Conjunctivitis (Pinkeye)
Help for irritated eyes
Conjunctivitis is a swelling of the conjunctiva, thin membranes that line the inner eyelid and cover part of the eyeball. Commonly known as "pinkeye" because of reddening in the eye, other symptoms include discharge, swelling, and itchy eyes. Conjunctivitis is the most common eye disorder.
Pronunciation
kon-junk-ti-VEYE-tis
Synonyms
- Pinkeye
Detailed Description
Conjunctivitis, or pinkeye, is a catchall term for several disorders causing inflammation of the mucous membranes that line the inner eyelid and cover part of the eyeball, known as conjunctiva. The eye usually feels gritty and has a runny discharge. You may also experience itching or sensitivity to bright light.
The most common cause of conjunctivitis is a viral infection, which may be accompanied by a cold or sore throat. Less common are bacterial infections, often associated with middle ear infections, especially in children. Other possible causes include chemical irritation, air pollution, exposure to intense light, and an allergic reaction to a variety of substances. Genital herpes in a pregnant woman can result in a severe form of conjunctivitis in a newborn. Conjunctivitis is extremely contagious and is often transmitted by finger contact (especially from one eye to the other).
Characteristics of Conjunctivitis
Principal features of conjunctivitis include the following:
- Red, itchy, swollen eyes
- Various causes include viral, bacterial, and allergic reactions, and air pollution
- Highly contagious
- Common-sense hygiene to prevent spread
How Common Is Conjunctivitis?
The condition is extremely common. The affected age group varies, depending on the cause of the inflammation. The condition affects both males and females at the same rate.
What You Can Expect
Left untreated, conjunctivitis may spread and damage the cornea, resulting in permanently impaired vision. However, when treated, most forms clear up in a few weeks. For example, infection with bacterial conjunctivitis typically lasts about two weeks and doesn't affect vision. Viral conjunctivitis, depending on the type, can last from two to eight weeks, and can clear up on its own.
Established Causes
Conjunctivitis typically follows viral and bacterial infections, and may also be caused by an allergic reaction and chemical irritants.
Bacterial infections:
- Staphylococcus aureus (bacteria that causes skin and mucous membrane infections)
- Haemophilus influenzae (bacteria that causes respiratory infections, conjunctivitis, and meningitis)
- Gonorrhea
Viral infections:
- Adenovirus
- EKC (epidemic keratoconjunctivitis)
- Herpes simplex
- Measles
- Chickenpox
- Chlamydia
Allergens:
- Cosmetics
- Pollens (hay fever)
- Contact lenses (giant papillary conjunctivitis)
- Climate and temperature fluctuation
Chemical and other irritants:
- Common household and industrial chemicals
- Wind
- Smoke
- Ultraviolet or intense light
- Fungi and parasites
Risk Factors
There are numerous risk factors for the condition. Some of the most common:
- Sharing towels, eye makeup, and other articles that contact the eyes
- Living in an unsanitary environment
- Being a newborn child of a mother with gonorrhea or genital herpes
- Having a viral or bacterial infection
Risk factors are traits or behaviors that may make you statistically more likely than others in the general population to have a certain condition. They are not necessarily "causes" of the condition.
Symptoms
Conjunctivitis is usually a secondary condition of viral and bacterial infections, allergic reactions, or from chemical or other irritants. Depending on the cause, these signs and symptoms may vary.
Common to all causes:
- Burning sensations
- Itching of the eye or area immediately around the eye
- Discharge from one or both eyes
- Hypersensitivity to bright light
- Excessive blood in the mucous membrane lining the eyeball (conjunctiva)
- Abnormal or excessive watering of the eye
- Swelling of the eyeball's lining
- Swelling of the lymph nodes by the ears
- Growth on the inside or border of the eyelids
Conditions That May Be Mistaken for Conjunctivitis
Conjunctivitis may be misdiagnosed as other, more serious eye diseases or inflammations, and vice versa. The eye diseases that may be confused with conjunctivitis are:
- Uveitis (painful swelling of the middle of the eye)
- Acute glaucoma
- Canaliculitis and dacryocystitis (diseases that obstruct tear ducts)
- Scleritis and episcleritis (inflammation of the white of the eye)
- A foreign body under the eyelid
How Conjunctivitis Is Diagnosed
Diagnosis with a physician usually involves physical examination along with simple laboratory tests. The doctor may perform a slit-lamp exam if he or she suspects a scrape on your eye (cornea).
Laboratory Work
Simple laboratory tests are used to identify conjunctivitis:
- Cell culture from the conjunctiva
- Discharge or cell sample staining
Specific Tests
There are special tests used to diagnose specific types of conjunctivitis (i.e., bacterial and viral). The tests are usually done once the physician identifies the cause.
- Herpes simplex conjunctivitis: viral culture and immunofluorescence test for the virus, Bovin fixation and Papanicolaou stain for the presence of a specific cell found in this type of conjunctivitis
- Chlamydia: immunofluorescence test for antibody
- Lymphogranuloma venereum: Frei test (a serum test)
- Keratoconjunctivitis (inflammation of both the conjunctiva and cornea): cell culture of HeLa, cells used to culture viruses
Goals of Treatment
Depending on the cause, conjunctivitis can be easily cured. Several treatments are available to reduce symptoms and cure infections.
Treatment options
The main goal of treating conjunctivitis is to get rid of the cause of the infection-- this will determine the treatment. For example, antibiotics would only be helpful for a bacterial infection. Corticosteroid eye drops can relieve irritation but aren't used with antibiotics; they can make a herpes infection worse.
Certain treatments can help with symptoms. For example, cold compresses and artificial tears can help relieve eye irritation. Antihistamines may relieve itching and irritation. Also, several alternative therapies are quite effective for relieving symptoms.
