Conjunctivitis

Jai Ganesh · Yesterday 17:14:01

Conjunctivitis

Gist

Conjunctivitis (pink eye), specifically bacterial and viral types, spreads rapidly through direct contact with an infected person's eye secretions, touching contaminated surfaces, or inhaling airborne droplets from coughs/sneezes. It is highly contagious, often spreading via unwashed hands touching the eyes. Contrary to myths, it does not spread by just looking at someone.

Inflammation of the conjunctiva is known as conjunctivitis and is characterized by dilation of the conjunctival vessels, resulting in hyperemia and edema of the conjunctiva, typically with associated discharge. The prevalence of conjunctivitis varies according to the underlying cause, which may be influenced by the patient’s age, as well as the season of the year.

Summary

Conjunctivitis, also known as pink eye, is inflammation of the conjunctiva, the thin and clear layer that covers the white surface of the eye and the inner eyelid. It makes the eye appear pink or reddish. Pain, burning, scratchiness, or itchiness may occur. The affected eye may have increased tears or be stuck shut in the morning. Swelling of the sclera may also occur. Itching is more common in cases that are due to allergies. Conjunctivitis can affect one or both eyes.

The most common infectious causes in adults are viral, whereas in children bacterial causes predominate. The viral infection may occur along with other symptoms of a common cold. Both viral and bacterial cases are easily spread among people. Allergies to pollen or animal hair are also a common cause. Diagnosis is often based on signs and symptoms. Occasionally a sample of the discharge is sent for culture.

Prevention is partly by handwashing. Treatment depends on the underlying cause. In the majority of viral cases, there is no specific treatment. Most cases that are due to a bacterial infection also resolve without treatment; however antibiotics can shorten the illness. People who wear contact lenses and those whose infection is caused by gonorrhea or chlamydia should be treated. Allergic cases can be treated with antihistamines or mast cell inhibitor drops.

Between three and six million people get acute conjunctivitis each year in the United States. Typically they get better in one or two weeks. If visual loss, significant pain, sensitivity to light or signs of herpes occur, or if symptoms do not improve after a week, further diagnosis and treatment may be required. Conjunctivitis in a newborn, known as neonatal conjunctivitis, may also require specific treatment.

Details

Pink eye (conjunctivitis) is inflammation in your eyes. It happens when the membrane that covers the white of your eye is irritated. Viral and bacterial infections are the most common causes. You may not need treatment. But visit a healthcare provider if you have symptoms that are getting worse after a few days.

What Is Pink Eye?

What does pink eye look like? The white of your eye will be light pink to reddish and you might have puffiness, crusting or fluid (discharge) coming from your eye.
Pink eye is inflammation in the conjunctiva in your eye. The conjunctiva is the clear membrane that covers part of your eye and the inside of your eyelid. The medical name for pink eye is conjunctivitis. It’s extremely common. It can affect one eye or both at the same time.

Pink eye can be short term (acute) or long term (chronic). Acute pink eye lasts for fewer than four weeks. Chronic pink lasts for more than four weeks.

Pink eye caused by an infection can easily spread. You can accidentally pass it to other people or spread it from one eye to the other.

What does conjunctivitis look like?

Just like it sounds, pink eye can make the white part of your eye look pink or reddish. It can also make your eyelids look puffy or droopy. You may notice discharge coming from your affected eyes.

Symptoms and Causes

The most common conjunctivitis symptoms include:

* Red eye
* Thick eye discharge (yellow, green or white)
* Crusting on your eyelashes or eyelids
* Feeling like something’s stuck in your eye
* Dry, watery, itchy, irritated eyes
* Burning eyes
* Blurred vision (may come and go)
* Light sensitivity
* Swollen eyelids
* Eye pain (usually mild)

Pink eye can share symptoms with lots of other eye conditions. An eye doctor can help you understand what’s affecting your eyes.

