Pink Eye (Conjunctivitis)

1 What is Pink Eye (Conjunctivitis)?

Pink eye (conjunctivitis) is an inflammation or infection of the conjunctiva. The conjunctiva is the transparent membrane that lines your eyelid and covers the white part of your eyeball. Pink eye is typically caused by a bacterial or viral infection or an allergic reaction.

When the blood vessels in the conjunctiva become inflamed, this causes your eyes to appear reddish or pink.

Pink eye affects either one or both eyes, but it rarely affects your vision. It can be irritating, though there are treatment options that can help ease the discomfort.

Pink eye is contagious and in order to prevent its spreading to other individuals, it is important to diagnose and treat the eye condition as soon as possible.

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2 Symptoms

Signs and symptoms of pink eye (conjunctivitis) include:

  • Redness – If your eyes appear reddish or have the appearance of a pinkish color, this may indicate conjunctivitis. Simply put, as the blood vessels in your eyes become inflamed, they give out a reddish hue. Consult with your doctor for an early diagnosis and proper treatment.
  • Gritty sensation – If you continue to experience a gritty sensation in and around one or both your eyes, then chances are that the blood vessels in your eyes are inflamed. Should your symptoms persist, it is important that you seek help from your doctor right away.
  • Itchy eyes – If you have developed a persistent itching sensation in and around your eyes, this may be a sign of conjunctivitis. It could, however, also be on account of another medical issue. In any case, consult with your doctor to determine the exact reason behind the itchy sensation. He or she can help you receive the necessary treatment you require.
  • Discharge during the night – A discharge that forms a crust during the night can make it difficult for you to open your eyes in the morning. If you have watery discharge, this is a sign of viral conjunctivitis. If you have a thicker yellow-greenish discharge, this is a sign of bacterial conjunctivitis. Any type of conjunctivitis may cause eye discharge; however, the condition can easily be treated with the right medication. It should help alleviate some of your symptoms right away.
  • Increased tearing – If you find yourself in tears for no reason at all, it could be an issue with your tear ducts or conjunctivitis. This particular condition can cause you to become teary-eyed because the eyes tend to produce excess tears to combat irritation.

When to see a doctor

Talk to your doctor if you experience any signs or symptoms of pink eye (conjunctivitis).

This eye condition can be highly contagious for up to two weeks after the symptoms appear. To limit the spreading of conjunctivitis, it is important to diagnose and treat the eye condition early on.

If you wear contact lenses, stop using them as soon as your symptoms appear. If your eyes don’t get better within 12-24 hours, it is imperative that you visit your doctor to check if you have a more severe eye infection related to contact lenses use.

Even if you have another severe eye condition that is causing eye redness, it is necessary to see your doctor if you are experiencing eye pain, blurry vision or light sensitivity.

3 Causes

The causes of pink eye (conjunctivitis) include:

  • Bacteria - Bacteria can cause your eyes to develop conjunctivitis, though the infection can be safely treated with antibiotics.
  • Virus – A viral infection can also cause conjunctivitis and it is quite contagious. For this reason, it is important that you wash your hands with a disinfectant after touching your eyes.
  • Allergies – Allergic conjunctivitis is typically a response to an allergy-causing substance in the form of conjunctivitis. If you have allergic conjunctivitis, you may experience frequent discharge from both eyes.
  • A chemical splash in the eye – Sometimes, your eyes may tear up from coming into contact with a chemical substance. These substances further inflame the blood vessels in your eyes, causing a mild case of conjunctivitis.
  • A foreign object in the eye – The eye is a wonderful and complex organ and it is designed to react immediately to any foreign objects that it comes into contact with. If your eyes start getting watery, this could be on account of a foreign object. If this is the case, it is important that you avoid rubbing your eyes and seek immediate help from an ophthalmologist.

Viral and bacterial conjunctivitis, both very contagious conditions, spread through direct or indirect contact with the secretion of infected eyes. While both adults and children can develop pink eye, children are more likely to become infected with bacterial conjunctivitis. This is due to the fact that they are more likely to take fewer precautions with others suffering from conjunctivitis.  

Allergic conjunctivitis affects both eyes and is a response to allergens (substances that triggers allergic reactions). An example of such an allergen is pollen. In response to allergens, your body produces an antibody known as immunoglobulin E (IgE). This antibody triggers mast cells (which are present in the mucosal lining of the eyes) and releases inflammatory agents known as histamines. The release of histamine generates a number of allergy signs and symptoms, including pink eye. When you develop allergic conjunctivitis, you may experience excessive itchiness, increased tearing and eye inflammation along with sneezing and watery nasal discharge.

