Conjunctivitis (Pinkeye)

Conjunctivitis, also known as pinkeye, is an inflammation of the conjunctiva. The conjunctiva is the thin clear tissue that lies over the white part of the eye and lines the inside of the eyelid.

What Causes Pinkeye?

Pinkeye has a number of different causes, including:

  • Viruses
  • Bacteria (such as gonorrhea or chlamydia)
  • Irritants such as shampoos, dirt, smoke, and pool chlorine
  • Allergies, like dust, pollen, or a special type of allergy that affects some contact lens wearersConjunctivitis, also known as pinkeye, is an inflammation of the conjunctiva. The conjunctiva is the thin clear tissue that lies over the white part of the eye and lines the inside of the eyelid.

    What Causes Pinkeye?

    Pinkeye has a number of different causes, including:

    • Viruses
    • Bacteria (such as gonorrhea or chlamydia)
    • Irritants such as shampoos, dirt, smoke, and pool chlorine
    • Allergies, like dust, pollen, or a special type of allergy that affects some contact lens wearersPinkeye caused by some bacteria and viruses can spread easily from person to person, but is not a serious health risk if diagnosed promptly. Pinkeye in newborn babies, however, should be reported to a doctor immediately, as it could be a vision-threatening infection.

      .

      What Are the Symptoms of Pinkeye?

      The symptoms of pinkeye differ based on the cause of the inflammation, but may include:

      • Redness in the white of the eye or inner eyelid
      • Increased amount of tears
      • Thick yellow discharge that crusts over the eyelashes, especially aftersleep
      • Green or white discharge from the eye
      • Itchy eyes
      • Burning eyes
      • Blurred vision
      • Increased sensitivity to light

      See your eye doctor if you have any of these symptoms of pinkeye. Your eye doctor will conduct an exam of your eyes and may use a cotton swab to take a sample of fluid from the eyelid to be analyzed in a lab. Bacteria or viruses that may have caused conjunctivitis, including those that can cause a sexually transmitted disease or STD, can then be identified and proper treatment prescribed.

    • What Can I Do to Relieve Symptoms of Pinkeye?

      To relieve the symptoms of pinkeye:

      • Protect your eyes from dirt and other irritating substances.
      • Avoid the use of makeup.
      • Remove contact lenses if you wear them.
      • Non-prescription “artificial tears,” a type of eye drops, may help relieve itching and burning from the irritating substances causing your pinkeye. However, other types of eye drops may irritate the eyes and should not be used, including those promoted to treat eye redness. Note: Do not use the same bottle of drops in an uninfected eye.Conjunctivitis is a common condition that causes redness and inflammation of the thin layer of tissue that covers the front of the eye (the conjunctiva).

        People often refer to conjunctivitis as red eye.

        Other symptoms of conjunctivitis include itchiness and watering of the eyes, and sometimes a sticky coating on the eyelashes (if it’s caused by an allergy). Read more about the symptoms of conjunctivitis.

        Conjunctivitis can affect one eye at first, but usually affects both eyes after a few hours.

        What causes conjunctivitis?

        The conjunctiva can become inflamed as a result of:

How Is Pinkeye Treated?

The treatment for pinkeye depends on the cause.

Conjunctivitis

  • Bacteria. Pinkeye caused by bacteria, including those related toSTDs, is treated with antibiotics, in the form of eye drops, ointments, or pills. Eye drops or ointments may need to be applied to the inside of the eyelid three to four times a day for five to seven days. Pills may need to be taken for several days. The infection should improve within a week. Take or use the drugs as instructed by your doctor, even if the symptoms go away.
  • Viruses. This type of pinkeye often results from the viruses that cause a common cold. Just as a cold must run its course, so must this form of pinkeye, which usually lasts from four to seven days. Viral conjunctivitis can be highly contagious. Avoid contact with others and wash your hands frequently especially before handling food that you touch with your fingers before you eat it. If you wear contact lenses, you should throw away contacts worn while you have pinkeye and wear glasses. Same for makeup.  If you develop blurred vision with pinkeye, see your eye doctor immediately. Some viruses cause scarring of the cornea.
  • Irritants. For pinkeye caused by an irritating substance, use water to wash the substance from the eye for five minutes. Your eyes should begin to improve within four hours. If the conjunctivitis is caused by acid or alkaline material such as bleach, immediately rinse the eyes with lots of water and call your doctor immediately.
  • Allergies. Allergy-associated conjunctivitis should improve once the allergy is treated and the allergen removed. See your doctor if you have conjunctivitis that is linked to an allergy.

 

How Can I Prevent Spreading Pinkeye?

If you or your child has pinkeye:

  • Don’t touch or rub the infected eye(s).
  • Wash your hands often with soap and warm water, especially before eating.
  • Wash any discharge from your eyes several times a day using a fresh cotton ball or paper towel. Afterwards, discard the cotton ball or paper towel 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.
  • Never wear another person’s contact lenses.
  • Wear eyeglasses 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 and glasses.
  • Wash your hands after applying the eye drops or ointment to your eye or your child’s eye.
  • Do not use eye drops that were used for an infected eye in a non-infected eye.
  • If your child has bacterial or viral pinkeye, keep your child home from school or day care until he or she is no longer contagious. It’s usually safe to return to school when symptoms have been resolved; however, it’s important to continue practicing good hygiene just to be sure.

