NOT QUITE IN THE PINK?

Many of us remember waking up as children with crusted eyes, red and watering, painful to the touch, with bright light adding to the discomfort. These are typical symptoms of conjunctivitis. Conjunctivitis or pinkeye, as it is often called, is an infection or inflammation of the conjunctiva, the clear membrane over the white of the eye and the inner eyelids, causing them to become red or pink. Most frequently seen in children, it can occur in adults, adolescents and sometimes new-borns. While it may look and feel uncomfortable, it is usually not serious.

What causes conjunctivitis?

There are three main types of conjunctivitis each with a different cause. Infectious conjunctivitis is most often caused by a bacteria or virus, often those associated with a cold or upper respiratory infection. Allergic conjunctivitis occurs commonly among people who have seasonal allergies and is usually an allergic reaction to organisms in the environment. It can occur in people who wear contact lenses. Irritants in the environment including swimming pool chemicals or air pollution can lead to chemical or reactive conjunctivitis.

What are the symptoms of conjunctivitis?

As the name ‘pink eye’ implies, the classic symptom is red eyes.

Other symptoms include swelling, pain, itching, burning, watering, puffiness around the eyes, a gritty feeling in the eyes and sensitivity to bright light. There may be a discharge from the eyes and its nature depends on the cause – in the case of viral or allergic conjunctivitis, it is clear and watery, while the discharge with a bacterial infection is yellow or green and may crust the eyelids overnight.

Allergic conjunctivitis is often accompanied by symptoms such as coughing, sneezing and a runny nose in response to an allergen.

Is it necessary to see a doctor?

It is advisable to seek medical intervention if the conjunctivitis does not clear after 3 – 4 days, if the eyelid becomes swollen and painful, if the child has a fever and is lethargic, or if he complains of problems with his vision.

How is conjunctivitis diagnosed?

The doctor or optometrist will ask questions to determine the symptoms, when they began, the possible cause and whether any general health or environmental conditions may be contributing to the problem. The conjunctiva and other eye tissue will be examined, and a test of visual acuity may be done to assess whether vision has been affected.

A smear of the conjunctiva or sample of the discharge may be taken to ascertain the virus or bacteria responsible for the infection and to indicate the appropriate treatment.

How is conjunctivitis treated?

Treatment depends on the cause of the condition and has three main goals. These are to lessen discomfort, to reduce the course of the inflammation or infection and to prevent its spread. Conjunctivitis caused by a virus, like a cold, usually needs to run its course until it goes away without any specific treatment. If it is caused by bacteria it is treated with antibiotic eye drops or ointment or sometimes oral antibiotics.

For allergic conjunctivitis, antihistamine medication may be prescribed, either orally or in eye drops.

Careful flushing of the eyes with cold water or a saline solution is a standard treatment for chemical conjunctivitis, but severe chemical injuries, particularly alkali burns, are medical emergencies and need immediate medical intervention.

The discomfort of conjunctivitis can be eased by applying warm or cool compresses (or even cooled tea bags) to the eyes and wiping them gently several times a day with clean cotton wool soaked in warm water. Over-the-counter eye drops or artificial tears may help to soothe the eyes. Ask your optometrist to suggest the most suitable one.

It is advisable not to wear contact lenses until the conjunctivitis has cleared. It is usually recommended to keep children with contagious conjunctivitis out of school for a few days to prevent it spreading to other children. Remind children not to touch their eyes, to wash their hands regularly and to use a separate towel.

How does conjunctivitis spread?

Bacterial and viral conjunctivitis are highly contagious and spread rapidly by direct contact with the eyes or contact with objects that were contaminated such as towels or used tissues. Like a cold, it is possible for it to spread by coughing and sneezing, and conjunctivitis in one eye can infect the other eye by rubbing or touching the infected eye.

Conjunctivitis caused by a bacteria can spread to others as soon as symptoms appear and for as long as there is discharge from the eyes.

Viral conjunctivitis is generally contagious before symptoms appear and can remain so as long as the symptoms last. Practicing good careful hygiene is the most effective way to control the spread of conjunctivitis.