Pink eye is also known as conjunctivitis which literally means “inflammation of the conjunctivia.” The conjunctiva is the thin membrane that lines the inside surface of the lids and the white portion of your eye. It is one of the most common conditions seen in the medical office in kids and adults, especially because it can be contagious and parents bring their children in to the doctor because they cannot attend daycare. Kids are often sent home from school with this condition due to worry about spreading it around the classroom.
Conjunctivitis is usually not serious, and often goes away on it’s own even if no treatment is given. More serious conditions that can cause pink eyes are acute angle closure glaucoma, iritis, and infectious keratitis.
It is important to be examined by a healthcare provider since there are many conditions that can cause eye redness and discharge. Common questions that your healthcare provider may ask are: When it began? Has anyone else in the house had similar symptoms? Is there continuous discharge from the affected eye? Is the discharge watery, thin and mucus-like or thick and sticky? Are there non-eye symptoms such as cough, fever, sore throat, runny nose, or sneezing?
There are 4 main types of conjunctivitis:
1) Viral infectious
2) Bacterial infectious
3) Allergic non-infectious
Viral conjunctivitis: Can be caused by a common cold. You may have symptoms of an eye infection alone, or as part of a general cold syndrome with swollen lymph nodes (glands), fever, sore throat and runny nose. It is very contagious, and usually spread by contact with objects that have come into contact with the infected person’s secretions. An example is when the infected person touches their eye, and then touches another surface such as a door handle or shares an object that has touched their eye (pillow case for example).
Symptoms of viral conjunctivitis are redness, gritty feeling in one or both eyes, mucus or watery discharge. There might be crusting in the morning followed by watery discharge. The second eye then might also become infected within a couple days.
Treatment of viral eye infections: There is not a medicine that will cure a viral conjunctivitis. You usually will start feeling better within a few days although symptoms can get worse for the first 3-5 days. Gradual improvement usually occurs over 1-2 weeks. Morning crusting can continue for up to 2 weeks after initial symptoms although redness, irritation and tearing should be improved. A topical antihistamine eye drop may help relieve the itching and irritation of the viral eye infection. These drops do not require a prescription. A common eye drop used is called Visine (don’t use the one that says it has a decongestant or says “gets the red out.” Another antihistamine medicine that is often helpful is called Zaditor. Make sure you wash your hands to prevent spread of the infection. A warm or cool compress over the eye may also help reduce the discomfort.
Bacterial conjunctivitis: It can be very difficult to distinguish between a bacterial and viral eye infection. A bacterial eye infection is very contagious and often affects multiple family members. It is spread by contact similarly to viral eye infections. The symptoms may be redness, and thick discharge from the affected eye. Both eyes, however may become infected. Discharge may be yellow, white or green and it usually continues through the day. The affected eye is often stuck shut in the morning.
Treatment of Bacterial conjunctivitis: Usually we treat with an antibiotic eye drop or ointment. The ointments stay in the eye longer and therefore usually don’t have to be applied as often. Erythromycin ophthalmic ointment is an example, and is applied inside the lower eye-lid about 3-6 times per day for 10 days. The ointment tends to blur the vision while it’s there because it’s an ointment, so many patients prefer the drops instead. The antibiotic eye drops and applied more often (up to every 2 hours) because they are washed away easier by tears. Sometimes eye redness can get worse after using antibiotics if the patient is allergic to the drop. This is common with gentamycin antibiotic eye drops. If that occurs, switching to a different antibiotic can be helpful. The redness, irritation and discharge to should improve within 24-48 hours.
Non-Specific conjunctivitis: Sometimes inflammation of the conjunctiva of the eye occurs without infection or allergy. There are several causes for this: Dry eyes, inflammation due to contact with a chemical/irritant, or a foreign body in the eye (such as dust, or an eyelash). The redness and discharge can continue for 12-24 hours after the object is removed.
Allergic conjunctivitis: Eye symptoms/redness caused by allergies usually is accompanied by itching, and possibly a runny nose, itchy throat and sneezing. Some or all of these accompanying symptoms due not have to be present.
If you wear contact lenses: You should be examined by a health-care provider before starting treatment. Sometimes an infection to the cornea can occur when wearing contacts and that is more serious. While you have conjunctivitis, it is generally recommended not to wear your contact lenses.
When to see an eye care specialist: Usually your doctor will refer you to an eye specialist if you have any of the following symptoms which may indicate a more serious problem: Pain with eye movement, trouble seeing, difficulty keeping the eye open or sensitivity to light, severe headaches with nausea, recent eye trauma, use of contact lenses.
This document is for informational purposes only, and should not be considered medical advice for any individual patient. If you have questions please contact your medical provider.
I hope that you have found this information useful. Wishing you the best of health,
Scott Rennie, DO