Conjunctivitis

Conjunctivitis is an inflammation or swelling of the conjunctiva. The conjunctiva is the thin transparent layer of tissue that lines the inner surface of the eyelid and covers the white part of the eye. Often called "pink eye," conjunctivitis is a common eye disease, especially in children. It may affect one or both eyes. Some forms of conjunctivitis are highly contagious and can easily spread in schools and at home. While conjunctivitis is usually a minor eye infection, sometimes it can develop into a more serious problem.

 

A viral or bacterial infection can cause conjunctivitis. It can also develop due to an allergic reaction to air irritants such as pollen and smoke, chlorine in swimming pools, ingredients in cosmetics, or other products that contact the eyes, such as contact lenses.

People with conjunctivitis may experience the following symptoms:

  • A gritty feeling in one or both eyes
  • Itching or burning sensation in one or both eyes
  • Excessive tearing
  • Discharge from one or both eyes
  • Swollen eyelids
  • Pink discoloration to the whites of one or both eyes
  • Increased sensitivity to light

What Causes Conjunctivitis?

Allergic conjunctivitis: more commonly among people who already have seasonal allergies. They develop it when they come into contact with a substance that triggers an allergic reaction in their eyes.


Giant papillary conjunctivitis: a type of allergic conjunctivitis caused by the chronic presence of a foreign body in the eye. People who wear hard or rigid contact lenses, wear soft contact lenses that are not replaced frequently, have an exposed suture on the surface of the eye or have a prosthetic eye are more likely to develop this form of conjunctivitis.

Bacterial conjunctivitis: an infection most often caused by staphylococcal or streptococcal bacteria from your own skin or respiratory system. Insects, physical contact with other people, poor hygiene (touching the eye with unclean hands), or using contaminated eye makeup and facial lotions can also cause the infection. Sharing makeup and wearing contact lenses that are not your own or are improperly cleaned can also cause bacterial conjunctivitis.

Viral conjunctivitis: most commonly caused by contagious viruses associated with the common cold. It can develop through exposure to the coughing or sneezing of someone with an upper respiratory tract infection. Viral conjunctivitis can also occur as the virus spreads along the body's own mucous membranes, which connect the lungs, throat, nose, tear ducts and conjunctiva. Since the tears drain into the nasal passageway, forceful nose blowing can cause a virus to move from your respiratory system to your eyes.

Ophthalmia neonatorum: a severe form of bacterial conjunctivitis that occurs in newborn babies. This is a serious condition that could lead to permanent eye damage if it is not treated immediately. Ophthalmia neonatorum occurs when an infant is exposed to chlamydia or gonorrhea while passing through the birth canal.

Chemical Conjunctivitis: caused by irritants like air pollution, chlorine in swimming pools, and exposure to noxious chemicals.

Treating conjunctivitis has three main goals:

  1. Increase patient comfort.
  2. Reduce or lessen the course of the infection or inflammation.
  3. Prevent the spread of the infection in contagious forms of conjunctivitis.

The appropriate treatment for conjunctivitis depends on its cause:

  • Allergic conjunctivitis. The first step is to remove or avoid the irritant, if possible. Cool compresses and artificial tears sometimes relieve discomfort in mild cases. In more severe cases, nonsteroidal anti-inflammatory medications and antihistamines may be prescribed. People with persistent allergic conjunctivitis may also require topical steroid eye drops.

  • Bacterial conjunctivitis. This type of conjunctivitis is usually treated with antibiotic eye drops or ointments. Bacterial conjunctivitis may improve after three or four days of treatment, but patients need to take the entire course of antibiotics to prevent recurrence.

  • Viral conjunctivitis. No drops or ointments can treat viral conjunctivitis. Antibiotics will not cure a viral infection. Like a common cold, the virus has to run its course, which may take up to two or three weeks. Symptoms can often be relieved with cool compresses and artificial tear solutions. For the worst cases, topical steroid drops may be prescribed to reduce the discomfort from inflammation. However, these drops will not shorten the infection.

  • Chemical conjunctivitis. Careful flushing of the eyes with saline is a standard treatment for chemical conjunctivitis. People with chemical conjunctivitis also may need to use topical steroids. Severe chemical injuries, particularly alkali burns, are medical emergencies and can lead to scarring, damage to the eye or the sight, or even loss of the eye. If a chemical spills in your eye, flush the eye for several minutes with a lot of water before seeing your medical provider.

Self Care

Practicing good hygiene is the best way to control the spread of conjunctivitis. Once an infection has been diagnosed, follow these steps:

  • Don't touch your eyes with your hands.
  • Wash your hands thoroughly and frequently.
  • Change your towel and washcloth daily, and don't share them with others.
  • Discard eye cosmetics, particularly mascara.
  • Don't use anyone else's eye cosmetics or personal eye-care items.
  • Follow your eye doctor's instructions on proper contact lens care.

You can soothe the discomfort of viral or bacterial conjunctivitis by applying warm compresses to your affected eye or eyes. To make a compress, soak a clean cloth in warm water and wring it out before applying it gently to your closed eyelids.

For allergic conjunctivitis, avoid rubbing your eyes. Instead of warm compresses, use cool compresses to soothe your eyes. Over-the-counter eye drops might also help. Antihistamine eye drops can alleviate the symptoms, and lubricating eye drops can rinse the allergen off the surface of the eye.