Conjunctivitis
What is conjunctivitis?
- Conjunctivitis is inflammation (redness, pain, and swelling) of your conjunctiva. Conjunctivitis is also known as pink eye. Your conjunctiva is a thin and moist skin tissue that covers the front part of your eyeball. It also covers the back of your eyelids. Your conjunctiva contains cells that help fight infections caused by germs called bacteria or viruses. If your conjunctivitis is mild, then it may heal without treatment.
- If your conjunctivitis is moderate or severe, then you may need treatment. Having your conjunctivitis treated may help you heal faster. You may be less likely to have eye problems from your conjunctivitis. Treatment may help many of your symptoms, including any redness, pain, and itching in your eye. You may become less likely to spread the infection to other people. This may help you go back to work or be around other people sooner than without treatment.
- Conjunctivitis may get better with or without treatment. Your Eye specialist may give you medicine to help relieve your symptoms. Bacterial conjunctivitis may be treated with antibiotics (germ-killing medicine). Allergic conjunctivitis is usually treated by removing the allergen (what is giving you allergies). You also may be treated with anti-allergy medicines. If you have viral conjunctivitis, it will usually go away on its own. Treatment may help decrease your symptoms and you may be less likely to spread the infection to others.
What causes conjunctivitis?
The most common infections that cause conjunctivitis are from viruses or bacteria. Conjunctivitis is also commonly caused by allergies.
- Allergies: You may have allergic conjunctivitis. This happens when the cells in your conjunctiva react to an allergen. An allergen is something that causes an allergy. Some common allergens that may appear during certain seasons include grass, dust, weeds, and mold. Allergens that commonly occur all year round include animal fur, feathers, and cockroaches. Eye medicine, mascara, or contact lens fluid may also cause allergic conjunctivitis. You may get allergic conjunctivitis once or it may happen again.
- Bacteria: You may get conjunctivitis from bacteria. You may put bacteria in your eye by accident when you touch your eye with your hand. Things that touch your eye like contact lenses and contact lens fluid may also give you bacterial conjunctivitis. Bacteria from a sexually transmitted disease (STD) may also give you conjunctivitis.
- Viral: You may get viral conjunctivitis by being around people with conjunctivitis or other infections. Some viruses that may cause conjunctivitis include adenovirus and varicella (the virus that causes chicken pox and shingles). If you are under a lot of stress, herpes simplex virus may cause conjunctivitis. Common places you may get viral conjunctivitis include work, school, and swimming pools. Viral conjunctivitis often gets better on its own without treatment.
What are the signs and symptoms of conjunctivitis?
With allergic conjunctivitis, you will usually have symptoms in both eyes. You may also have signs of other allergic conditions such as asthma, a rash, or a runny nose. With bacterial conjunctivitis, you may have crusty eyelids when you wake up in the morning. You may also have tiny bumps on your conjunctiva. Discharge may be watery with allergic or viral conjunctivitis but is usually thick and sticky with bacterial conjunctivitis. If you have viral conjunctivitis, petechiae (small dots of blood) may appear on your conjunctiva. You may also have symptoms of your virus, such as sore throat and fever (high body temperature). Other common symptoms for all three of these types of conjunctivitis include:
- Redness in the whites of your eye. Your eyes may also appear pale or milky.
- Itching in your eye, throat, or skin around your eye.
- Burning or stinging in your eye.
- Watering (tearing) of your eyes.
- Mucous or watery discharge from your eye.
- Swelling of your eye.
- Pain when you see bright light.
- Feeling like there is something in your eye.
How is conjunctivitis diagnosed?
Conjunctivitis may often be diagnosed with a physical exam and questions about your medical history and symptoms. Your Eye specialist may ask you if anyone you know has conjunctivitis or another type of infection. He will ask you if you or any of your family members have allergies. Your Eye specialist may ask you if you wear contact lenses or if you take any medicine. He may also ask you whether you have an STD. You may need any of the following:
- Eye exam: Your Eye specialist will look at your eyes, eyelids, eyelashes, and the skin around your eyes. He will ask you to look in different directions. He may gently press on your eye or eyelid to see if there is discharge. He will also look for redness and swelling in your eyelids or conjunctiva. Your Eye specialist will also look for signs of infection or allergies.
- Tests:
- Slit-lamp microscope: Your Eye specialist will use a special microscope with a bright light to look into your eye. He will look for signs of infection or inflammation. This microscope also helps your Eye specialist see if the different parts of your eyes are healthy.
- Lab tests: You may need to have blood tests to help your Eye specialist figure out what caused your conjunctivitis. Your Eye specialist may also take samples from your conjunctiva and send them to a lab for tests. The blood or tissue samples may be cultured (grown) or stained with chemicals. Your Eye specialist may also test your skin for allergies.
How is conjunctivitis treated?
Your treatment depends on what is causing your conjunctivitis. Bacterial conjunctivitis is usually treated with antibiotics (germ-killing medicine). Allergic conjunctivitis is usually treated by removing the allergen. You also may be treated with anti-allergy medicines. If you have viral conjunctivitis, it will usually go away on its own. Supportive therapy may help decrease symptoms from any type of conjunctivitis. You may need any of the following:
- Supportive therapy: Supportive therapy helps decrease your symptoms. Your Eye specialist may want you to put a cold compress on your eye to decrease swelling. Ask your Eye specialist about the proper way to use a cold compress. Your Eye specialist may also suggest you put artificial (fake) tears in your eye to help get rid of allergens. These tears also help to moisten your eye.