Pink eye causes

Lots of issues and conditions can cause pink eye. Healthcare providers usually divide conjunctivitis into two categories — infectious and noninfectious.

Infectious pink eye

This happens when an infection causes conjunctivitis. Any type of infection can cause pink eye, including:

* Viral infections: Infections from the adenovirus family are the most common cause of acute pink eye. Other viral infections that can cause viral conjunctivitis include measles, mumps, COVID-19, eye herpes, molluscum contagiosum and hand, foot and mouth disease. Some viruses that cause sexually transmitted infections (STIs) can lead to pink eye.
* Bacterial infections: Bacterial infections are the second most common cause of pink eye. The bacteria that cause staph infections, strep throat and some types of meningitis can all cause bacterial conjunctivitis. STIs like chlamydia, gonorrhea and syphilis can, too.
* Fungal and parasitic infections: It’s possible for a fungus or parasite to cause pink eye. But it’s much less common than pink eye from a viral or bacterial infection.

Noninfectious conjunctivitis

This happens when something other than an infection causes conjunctivitis. This is pink eye that doesn’t spread to you from other people, animals or contaminated objects.

Examples include:

* Allergens: Molds, pollen or other substances that cause allergies can irritate your conjunctiva. This is called allergic conjunctivitis.
* Irritants or toxic substances: Anything that gets in your eye can cause inflammation. This includes soap, cosmetics, dirt, smoke or pool chlorine. Your contact lenses or contact solution can irritate your eyes sometimes, too, even if they usually don’t. Some medications can cause pink eye as a side effect.
* Eye injuries: Anything that damages your conjunctiva can lead to conjunctivitis.
* Other health conditions: Autoimmune diseases can irritate your eyes. It’s much less common, but so can tumors or eye cancers.

What are the complications of pink eye?

Untreated conjunctivitis can cause permanent eye damage and even blindness. But this is rare. Complications that can lead to vision loss include:

* Trachoma
* Uveitis
* Corneal inflammation and cornea-conjunctiva inflammation
* More severe corneal diseases, especially corneal ulcers and recurrent corneal erosions

See an eye doctor or your primary care provider if symptoms are getting worse after more than a few days. That’s the best way to avoid complications.

Diagnosis and Tests:

How doctors diagnose pink eye

A healthcare provider will diagnose conjunctivitis with an eye exam. They’ll examine your eye and ask about the symptoms. Tell your provider when you first noticed symptoms and how they’ve changed or gotten worse.

Your provider may also test for bacterial infections. They’ll use a soft-tipped swab to collect some of the fluid oozing from your eye for lab testing. Your provider can use the results to guide your treatment.

You might need a follow-up appointment. Your provider will make sure your eyes are healing and check for signs of complications.

Management and Treatment:

How is conjunctivitis treated?

Most of the time, you can treat pink eye symptoms at home until they get better. Your healthcare provider will suggest ways to manage symptoms, including:

* NSAIDs like ibuprofen (Advil® or Motrin®)
* Corticosteroids
* Applying a warm or cool compress to your eye (don’t share washcloths or towels with others)
* Artificial tears
* Wearing your glasses instead of contact lenses while you have symptoms

If an irritant gets in your eye, you need to rinse it out. Flush your eyes with warm water for five minutes. If a strong acid or alkaline substance (like drain cleaner) gets in your eye, flush your eyes the same way. Then, get immediate emergency medical attention.

Your provider might give you medications to treat a specific cause, including:

* Antivirals: Many viruses that cause pink eye don’t need treatment. But your provider will treat herpes simplex, chickenpox/shingles or an STI. These infections have a higher risk of complications.
* Antibiotics: Eye drops, ointments and pills can all treat bacterial infections.
* Antifungals or antiparasitics: These medications treat infections from fungi or parasites.
* Allergy medications: Your provider will suggest prescription or over-the-counter antihistamines or decongestants to manage allergies.
* Immunosuppressants: These medications can treat autoimmune diseases. They calm your immune system and can prevent it from damaging your eyes.

