Healthy Living

Conjunctivitis: When to See an Ophthalmologist and What to Expect

Conjunctivitis: When to See an Ophthalmologist and What to Expect

Key Takeaways

  • There are conditions and symptoms that may indicate a serious form of conjunctivitis or some worse illness. If any of the following pertain to you, see the ophthalmologist as soon as possible: moderate to severe pain in the eyes, intense redness in the eyes, an immune system that has been weakened by HIV or cancer, loss of vision, changes in vision, physical changes in the eye (e.g., conjunctivitis, black spots, cloudiness), and changes in color vision. 
  • When you visit an ophthalmologist for the first time, your appointment will be longer than you probably expected, because the ophthalmologist will need to make a thorough evaluation while considering every possible condition.
  • The doctor will also take a sample of your eyes' secretion for laboratory analysis if you appear to have very severe conjunctivitis, if your corneas are affected, or if you have had recurring infections that were unresponsive to treatment. 

Our eyes are our windows to the world, and we each get only a single pair in our lifetime. Life without our sense of sight can spell great difficulty. Imagine being born and living with good vision for decades, only to have it impaired by some disease we could have prevented or gotten treatment for. Who would want to live the rest of their lives with sub-optimal or no vision and regret over their carelessness and neglect? When we experience abnormal symptoms having to do with our eyes, therefore, we cannot afford to disregard them. Seeing an ophthalmologist is always the wise thing to do.    

Conjunctivitis, or 'pinkeye', is the inflammation of the conjunctiva, the clear lining on the whites of the eyes and the insides of the eyelids. The infection may be caused by viruses, bacteria, allergens, or other irritants. Most people see conjunctivitis as a minor discomfort and not at all a serious health risk. This is true in most cases, as long as one gets diagnosed and treated promptly.

However, cases do occur in which the disease is vision-threatening. Some forms of conjunctivitis, such as those caused by chlamydia, gonorrhea, and certain other viruses, can cause scarring of the cornea, which requires a corneal transplant to correct. Conjunctivitis in newborn babies, meanwhile, is an especially urgent matter, as it might be the kind caused by a vision-threatening virus or bacterium, or worse, might be associated with a life-threatening systemic infection.  

What are the Symptoms of Conjunctivitis?

Make an appointment with an ophthalmologist even if you think and feel the symptoms you are experiencing are minor. Consider diagnosis and treatment as important for the health and preservation of your eyes, rather than merely for your comfort. Your eyes' first line of defense is the ophthalmologist, who can diagnose and prescribe treatment for your condition, or say whether other possibilities need to be investigated. The main symptoms of conjunctivitis are the following:

  • Red/pink appearance of the white part of the eye or inner eyelid
  • Yellow discharge crusting on your lash line especially while you sleep
  • Green or white secretions 
  • Feeling the eye burning and/or itching
  • Excessive tear production by the eye
  • The eye becoming more sensitive to light
  • Blurred vision

Suspecting that you have conjunctivitis should be enough to make you book an appointment with an ophthalmologist, albeit without a sense of alarm. However, there are other conditions and symptoms that may indicate a serious form of conjunctivitis or some worse illness. If any of the following pertain to you, see the ophthalmologist as soon as possible:

  • Intense redness in the eye
  • Moderate to severe pain in the eye 
  • Loss of or major changes in vision
  • Changes in color vision
  • Other physical changes in the eye, such as black spots or cloudiness
  • An immune system that has been weakened by HIV or cancer

What Happens on My First Appointment with an Ophthalmologist? 

When you visit an ophthalmologist for the first time, your appointment will be longer than you may have expected, because the doctor will need to make a thorough evaluation as well as consider every possible condition. Your ophthalmologist will conduct some standard tests, such as check your vision and your eyes' response to light, examine samples of your eye secretions under a microscope, and possibly other tests done for specific conditions in the eyes.

You should be prepared to give all the information relevant to your eyes. There will likely be some restrictions to observe in the days before the visit, such as not using contact lenses and eye drops. List of every symptom that you have experienced and are experiencing, including any that may seem unrelated to your reason for having scheduled the appointment. Also, you should inform the ophthalmologist about any medicines, vitamins, and supplements that you are taking. Most importantly, write down every question you have for the doctor, including:

  1. What could be the most likely cause of my symptoms?
  2. What tests do I need to undergo?
  3. Is there a possible threat to my vision?
  4. How long will I be contagious if I have bacterial or viral conjunctivitis?
  5. How can I prevent infecting others?
  6. Do I need to stay home from work?
  7. Are there activities I need to refrain from doing?
  8. What treatments are available?
  9. Are there any alternative medications that can be used?
  10. Do you have reading material I can look at, or recommend any websites for me to check out? 
  11. Will I have to come back for a follow-up visit?

