Pink Eye
Pink eye (conjunctivitis) is an
inflammation of the conjunctiva, a membrane covering the inner eyelid and front
of the eye.
Conjunctivitis
reddens the eye and eye-lid; thus the common name, “pink eye”.
Conjunctivitis can be infectious or
non-infectious.
Infectious pink eye is contagious.
Infectious
pink eye can be caused by bacteria or viruses.
Non-infectious
conjunctivitis can be caused by allergy, chemical irritation, underlying
inflammatory diseases, or trauma.
Description
Conjunctivitis is an inflammation of the conjunctiva, which is a
thin, transparent membrane that covers the surface of the inner eyelid and the
front of the eye. This membrane reacts to a wide range of bacteria, viruses,
allergy-provoking agents, irritants and toxic agents, as well as to underlying
diseases within the body. The conjunctiva is usually clear, but if irritation or
infection occurs, the lining becomes red and swollen.
The
common name for conjunctivitis is "pink eye". Pink eye is very common, usually
not serious, and often resolves in a few days without medical treatment.
The main
types of conjunctivitis are infectious and allergic.
Neonatal
conjunctivitis occurs in a newborn child. One of the most common causes is
sexually transmitted diseases such as chlamydia which are acquired by the baby
as it is born. This needs to be treated with antibiotics and the mother and
partner will also need treatment.
Infectious conjunctivitis is usually
caused by a contagious virus or bacteria (but may occasionally be caused by a
fungus or other organism).
"Pink eye" refers to any kind
of conjunctivitis. However, especially in schools, "pink eye" refers to a
particular viral conjunctivitis (caused by the adenovirus) that is very
contagious. Occasionally this form of pink eye can be associated with infection
of the cornea (the clear portion of the front of the eyeball).
Other
viruses, such as those causing herpes simplex, chicken pox, shingles, or
measles, can also infect the conjunctiva.
Blepharitis
is inflammation and infection of the eyelids usually marked by redness and
crusting at the margins along the lash line. This can cause a secondary
bacterial conjunctivitis. Other problems with the eyelids that can lead to or
exacerbate conjunctival irritation are styes, a lump called a chalazion, or tear
deficiency.
A raised, yellowish growth on the wall
of the eye called a pingueculum can often become inflamed by exposure to
irritating environments, such as a dry, windy climate.
Allergies
to pollen, cosmetics, animals or fabrics often bring on allergic conjunctivitis.
Chemical pink eye can result when any
irritating substance enters the eyes. Common irritants are household cleaners,
sprays, smoke, smog, industrial pollutants and chlorine in swimming pools.
Conjunctivitis may be drug-induced.
Reactions can occur to preservatives in eye drops, or after prolonged use of
topical antibiotics or antivirals.
Conjunctivitis
is a well-known complication of wearing contact lenses.
Mimicking disorders
Uncommon underlying illnesses can
cause redness of the eye, mimicking conjunctivitis. Most often these are
rheumatic diseases, such as rheumatoid arthritis and certain inflammatory bowel
diseases.
Subconjunctival haemorrhage, or "eye
bruise", occurs when a portion of the wall of the eye (white of the eye)
suddenly becomes bright red. This occurs when the tiny blood vessels covering
the whites of the eyes rupture from trauma or changes in pressure within the
head (for example, as a result of forceful laughing, coughing, sneezing or
vomiting, diving under water, or even bending upside down). This tends to be
asymptomatic and is usually pointed out by another person. It can appear quite
alarming, but is in fact a harmless haemorrhage or bruise under the conjunctiva.
The wall of the eye beneath the
conjunctiva can become inflamed (episcleritis or scleritis). These conditions
often involve only one eye. They are generally not infectious processes, and
sometimes are associated with various medical conditions. They are potentially
serious and need to be evaluated by an ophthalmologist and usually treated with
anti-inflammatory medications.
Acute
glaucoma (raised pressure within the eye) can cause a red eye.
Foreign
bodies, scrapes and sores on the cornea can cause a red eye.
Symptoms
Common symptoms of pink eye are:
Red,
watery eyes
Eye
pain
Swollen eyelids
A sandy or scratchy feeling in the
eyes, itching or burning
Mild sensitivity to light
Drainage from the eye – pus-like or
watery discharge around the eyelids may indicate an infectious form of the
disease. Discharge as a result of bacterial infection may be thick or crusty,
and is usually yellow or greenish. The discharge commonly accumulates during
sleep, often sticking the eyelids together and making it difficult to open the
eyes on waking. Viral pink eye is usually associated with a more watery
discharge that is not green or yellow, and is frequently associated with viral
"cold-like" symptoms.
Blurred vision
Prevalence
Conjunctivitis is a common condition. It affects people of all ages,
and is common in childhood. Allergic pink eye is frequently seasonal, and goes
along with other typical "allergy" symptoms such as sneezing, itchy nose, or
scratchy throat.