Irritation from a chemical splash or the presence of a foreign object in your eye is also associated with conjunctivitis. In some instances, symptoms such as redness and irritation can be caused by flushing and cleaning the eye to get rid of the chemical or foreign object. The signs and symptoms – which may include watery eyes and mucous discharge - typically disappear within a few days.

Pink Eye VS Allergy

4 Making a diagnosis

To diagnose pink eye, your doctor will ask you about your medical history and any symptoms that you are currently experiencing. He or she will then proceed to give you an eye examination.

Visit your doctor if you experience any worrisome signs and symptoms of pink eye. You may be referred to an ophthalmologist (an eye specialist) if your symptoms don't resolve, despite given treatment.

If you have allergic conjunctivitis, you may be referred to an allergy specialist.

How should you prepare myself for a visit to the doctor?

Preparing for a visit to your doctor can help you receive the necessary treatment you require.

Write down important information such as:

  • A list of all your symptoms (from pain and irritation to watery discharge). Describe your symptoms in detail so that your doctor is able to make an accurate diagnosis.
  • A list of all medications, vitamins, or supplements you are currently taking. This is done to rule out allergic conjunctivitis since you may have developed an allergic reaction to one of the current medications or dietary supplements you are taking.
  • A list of the questions that you would like to ask your doctor. Doing so can help you clear up any doubts or worries you may be experiencing.

What type of questions should you ask your doctor?

  • What are the possible causes of my symptoms?
  • Do I need to undergo any tests?
  • What are my treatment options?
  • After starting treatment, am I still considered contagious?
  • Do I need a follow-up examination?
  • Can this condition pose any threat to my vision?

A clear, informative and insightful talk with your doctor can help you receive the necessary treatment you require and improve any outcomes. Your doctor may also ask you a few essential questions about your condition so be prepared with your answers.

What type of questions will your doctor ask you?

  • When did you first start noticing the symptoms?
  • Do you experience these symptoms occasionally or continuously?
  • Has the condition affected one or both of your eyes?
  • How severe are your symptoms?
  • Do you use contact lenses? How do you clean them?
  • How often do you replace your contact lenses storage case?
  • Are you aware of any particular factor that relieves or worsens your symptoms?
  • Have you recently been in close contact with any individuals suffering from pink eye or flu symptoms?
  • Is your vision affected?

The doctor may take a sample of the discharge from your eyes for analysis if:

  • You have severe conjunctivitis
  • Your cornea is affected
  • You are not responding to treatment and the inflammation occurs on an ongoing basis. Consultation with a specialist, along with further analysis, should help identify the underlying cause and determine the proper treatment you need to receive.

Your doctor may even suggest undergoing an allergy test in order to identify possible allergens in case of allergic conjunctivitis.

What should you do in the meantime?

  • Do not use contact lenses until you see your doctor. Contact lenses are known to inflame the blood vessels in your eyes and using them during the onset of conjunctivitis is not recommended. In fact, they may cause your symptoms - pain and irritation - to worsen. It may be a better idea to consider wearing glasses until your eye inflammation clears up completely.
  • Wash your hands on a regular basis and don’t share your any towels or toiletries in order to minimize the risk of infecting others. Sharing even a handkerchief with another individual can cause the contagion to spread. More so, avoid touching your eyes repeatedly and always use a disinfectant on your hands before touching everyday objects.
  • Apply warm or cold compresses /use artificial tears to soothe your eyes. Applying such compresses can actually help to relieve some of your most painful symptoms and soothe your eyes.
  • Avoid any known allergens. If you know that you are allergic to certain substances, it is definitely advisable that you avoid them in order to avoid developing an allergic reaction. Any allergic reaction can result in a full-blown case of allergic conjunctivitis.

5 Treatment

In most cases, pink eye (conjunctivitis) begins to heal within a week or two without any treatment.

Your doctor may prescribe antibacterial eye drops or an ointment which can help speed up the healing process.

Your vision may not be clear for up to 20 minutes after applying the ointment. Any signs or symptoms of pink eye tend to disappear within a few days after the use of medication. To prevent the recurrence of the infection, your doctor may prescribe an antibiotic to be consumed only for a specific time period.