The ophthalmologist will also have questions for you. These are among the most common questions a doctor will ask:

  1. Is your vision affected, how, and how badly?
  2. What are the symptoms you have experienced?
  3. Do the symptoms affect one or both eyes?
  4. When did you experience the first symptom?
  5. Have your symptoms been continuous or occasional?
  6. Did anything trigger the symptoms?
  7. Is there anything that triggers the worsening of the symptoms?
  8. Do you have any allergies
  9. Do you feel pain in your eye?
  10. Do you use contact lenses?
  11. How often do you clean your contact lenses?
  12. How often do you clean your lens case?
  13. Did you start using a different brand of lenses, lens cleaner, or lubricant?
  14. What other products do you use in and on your eyes?

From the time you first experience symptoms, you should forego contact lenses and wear glasses instead. Avoid using any products in and around your eyes, including makeup. Do not share face towels with the members of your family because assuming you have an infection, you could be highly contagious. Wash your hands frequently to lessen the chances of infecting other people. Apply a cold compress on your eyes for three to five minutes several times a day or use artificial tears to ease the discomfort.

The ophthalmologist will ask you about your and your family’s health histories and conduct an eye examination. This examination will focus on assessing the visual acuity, type of discharge, and corneal opacity of your eyes. It will also assess the shape and size of your pupils as well as any eyelid swelling and abnormal protrusion of the eyeballs. Further, the inner structures of the eyes will be examined to ensure that no other tissue is affected. Eye examinations often take less than an hour, but a first appointment with an ophthalmologist may take longer than usual. But remember that keeping your eyes in a healthy condition is worth every hour you spend there.

The doctor will also take a sample of your eyes' secretion for laboratory analysis if you appear to have very severe conjunctivitis, if your corneas are affected, or if you have had recurring infections that were unresponsive to treatment. If the test shows no viruses or bacteria, the ophthalmologist will ask you to go for an allergy test to identify whether you have any allergies and identify the allergens that you have to avoid in the future.

Once the doctor has made a diagnosis, treatment will be prescribed and advice will be given depending on the type of conjunctivitis you have.

How Is Bacterial Conjunctivitis Treated?

Most bacterial conjunctivitis cases clear up in ten to fifteen days without any treatment. Using an antibiotic can shorten the duration of the infection and help prevent contagion and complications, so the doctor may prescribe antibiotic eye drops or ointment. The drops are likely to cause blurred vision for up to twenty minutes after application. 

With either form of antibiotic, the patient should expect signs and symptoms to start improving in a few days. The patient must follow the doctor's instructions on the use of the antibiotic eye drops or ointment to help prevent conjunctivitis from recurring. 
For a mild case of bacterial conjunctivitis, you might want to consider foregoing antibiotics, to avoid developing antibiotic resistance. Save your antibiotic use for more serious infections.  

How Is Viral Conjunctivitis Treated?

In most cases, no treatment is available for viral conjunctivitis. The doctor may prescribe an antiviral medication if your condition is one of the more serious forms of viral conjunctivitis, such as conjunctivitis caused by the herpes simplex virus or the varicella-zoster virus. Topical steroids drops may also be prescribed to reduce the inflammation, and artificial tears may be used to relieve the symptoms.   

Viral conjunctivitis quite often occurs first in one eye and then infects the other eye within a few days. The signs and symptoms will likely clear up as the virus runs its course over one to two weeks.

How Is Allergic Conjunctivitis Treated?

Allergic conjunctivitis is the inflammatory response of the conjunctiva to allergenic elements such as pollen, animal dander, and other environmental antigens. If you have allergic conjunctivitis, your doctor will likely prescribe medication from among many different types of eye drops for people with allergies. These could include:

  • Medicines that help control allergic reactions, such as a combination of antihistamines and mast cell stabilizers
  • Drugs that help control swelling, such as decongestants, steroids, and anti-inflammatory eyedrops