Conjunctivitis

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Pink Eye is very common. There are likely over 5 million cases in the US a year. It's a common reason for kids to miss daycare or school.

It is the inflammation or infection the layer covering the eyeball or the inside the eyelids. It can cause the white of the eye to become pink.

Cases are usually mild. Some may need antibiotics (if bacterial). These antibiotics can often come as eye drops, rather than pills.

What does Pink Eye cause?

  • Can affect one or both eyes
  • Pink or red color of the whites of the eyes
  • Eye discharge and crusting
  • Itchy eyes
  • Eyelid swelling

What causes Red Eye?

  • Viruses
  • Bacteria
  • Allergies
  • Irritants (chlorine in a pool, air pollution, dirt, small "foreign body" in the eye)

When should you seek help?

Most cases are mild. Many get better on their own. There are times when you should seek help quickly:

  • Pink eye in a newborn
  • New blurry vision (that doesn't clear with wiping discharge out of the eye)
  • Bright light hurts (sensitivity to light)
  • Bad or moderate Pain
  • Red eye(s) rather than just pink, especially if any pain
  • Suspicion of herpes, chickenpox, shingles being involved
  • Bacterial conjunctivitis not getting better on antibiotics after a day
  • Already have eye problems that may put you more at risk
  • Immune system weakness - such as from chemotherapy, cancer, HIV, or immune suppressive drugs for Rheumatoid Arthritis or other diseases
  • Small object in the eye that did not flush out

You should talk to your healthcare provider about any concerns. Your doctor or nurse can help decide what type of Pink Eye you have and what treatment - if any - would be best.

How is spreading stopped?

Conjunctivitis is often spread by touching. One child rubs an itchy eye and then touches another child.

The child may even touch a door knob or countertop that another child touches, who then touches her eye. The infection can also spread from contact with other body fluids - tears, coughs, and even diapers, for some viruses. Infections can spread quickly in day care settings.

To be careful:

  • Wash your hands. This is always a good idea.
  • Don't rub or touch your eyes - whether you're infected or not
  • Avoid sharing eye make-up, contact lenses, contact lens containers, and even eyeglasses
  • If it is caused by allergens or irritants, it won't spread from person to person.

Viral Conjunctivitis - caused by a virus

  • Spreads easily between people, causing outbreaks.
  • Can begin in one eye and spread to the other
  • Can be caused by many different viruses, which may also cause a cold, sore throat, or cough.
  • Usually clears up within 1 to 2 weeks without treatment and without complications. Sometimes it can take 3 weeks.

There are many viruses that cause viral conjunctivitis. Many viruses will clear up on their own. Adenovirus is the most common cause.

Enteroviruses are also common.

A few less common infections can lead to more complications. Chickenpox and Shingles (Varicella and Zoster) can lead to dangerous eye problems for some if the infection has spread to the eye. Others can have herpes infections of the eye.

Measles can also cause conjunctivitis.

Bacterial Conjunctivitis - caused by bacteria

  • Can spread from one eye to another
  • Common infection in daycare. Most cases in children under 5.
  • Most cases are mild and last 2-3 days, sometimes up to 2-3 weeks.
  • Antibiotics may be prescribed (such as topical antibiotics)

Bacteria to blame are often Staph Aureus (including MRSA), Strep pneumo, H flu, or Moraxella catarrhalis. Chlamydia trachomatis or Neisseria gonorrhoeae - both STDs - can cause infections in the eyes of newborns who catch the bacteria at birth. These require antibiotics.

In other cases, infection is often spread by hands touching eyes. The infection can also spread by coughs and sneezes in some cases.

There are ways for your doctor to tell bacterial and viral cases apart. Bacterial infections may case white, thicker (purulent) discharge, while viral infections can cause more watery eyes. Your doctor will know the medical history and whether any contacts have had similar cases and can best decide your course of treatment, as needed.

Allergic Conjunctivitis

Allergic responses can occur when our bodies react to pollen, grasses, plants, mold, animal dander, and dust mites. Some may have reactions to smog or chlorine in the pool or to contact lenses, their lens solutions, eye make-up, or perfume.

It is important to avoid the irritant if possible (like eye make up or smog) if that helps. Otherwise, some need medications for their allergies (like seasonal allergy medications).

Allergic Conjunctivitis usually occurs

  • in people who have allergic reactions, like those with seasonal allergies, asthma, or eczema, 
  • in both eyes at once
  • in certain seasons - if the allergen causing the reaction is seasonal
  • all year round - if the allergen, like eye make-up or dust mites, is found all year round

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