Drug Therapy
Drugs most commonly prescribed
There are various antibacterial eye drops and ointments used to treat bacterial conjunctivitis. They may be prescribed even if a viral cause is suspected, because it is often difficult to distinguish between these two causes (and there may be secondary infections).
Commonly used broad-spectrum antibiotics:
- Ciloxan (ciprofloxin)
- Ilotycin (erythromycin)
- Sulf-10, others (sulfacetamide)
- Tobrex (tobramycin)
Surgery
In rare cases, surgery may be needed to correct severe scarring or to open clogged tear ducts.
Healthcare Professionals Who May Be Involved in Treatment
These are the health professionals who would most likely diagnose and treat this condition:
- Family physicians
- General physicians
- Ophthalmologists
- Optometrists
Activity & Diet Recommendations
Common-sense hygiene precautions, such as washing your hands often and not sharing towels, pillow cases, or makeup, can help prevent spreading the disease.
Managing Conjunctivitis Treatment
After diagnosis and initiation of treatment, you should take special considerations to manage the condition:
- If conjunctivitis is caused by a bacterial infection, make sure to take ALL the antibiotics prescribed by your physician.
- Do not share washcloths, towels, eye makeup, and other articles that contact the infected eye.
- Wash hands frequently to avoid spreading to uninfected eye.
- Use warm-water soaks to reduce discomfort.
- Don't touch the infected eye. Use disposable tissue to wipe discharge and tears, or wash your washcloth in hot water and a little bleach after each use.
- If your pinkeye is caused by allergies, avoid the allergen as much as possible.
Although different types of conjunctivitis have similar symptoms, do not share your medicine with someone else, because the medication is prescribed specifically for your condition.
Monitoring of the Condition
If you or your child has conjunctivitis, there are several warning signs that mean you should contact a physician:
- No sign of improvement in 48 hours, despite treatment
- Condition worsens in 24 hours
- Fever occurs (especially in children and infants)
- Increased pain
- Impaired vision
Possible Complications
Although conjunctivitis is usually easily treatable, if left untreated, it may lead to serious complications. As with signs and symptoms, how serious these complications are may vary with the cause of conjunctivitis:
- Damage to cornea, permanently damaging vision
- Scarring of the lids
- Bacterial superinfection
- Turning of border of eyelid, causing eyelashes to grow toward eyeball
Considerations for Women
One possible cause of conjunctivitis is an allergy to eye makeup. Discard any old eye makeup and switch to a hypoallergenic brand, or temporarily avoid eye cosmetics to see if the problem clears up. Also, eye makeup can be a breeding ground for bacteria, so never share your cosmetics.
Pregnancy
Pregnant women infected with either gonorrhea or genital herpes can give their infection to the newborn in the form of conjunctivitis. Talk to your doctor about possible risks.
Considerations for Children and Adolescents
Since conjunctivitis is highly contagious, your child's activities should be restricted until symptoms clear up. Viral conjunctivitis may accompany childhood diseases such as measles. Also, bacterial infections often occur with childhood middle-ear infections.
Current Therapies Available
A variety of effective oral medications, eye drops, and ointments are available to treat conjunctivitis. They can be used in combination or alone, but first check with your physician or pharmacist for possible harmful drug interactions.
Supplements
- Vitamin C: helps treat many viral infections. It may help with conjunctivitis.
Herbs
- Goldenseal: has antiviral action. Dilute a small amount with water to form a tincture, then use to wipe discharge from around your eyes.
Preventing Conjunctivitis
Simple hygienic practices, such as washing your hands often and avoiding touching your eyes, can help prevent the infectious form of conjunctivitis.
Conjunctivitis caused by environmental factors can be prevented with common-sense precautions. Always use a protective facemask during welding or similarly risky jobs. Wear sunglasses that screen out ultraviolet rays when in bright sunlight.
Self-Care Measures
If you already have conjunctivitis, there are ways you can avoid spreading the infection and reinfecting yourself:
- Wash your hands often with antiseptic soap.
- Use disposable towels, rather than cloth towels.
- Avoid touching your eyes; use disposable tissues moistened with warm water to wipe away discharge.
- Don't share washcloths or towels.
- Launder all bath linens in hot water, adding a little bleach as a disinfectant.
- Discard old makeup, use hypoallergenic brands, and never share cosmetics, especially mascara.
- Avoid wearing contact lenses until your infection is gone and thoroughly clean them before resuming use.
- If you're around a child with conjunctivitis, wash your hands very frequently with soap and water and consciously do not touch or rub your eyes.
- Try to keep the child's hands as clean as possible and away from his or her eyes.
Websites & Organizations
American Academy of Ophthalmology
P.O. Box 7424
San Francisco, CA 94120-7424
Phone: 415-561-8500
www.eyenet.org
American Optometric Association
243 Lindbergh Boulevard
St. Louis, MO 63141
Phone: 314-991-4100
Email: AmOptCCC@aol.com
www.aoanet.org
Canadian Ophthalmological Society
1525 Carling Avenue, Suite 610
Ottawa, Ontario, CANADA K1Z 8R9
Phone: 800-267-5763
Email: irc@lib.cnib.ca
www.cnib.ca
Eye Care
1319 F Street, NW
Washington, DC 20004
The Lighthouse Inc.
111 East 59th St.
New York, NY 10022
Phone: 212-467-9200 or 800-232-5497
National Eye Health Education Program
2020 Vision Place
Bethesda, MD 20892-3655
Phone: 301-496-5248
www.nei.nih.gov
National Institute of Allergy and Infectious Diseases
9000 Rockville Pike
Building 31, Room 7A-03
Bethesda, MD 20205
www.niaid.nih.gov
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