 

What Are the Complications of Pinkeye?

Usually, pinkeye is a self-limited disease, either clearing up on its own or after a course of antibiotics. However, certain forms of conjunctivitis can become serious and sight-threatening, because they can causecornea scarring. They include conjunctivitis caused by gonorrhea, chlamydia, or certain strains of the adeno virus.

How Can I Avoid Getting Pinkeye?

Viral pinkeye is highly contagious. However, maintaining proper hygiene such as frequent hand washing should minimize transmission. Avoid touching your face since the virus can enter the eyes, nose, and mouth.

With regards to allergic conjunctivitis, avoiding allergens and taking proper care of your contact lenses can help reduce your risk. If someone in your household has pinkeye, be sure to wash hands often and thoroughly. Avoid sharing washcloths, towels, pillowcases, mascara, or eyeliner with the person.

Eye drops are commonly given to treat conjunctivitis. Learn how to effectively insert eye drops.

Treating conjunctivitis

Treatment isn’t usually needed for conjunctivitis, because the symptoms often clear up within a couple of weeks. If treatment is needed, the type of treatment will depend on the cause. In severe cases, antibiotic eye drops can be used to clear the infection.

Irritant conjunctivitis will clear up as soon as whatever is causing it is removed.

Allergic conjunctivitis can usually be treated with anti-allergy medications such as antihistamines. If possible, you should avoid the substance that triggered the allergy.

It’s best not to wear contact lenses until the symptoms have cleared up. Any sticky or crusty coating on the eyelids or lashes can be cleansed with cotton wool and water.

Washing your hands regularly and not sharing pillows or towels will help prevent it spreading.

Read more about treating conjunctivitis.

See your GP immediately if you have:

  • eye pain
  • sensitivity to light (photophobia)
  • disturbed vision
  • intense redness in one eye or both eyes
  • a newborn baby with conjunctivitis 
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Prevention

The best effective prevention is hygiene and not rubbing the eyes by infected hands. Vaccination against adenovirushaemophilus influenzaepneumococcus, and neisseria meningitidis is also effective.[citation needed]

Povidone-iodine eye solution has been found to prevent conjunctivitis following birth.[20] As it is less expensive it is being more commonly used for this purpose globally.[20]

Management

Conjunctivitis resolves in 65% of cases without treatment, within two to five days. The prescription of antibiotics is not necessary in most cases.[21]

Viral

Viral conjunctivitis usually resolves on its own and does not require any specific treatment.[10] Antihistamines (e.g., promethazine) or mast cell stabilizers (e.g., cromolyn) may be used to help with the symptoms.[10] Povidone iodine has been suggested as a treatment, but as of 2008 evidence to support it was poor.

Allergic

For the allergic type, cool water poured over the face with the head inclined downward constricts capillaries, and artificial tears sometimes relieve discomfort in mild cases. In more severe cases, nonsteroidal anti-inflammatory medications and antihistamines may be prescribed. Persistent allergic conjunctivitis may also require topical steroid drops.

Bacterial

Bacterial conjunctivitis usually resolves without treatment.[10] Topical antibiotics may be needed only if no improvement is observed after three days.[23] In people who received no antibiotics, recovery was in 4.8 days, with immediate antibiotics it was 3.3 days, and with delayed antibiotics 3.9 days. No serious effects were noted either with or without treatment.[24] As they do speed healing in bacterial conjunctivitis, their use is also reasonable.[25]

In those who wear contact lenses, are immunocompromised, have disease which is thought to be due to chlamydia or gonorrhea, have a fair bit of pain, or who have lots of discharge, antibiotics are recommended.[10] Gonorrhea or chlamydia infections require both oral and topical antibiotics.[10]

When appropriate, the choice of antibiotic varies, differing based on the cause (if known) or the likely cause of the conjunctivitis.Fluoroquinolonessodium sulfacetamide, or trimethoprim/polymyxin may be used, typically for 7–10 days.[11] Cases of meningococcal conjunctivitis can be treated with systemic penicillin, as long as the strain is sensitive to penicillin.

When investigated as a treatment, Povidone-iodine ophthalmic solution has also been observed to have some effectiveness against bacterial and chlamydial conjunctivitis, with a possible role suggested in locations where topical antibiotics are unavailable or costly.

Chemical

Conjunctivitis due to chemicals is treated via irrigation with Ringer’s lactate or saline solution. Chemical injuries (particularly alkali burns) are medical emergencies, as they can lead to severe scarring and intraocular damage. People with chemically induced conjunctivitis should not touch their eyes, regardless of whether or not their hands are clean, as they run the risk of spreading the condition to another eye.

 

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