How long does pink eye last?

How long conjunctivitis lasts depends on what caused it. Viral infections typically last up to two weeks. It’s rare, but some may last longer. Bacterial infections usually last up to 10 days. Allergy-related pink eye lasts as long as you’re around the allergen causing the reaction.

When should I see my healthcare provider?

Visit a healthcare provider if you think you have pink eye and the symptoms keep getting worse after a few days.

Some symptoms can be a sign of a serious problem, like an eye ulcer. Visit a healthcare provider right away if you experience:

* A severe sensitivity to light
* Blurred vision or a decrease in vision
* Severe eye pain
* Feeling like there’s something stuck in your eye
* A large amount of eye discharge
* Worsening symptoms

Outlook / Prognosis:

What can I expect if I have conjunctivitis?

The outlook for pink eye is good, especially with treatment. Milder cases often go away on their own.

Call your provider if it seems like treatments aren’t helping. They may be able to adjust your medications.

Can conjunctivitis come back?

Yes, pink eye can come back. Allergy-related pink eye is the most likely kind to happen again. Your eyes may react every time you’re exposed to an allergen.

If you have bacterial or viral pink eye, you can accidentally reinfect yourself. To avoid that, you should:

* Wash your bed linens, pillowcases, towels and washcloths in hot water and detergent. Change them frequently.
* Avoid wearing eye makeup until the infection goes away. Throw out old eye makeup, makeup tools and any makeup you used right before you got pink eye.
* Wear glasses instead of contact lenses while you have conjunctivitis. Clean your glasses often.
* Throw away the contacts and the case you were using right before you noticed symptoms. Only use sterile contact solution. Wash your hands before touching your eyes and contacts.

Prevention:

How can you prevent conjunctivitis?

You may not always be able to prevent pink eye. But you can lower your risk of some types by:

* Washing or sanitizing your hands frequently: Use soap and water if your hands look or feel dirty. If they don’t look or feel dirty, you can use an alcohol-based hand sanitizer (at least 60% alcohol).
* Wearing eye protection: Make sure you wear the right eyewear for any work or hobbies. If you wear glasses, don’t assume they’re enough to protect your eyes.
* Never sharing things that touch your eyes: Grooming and hygiene items can spread conjunctivitis very easily. Don’t share makeup tools, personal grooming items, washcloths or anything else that directly touches your eyes.
* Safely using eye drops: Wash your hands before picking up the bottle. Only touch your face with the hand that isn’t holding the bottle. Make sure the bottle tip doesn’t touch your eye. After you put the drops in, set the bottle down, wash your hands and then put it away.

Additional Information

Pink eye is an inflammation of the transparent membrane that lines the eyelid and eyeball. This membrane is called the conjunctiva. When small blood vessels in the conjunctiva become swollen and irritated, they're more visible. This is what causes the whites of the eyes to appear reddish or pink. Pink eye also is called conjunctivitis.

Pink eye is most often caused by a viral infection. It also can be caused by a bacterial infection, an allergic reaction or — in babies — an incompletely opened tear duct.

Though pink eye can be irritating, it rarely affects your vision. Treatments can help ease the discomfort of pink eye. Because pink eye can be contagious, getting an early diagnosis and taking certain precautions can help limit its spread.

Symptoms

The most common pink eye symptoms include:

* Redness in one or both eyes.
* Itchiness in one or both eyes.
* A gritty feeling in one or both eyes.
* A discharge in one or both eyes that forms a crust during the night that may prevent your eye or eyes from opening in the morning.
* Tearing.
* Sensitivity to light, called photophobia.

When to see a doctor

There are serious eye conditions that can cause eye redness. These conditions may cause eye pain, a feeling that something is stuck in your eye, blurred vision and light sensitivity. If you experience these symptoms, seek urgent care.

