inflammation. Just as a cold must run its course, so must this form of conjunctivitis, which usually lasts from 4 to 7 days but can persist for up to two weeks or more.
  
  
• Allergic conjunctivitis results from a response to airborne pollen, dust, smoke, or environmental agents. Both eyes are usually affected and may itch, tear excessively and produce a stringy mucous discharge. You may also have other allergic reactions, such as a runny or itchy nose. Allergy tests can identify specific causes. Allergic conjunctivitis may also be caused by intolerance to substances such as cosmetics, perfume, or drugs.
  
  Treatment - Topical eye drops are available to relieve symptoms. Cool compresses and artificial tears sometimes relieve discomfort in mild cases. Your eye doctor may recommend oral medications such as over-the-counter or prescription decongestant-antihistamines. Eyecare products such as contact lens solutions or eye drops can cause allergic reactions as well. Discontinue use if you notice allergic conjunctivitis symptoms following the use of a particular product.
  
  
• Chemical conjunctivitis is caused by exposure to irritating liquids, powders, or fumes and requires immediate action. Common irritants in include chlorine, detergents, fuels, ammonia, smoke and pesticides.
  
  Treatment - First, flush the eye with cold water continuously for 15 minutes. Then, apply an over-the-counter artificial tear or ocular decongestant for minor irritants such as chlorine from a swimming pool; for chemicals such as ammonia or bleach, emergency medical treatment is needed.
  

A tip on children and eye drops - A child's eyes do not need to be open to put in drops! Have children lie on their backs and close their eyes. Put 2 or 3 drops in the corners nearest the nose. It will pool there until they blink. Then it slips in without that annoying 'plunk' of a falling drop hitting the eyeball.

If you have conjunctivitis:

• Don't touch or rub the infected eye(s).
• Wear eyeglasses instead of contact lenses.
• If you or someone in your household has conjunctivitis, be sure to wash your hands often and thoroughly with soap and warm water.
• Wash any discharge from your eyes twice a day using a fresh cotton ball. Discard used 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 while you have conjunctivitis. To prevent reinfection, throw away your used make-up and replace.
• Throw away disposable lenses; be sure to clean extended wear lenses and all eyewear cases. Replace contact lens solutions... they may be contaminated.
• Wash your hands after applying eye drops or ointment to your eye or your child's eye.
• If your child has bacterial or viral conjunctivitis, keep them home from school or day care until he or she is no longer contagious.

Prevention

Infective conjunctivitis is highly contagious and there is no foolproof way to avoid getting it. However, maintaining proper hygiene will minimize transmission.

To prevent allergic or chemical conjunctivitis, avoid exposure to irritants by keeping your environment well-ventilated, particularly when using products that produce smoke, chemicals or fumes. Always wear protective eyewear and clothing when handling chemicals.

Sources:

1. St Lukes Eye
2. University of Michigan Medicine
3. University of Chicago Medicine

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