- Anti-allergy medicine: This medicine helps decrease symptoms from allergic reactions such as itching, redness, or swelling. This may be given as a pill or eye drops. You may also be given anti-allergy medicine to spray into your nose.
- Antibiotic medicine: Once your Eye specialist determines what type of bacteria is causing your conjunctivitis, he may give you antibiotics. Many antibiotic medicines for conjunctivitis are given as eye drops or eye ointment. Antibiotic medicine may be given as a pill, as a shot into your muscle, or using an IV. An IV is a tube placed in your vein for giving medicine or liquids. This tube is capped or connected to tubing and liquid. Antibiotics may help decrease your symptoms and shorten the time that you are sick. Antibiotics may also help prevent you from getting conjunctivitis again.
- Non-steroidal anti-inflammatory medicine (NSAIDs): NSAIDs may help decrease your itching, pain, redness, and swelling.
- Steroid medicine: Steroid medicine may be given to decrease inflammation. This medicine may be given to you as eye drops, by mouth, or as a nasal spray. Steroids can help a lot but may also have side effects. Be sure you understand why you need steroids. Do not take more steroids than your Eye specialist says to take. Do not stop taking this medicine without your Eye specialist’s Instruction. Taking too much steroids or stopping on your own can cause problems.
How do I avoid getting or spreading conjunctivitis?
- Wash your hands often: Use soap and water every time you wash your hands. Wash your hands often, including after every time you touch your eyes. Avoid touching your eyes, nose, and mouth unless you have washed your hands first. Family members should also wash their hands often.
- Do not touch or rub your eyes: The best way to avoid infection is not to touch your eye. This way you will maintain the natural tear film barrier which protects you against many organisms.
- Avoid allergens: Try to avoid the things that give you allergies, such as pets. Dust and clean your home or work area often. Use cotton or synthetic (man-made) material for your bed covers. Use a cover for your mattress and pillows. If you are allergic to pollen, keep your bedroom windows closed. If possible, stay inside on days when there is a high pollen count in the air.
- Avoid contact: If someone you know has conjunctivitis, try not to touch anything that he has used. If you have conjunctivitis, stay away from others as much as possible and isolate yourself in a room. Avoid public places with a lot of people, such as school, work, and swimming pools. Do not return to work or school until your Eye specialist says it is OK.
- Do not share makeup: If you or someone your known has conjunctivitis, do not share makeup.
- No preventive Medicine: There are no medicines that you put and the conjunctivitis will not occur. Rather by putting medicines in your normal eye, you are inviting infection to your eye – because by this way you are breaking the natural tear film barrier which protects you from many organisms.
- Use separate linens: Do not share sheets and towels with anyone else.
- Use separate Drops & medicine: Do not share Eye Drops and Ointment with anyone else. Keep yours drops and ointment for you only.
What are the risks of having conjunctivitis?
- You may have a burning, itching, or stinging feeling in your eye when you use eye drops or ointment. Taking anti-allergy medicine may make you drowsy, or cause dryness of your eyes, nose, or mouth. Antibiotics may cause you to have a bad taste in your mouth. Your eyes may also become sensitive to light. Your eyes may water (tear) more than usual or become crusty. You may have an allergic reaction to your medicine and have trouble breathing.
- Using steroid medicine may cause serious eye problems, such as glaucoma (increased pressure in the eye). Steroids may also cause you to have cataracts (clouding of the eye) and poor eyesight. Without treatment, you may get scars or sores in your eye. Bacteria in your eye may infect your sinuses (holes in your skull). Bacteria may also infect the other parts of your eye and the tissue lining your brain. Your eyesight may become worse or you may become blind. If you get a serious eyeball inflammation like ophthalmitis or cellulitis, you may die. Ask your Eye specialist if you have questions or concerns about your condition or care.
When should I consult my Eye specialist?
Consult your Eye specialist if:
- Your eye pain becomes worse, even after taking pain medicine.
- You have a new rash on your skin that your Eye specialist has not seen.
- Your eyesight becomes blurry.
- You have tiny bumps or spots of blood on your eye.
- You have your questions or concerns about your condition, treatment, or care.
When should I seek immediate care?
Seek care immediately if:
- You suddenly have pain and swelling in your eyelids or around your eyes.
- Your vision suddenly becomes worse or you cannot see anything at all.
- Your eye begins to bleed.
Tips & Warnings
- Health care professionals usually recommend keeping a child with conjunctivitis out of school while symptoms are present.
- If you know your child is prone to allergic conjunctivitis, keep windows and doors closed when the pollen count is heavy. Vacuum and dust often to decrease the allergic triggers in the home.
- If your child develops increased redness, tenderness and swelling in the eyelids and around the eye, along with a fever, call your Eye specialist. These symptoms may indicate the infection has spread beyond the conjunctiva, requiring additional treatment.
Teach your child to wash his hands often with warm soap and water. Make sure you wash your hands thoroughly after touching your child's eyes or upon administering eye drops or other medication, as this will prevent the conjunctivitis from spreading.
Wash any toys or hand-held items that your child may have come in contact with while exhibiting symptoms of conjunctivitis. Wash all towels and washcloths separately from the rest of the laundry.