Treatment
Home
Home treatment will help reduce the pain of conjunctivitis and keep
your eye free of drainage.
If
you wear contact lenses, remove them and wear glasses until your symptoms have
cleared up.
Cool or warm compresses can be used,
whichever feels better. If an allergy is the problem, a cool compress may be
more soothing. With infectious pink eye, a warm, moist compress may help reduce
redness and swelling. Use a different compress for each eye, and a clean
compress for each application of warmth, to prevent spreading the infection.
Clean the eyelid margins and eyelashes
gently and repeatedly with a warm, moist cloth or cotton ball. Wipe from the
inside, next to the nose, towards the outside of the eye. Use a clean surface
for each wipe so drainage being cleaned away is not rubbed back across the eye.
Throw used wipes away. After wiping your eye, wash your hands to prevent
drainage from spreading.
If
a chemical substance has gone into the eye, wash the eye out immediately and
copiously with water or any non-irritant fluid available, and phone a doctor as
soon as possible for advice. Certain forms of conjunctivitis can develop into a
serious condition that may harm your vision. Therefore, it is important to have
conjunctivitis diagnosed and treated quickly.
The ideal treatment for allergic and
chemical conjunctivitis is to remove the cause of the allergy or irritation. For
instance, avoid contact with animals or other environmental factors that cause
an allergic reaction. Wear swimming goggles if chlorinated water irritates the
eyes. In cases where these measures won’t work, prescription and
over-the-counter eye drops are available to help relieve the discomfort.
Pink eye
may be more serious if any one of the following is applicable:
Only one eye is affected.
Your vision is affected.
It is very painful.
It
does not settle within three days.
You
wear contact lenses.
A doctor
should evaluate conjunctivitis in an infant or toddler because additional
treatments such as systemic antibiotics may be necessary.
Medication
Infectious conjunctivitis caused by bacteria is usually treated with
antibiotic eye drops or ointment and usually responds within a few days. Some
kinds of bacterial conjunctivitis need to be treated with oral antibiotics as
well as eye drops or ointments. Be careful not to use medication prescribed for
someone else, or for an old infection, as these may be inappropriate for the
current infection or may have been contaminated by previous infections.
Viruses
in general do not respond to antibiotics: the infection tends to run its course
and resolve by being fought off by your body’s immune system. Some antibiotics
may be prescribed, however, to prevent secondary bacterial infections from
developing. It is sometimes difficult to distinguish between bacterial and viral
conjunctivitis.
To apply
eyedrops or ointment:
For
older children and adults, pull the lower eyelid down with two fingers to form a
small pouch. Put the drops or ointment there. Close the eye for a minute to
prevent the medication running out of the eye.
Ask younger children to lie down with
eyes closed. For eyedrops, put a drop in the inner corner of the eye. When the
eye opens, the drop runs in. For ointment, pull the lower eyelid down to form a
pouch in which to put the ointment. Ask the child to close his or her eyes and
move the eyeball from side to side to move the drops or ointment around the eye.
With
allergic conjunctivitis topical antihistamines may be prescribed. In severe
cases short-term topical steroids may be considered.
Prevention
Viral and bacterial pink eye are contagious and spread very easily.
Poor hand washing is the main cause of the spread of pink eye. Sharing an object
with a person who has pink eye can spread the infection. Pink eye is spread
through contact with the eye discharge, which contains the virus or bacteria.
To
prevent pink eye:
Do
not share eye make-up.
Do not share contact lens equipment,
containers or solutions.
Do
not share towels, linens, pillows or handkerchiefs.
Wear safety glasses when working with
chemicals.
To
prevent the spread of pink eye:
Keep
your hands away from your eyes.
Wash
your hands before and after touching the eyes or face, or using medicine in your
eyes.
Change linens, towels and washcloths
daily, and do not share these items.
Do
not share eye make-up, contact lens equipment or eye medication.
If your eye infection was caused by a
bacteria or virus, throw away your old make-up and buy new products.
Do not use eye make-up until the
infection is fully cured, or you could reinfect yourself with the eye make-up
products.
Do not wear contact lenses until the
infection is cured. Thoroughly clean your contact lenses before wearing them
again.
Do not attend day-care, school, go to
work or use public swimming pools until symptoms of viral pink eye have begun to
improve, which should be within three to five days. Since there are no
medications to treat viral pink eye, it is important to prevent the spread of
the infection. Home treatment of the symptoms only helps you feel more
comfortable while the infection clears up.
Do not attend day-care, school, or go
to work until bacterial pink eye has been treated for 24 hours with an
antibiotic, which usually kills the bacteria.
If
eyedrops or ointment is prescribed, be sure the dropper is clean and does not
touch the eye, eyelid or any surface. Replace the dropper or bottle if their
tips touch the eye or surrounding area.
Seek treatment promptly.
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