Conjunctivitis (Pink Eye)

Conjunctivitis is one of the most common and treatable eye infections in children and adults. Often called "pink eye," it is an inflammation of the conjunctiva, the tissue that lines the inside of the eyelid. This tissue helps keep the eyelid and eyeball moist.

Whether caused by an allergen, a viral or bacterial infection, or a chemical reaction, conjunctivitis is characterized by hyperemia of the conjunctiva. The disorder is transmitted by contaminated towels, wash­cloths, or the patient's own hand and usually spreads rapidly from one eye to the other. Commonly benign and self-limiting, it seldom affects vision. Chronic conjunctivitis may signal degenerative changes or damage from repeated acute attacks.

Acute bacterial conjunctivitis - or pinkeye - usually lasts about 2 weeks. Some viral conjunctival infections may last 2 to 3 weeks, whereas others follow a chronic course and may produce severe disability. In the western hemisphere, conjunctivitis is probably the most common eye disorder.

Causes

Conjunctivitis may be triggered by a virus, bacteria, an allergic reaction (to dust, pollen, smoke, fumes or chemicals) or, in the case of giant papillary conjunctivitis, a foreign body on the eye, typically a contact lens. Bacterial and viral systemic infections also may induce conjunctivitis.

Pink Eye Symptoms and Signs

• Redness in the white of the eye or inner eyelid
• Greater amount of tears
• Thick yellow discharge that crusts over the eyelashes, especially after sleep (in conjunctivitis caused by bacteria)
• Other discharge from your eye (green or white)
• Itchy eyes (especially in conjunctivitis caused by allergies)
• Burning eyes (especially in conjunctivitis caused by chemicals and irritants)
• Blurred vision
• Increased sensitivity to light

Diagnostic tests

Stained smears of conjunctival scrapings show mostly monocytes if a virus causes conjunctivitis. Polymorphonuclear cells (neutrophils) predominate if bacteria cause conjunctivitis, and eosinophils predominate if an allergen causes conjunctivitis.

Culture and sensitivity tests may be used to identify a bacterial pathogen and indicate appropriate antibiotic therapy.

Treatment

A patient with bacterial conjunctivitis requires an appropriate topical antibiotic. Although viral conjunctivitis resists treatment, broad-spectrum antibiotic eye-drops may prevent secondary infection. Herpes simplex infection generally responds to trifluridine drops vidarabine ointment, or oral acyclovir, but the infection may persist for 2 to 3 weeks. Treatment for a patient with vernal conjunctivitis includes instilling corticosteroid drops followed by lodoxamide tromethamine (Alomide), a histamine1-receptor antagonist, cold compresses to relieve itching and, occasionally, oral antihistamines.

Instillation of a one-time dose of tetracycline or erythromycin ointment in the eyes of neonates prevents gonococcal and chlamydial conjunctivitis.

Is It Contagious?

All types of infectious conjunctivitis are contagious and can spread from one eye to the other by touching the eyes

Prevention

Good hygiene can help prevent the spread of conjunctivitis:

• Wash your bed linens, pillowcases, and towels in hot water and detergent.
• Don't share eyedrops or cosmetics such as eyeliner, eye shadow or mascara. Replace them after you're healed, to avoid re-infection.
• Wash your hands after applying the eye drops or ointment to your eye or your child's eye.
• Wash your hands often with soap and warm water.
• Replace eye cosmetics regularly.
• Do not share towels or handkerchiefs.

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