People who wear contact lenses need to stop wearing their contacts as soon as pink eye symptoms begin. If your symptoms don't start to get better within 12 to 24 hours, make an appointment with your eye healthcare professional to make sure you don't have a more serious eye infection related to contact lens use.

Causes

Causes of pink eye include:

* Viruses.
* Bacteria.
* Allergies.
* A chemical splash in the eye.
A foreign object in the eye.
* In newborns, a blocked tear duct.

Viral and bacterial conjunctivitis

Most cases of pink eye are caused by adenovirus. It also can be caused by other viruses, including herpes simplex virus and varicella-zoster virus.

Both viral and bacterial conjunctivitis can occur along with colds or symptoms of a respiratory infection, such as a sore throat. Wearing contact lenses that aren't cleaned properly or aren't your own can cause bacterial conjunctivitis.

Both types are very contagious. They are spread through direct or indirect contact with the liquid that drains from the eye of someone who's infected. One or both eyes may be affected.

Allergic conjunctivitis

Allergic conjunctivitis affects both eyes. It is a response to an allergy-causing substance such as pollen. In response to allergens, your body produces an antibody called immunoglobulin E (IgE). IgE triggers special cells in the mucous lining of your eyes and airways to release inflammatory substances, including histamines. Your body's release of histamine can produce a number of allergy symptoms, including red or pink eyes.

If you have allergic conjunctivitis, you may experience intense itching, tearing and inflammation of the eyes. You also could have sneezing and watery nasal discharge. Most allergic conjunctivitis can be controlled with allergy eye drops. Allergic conjunctivitis is not contagious.

Conjunctivitis resulting from irritation

Irritation from a chemical splash or foreign object in the eye also is associated with conjunctivitis. Sometimes flushing and cleaning the eye to wash out the chemical or object causes redness and irritation. Symptoms, which may include watery eyes and a mucous discharge, usually clear up on their own within about a day.

If flushing doesn't resolve the symptoms, or if the chemical is a caustic one such as lye, see your healthcare professional or eye specialist as soon as possible. A chemical splash into the eye can cause permanent eye damage. Ongoing symptoms could indicate that you still have the foreign body in your eye. Or you also could have a scratch on the cornea or the membrane covering the eyeball, called the conjunctiva.

Risk factors

Risk factors for pink eye include:

* Exposure to someone infected with the viral or bacterial form of conjunctivitis.
* Exposure to something you're allergic to, for allergic conjunctivitis.
* Using contact lenses, especially extended-wear lenses.

Complications

In both children and adults, pink eye can cause inflammation in the cornea that can affect vision. Prompt evaluation and treatment by your healthcare professional can reduce the risk of complications. See your professional if you have:

* Eye pain.
* A feeling that something is stuck in the eye.
* Blurred vision.
* Light sensitivity.

Prevention:

Preventing the spread of pink eye

Practice good hygiene to control the spread of pink eye. For instance:

* Don't touch your eyes with your hands.
* Wash your hands often.
* Use a clean towel and washcloth daily.
* Don't share towels or washcloths.
* Change your pillowcases often.
* Throw away old eye cosmetics, such as mascara.
* Don't share eye cosmetics or personal eye care items.

Keep in mind that pink eye is no more contagious than the common cold. It's okay to return to work, school or child care if you're able to practice good hygiene and avoid close contact. However, if work, school or child care involves close contact with others, it may be best to stay home until your or your child's symptoms clear up.

Preventing pink eye in newborns

Newborns' eyes are susceptible to bacteria present in the mother's birth canal. These bacteria often cause no symptoms in the mother. In some cases, these bacteria can cause infants to develop a serious form of conjunctivitis known as ophthalmia neonatorum. This condition needs immediate treatment to keep the baby's sight. That's why shortly after birth, an antibiotic ointment is applied to every newborn's eyes. The ointment helps prevent eye infection.

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Conjunctivitis

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