During the summer months, parents and their kids often go swimming to cool off and have a good time. Consider 9 y/o Johnny who emerges from the swimming pool one Saturday afternoon with “bloodshot eyes.” What to do?
Or consider Dan who accidentally poked himself in the eye while working in the backyard. His wife notices that the eye is red and asks,
“Do you have any pain? Can you see OK?”
“The pain is not too bad; the vision is just a little blurry. It’s nothing to worry about.” What to do?
Conjunctivitis, commonly called “pink eye,” is an inflammation or infection of the thin, transparent membrane (conjunctiva) that lines the inside of the eyelid and covers the outer, white part of the eyeball or sclera. (see figure below).
When the conjunctiva becomes inflamed, its blood vessels become enlarged and more visible causing the white of the eyeball to appear pink or reddish, “bloodshot.”
Pink eye is common, affecting about 3 million Americans, both young and old, every year. It can spread easily, particularly, in day care centers and schools. It usually doesn’t affect vision and the treatment depends on the cause of the problem.
Sclera is the white part of the eye. The conjunctiva covers the sclera and lines the inside of the eyelid.
Symptoms of Conjunctivitis – “Pink Eye”
The signs or symptoms of pink eye vary depending on the cause of the inflammation… It can affect one or both eyes and seldom do patients have the isolated complaint of just redness of the eye. The symptoms include:
- Redness in one or both eyes
- Tearing
- Discharge which may be clear, yellow or green
- Itchiness
- Burning, irritated eyes
- Gritty, foreign body feeling in the eye
- Crusting, matting together of eyelids and lashes especially in the morning
- Sensitivity to light
- Can’t use contact lenses
Courtesy National Eye Institute
Causes of Conjunctivitis — Pink Eye
The appearance of the sclera alone is not enough to make an accurate diagnosis of conjunctivitis. Many conditions cause redness of the eye. A careful medical history, eye examination and, at times, certain tests are needed to make the correct diagnosis and initiate proper treatment.
Most cases of conjunctivitis are caused by viruses and allergies. The three major categories of conjunctivitis are viral, bacterial and allergies.
- Viral
- Bacterial
- Allergies
- Irritants — substances that cause irritation to the eye —
- In newborns a blocked tear duct
- Dry eyes
- Chronic inflammation of the eyelids — Blepharitis
Viral conjunctivitis is a frequent, highly contagious form of pink eye. Adenoviruses, those viruses found in the common cold and upper respiratory infections (U.R.I.s), frequently cause pink eye. Less commonly, the herpes virus causes this problem.
Bacterial conjunctivitis is also highly contagious. This bacterial infection has been caused by Staphylococcus and Streptococcus. It often results in eye redness with green and yellow discharge (pus).
Allergic conjunctivitis affects both eyes and is non-contagious. It can be caused by allergies to dust, mold, pollen, animal dander and other allergens.
Irritants are substances that that can cause conjunctivitis such as cosmetics, contact lenses, chlorine in a swimming pool or a spec of dirt in the eye. When Should You See the Eye Specialist? The National Eye Institute recommends that you should “seek medical attention if you have the following symptoms”:
- Moderate to severe pain in the eye(s)
- Vision problems
- Intense redness
- If the symptoms worsen or persists
- If you have a compromised immune system from HIV or cancer treatments
Treatment of Conjunctivitis – Pink Eye
Many conditions are associated with pink eye and most of them do not require a medical prescription. Treatment is determined by what causes the problem.
Symptom relief can be obtained by the use of artificial tears for dry eyes, cold packs for inflammation, clean the eyelids with a damp cloth or antihistamine drops for pink eye due to allergies. Of growing concern is the inappropriate use of antibiotics for conjunctivitis.
According to Ophthalmologist, Dr. Kenneth Pearlberg, “There’s a tendency to over-prescribe antibiotics for conjunctivitis. Antibiotics do not help allergic or viral conjunctivitis. They do nothing for these conditions. They should not be prescribed.”
He continued, “On the other hand, antibiotics do help patients with bacterial conjunctivitis. And antiviral medications do help people with pink eye due to herpes simplex. The bottom line is you need the right diagnosis.”
References
American Academy of Ophthalmology; Five Things Physicians and Patients Should Question; Feb 21, 2013
Shekawat, NS et all; Antibiotic Fills for Acute Conjunctivitis …; Ophthalmology, June 14, 2017
NIH, National Eye Institute; Facts About Pink Eye; November, 2015
Kenneth R. Pearlberg, MD FACS — Chairman, Medical Advisory Board, HC Smart, Inc.(A personal communication).
This article is intended solely as a learning experience. Please consult your physician for diagnostic and treatment options.