Typically, no treatment is prescribed for viral conjunctivitis. However, an antiviral medication may be prescribed if the infection is caused by Herpes Simplex Virus. Viral conjunctivitis usually begins with infection of one eye followed by infection of the other. The signs and symptoms tend to disappear within a week or two.

Allergic conjunctivitis is treated with a combination of antihistamines and mast cell stabilizers that control the allergic reaction. The eye drops contain anti-inflammatory drugs, steroids, or decongestants.

6 Prevention

To prevent and limit the spreading of pink eye (conjunctivitis), practicing good hygiene is essential. A few preventative tips include the following:

  • Avoid touching your eyes with your hands. The more you touch your eyes with your hands, the more likely it is that you will end up spreading the contagion and infecting others. Try to limit touching the infected area with your bare hands as much as possible.
  • Wash your hands frequently. When you are outside, keep a hand sanitizer handy and use it to remove the germs from your hands. Using a disinfectant spray on your hands is also a good way to eliminate any germs and limit their spread.
  • Always use a clean towel and wash your clothes frequently. Remember not to share your clothes (especially towels) with other members within your family so that you avoid spreading the infection. You may even want to consider keeping your clothes in a separate pile from those of your family members and washing them separately in hot water.
  • Do not use eye cosmetics when you have an eye infection. Using cosmetics when you are suffering from conjunctivitis is not advisable, as it can cause further eye irritation and discomfort.
  • Avoid sharing eye cosmetics or personal eye care items. Sharing personal cosmetics with others (even a simple mascara stick) can spread the infection to the other individual. Avoid sharing your cosmetic products until your condition clears up.
  • Take antibiotics for the entire time period that they are prescribed. If you expect quick relief and recovery from your current condition, then you will be required to use a broad spectrum of antibiotics for the duration of the infection until your eyes begin to clear up.
  • Do not send your children to school if they have bacterial or viral conjunctivitis. Your child should wait a minimum of 24 hours after starting treatment before going back to school. It is best to consult with your doctor and confirm whether it is ok to send them back to school. After all, you wouldn’t want your child to infect the other children at their school.

Newborns are vulnerable to the bacteria present in the mother's birth canal. This bacterium can cause ophthalmia neonatorum (a severe form of conjunctivitis).

Ophthalmia neonatorum should be treated immediately in order to preserve eyesight. This explains the typical application of antibiotic ointment to the eyes of newborns.

7 Lifestyle and coping

Lifestyle modifications are necessary in order to cope with pink eye (conjunctivitis). They include:

  • Applying a warm or cool compress to help relieve symptoms. You can make a compress by soaking a clean cloth either in warm or cool water and wringing it out, followed by gently applying it to the closed eyelids.
  • Avoiding touching both eyes with the same compress if only one of your eyes is affected. Touching both eyes with the same hand, or for that matter with the same handkerchief, can help to spread the infection to the other eye as well.
  • Avoiding wearing contact lenses until your symptoms disappear. Ask your doctor whether your disposable contact lenses need to be thrown away. If your contact lenses are not disposable, clean them properly before re-using them. Make sure that you wash the lenses with a disinfectant and you completely sanitize them before re-using them again.
  • Using over-the-counter eye drops (artificial tears) to relieve conjunctivitis symptoms.
  • Using eye drops that contain antihistamines or other medications to relieve symptoms associated with allergic conjunctivitis.
  • Avoiding the excessive use of eye drops to prevent eye rebounding (rebound hyperemia).
  • Avoiding allergens to prevent allergic conjunctivitis.
  • Washing your clothes frequently and showering before bedtime to help prevent the possibility of allergic conjunctivitis.

8 Risks and complications

Your risk of contracting pink eye (conjunctivitis) increases with:

  • Exposure to allergens
  • Direct or indirect contact with an individual suffering from viral or bacterial conjunctivitis
  • Use of contact lenses (they tend to aggravate the condition, which is why it is advised to avoid wearing contacts until your eyes have completely cleared up).

Pink eye can affect vision if the cornea is inflamed. To minimize this risk, you should visit your doctor for diagnosis and treatment as soon as possible. Any delay in seeking effective diagnosis and treatment can result in other complications to your health – one of which is impaired vision.

Seek help from your doctor or specialist right away and seek immediate treatment if you suspect pink eye (conjunctivitis). Avoid the intake of any over-the-counter medication until you know more about the underlying cause of your condition.

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