Conjunctivitis, commonly known as “pink eye,” is an inflammation of the conjunctiva.
The conjunctiva is the thin, transparent mucous membrane that lines your eyelid and covers the sclera (the white of the eye.) The pink or reddish color comes from small blood vessels that become inflamed in the conjunctiva.
In the conjunctiva are glands that produce secretions to keep the eyes moist and antibodies to reduce infection. So, you can see that it plays an essential role in your eye’s health.
Causes and symptoms of Pink Eye
The usual cause is an infection by viruses or bacteria. It may also result from chemical irritants or an allergy. In cases of infection, both eyes will usually be affected.
Upon examination, a patient’s cornea (the clear, dome-shaped window of the front of your eye) should be bright, the pupil round, regular, and react to light.
A patient with Conjunctivitis will have red and irritated eyes, and the eyelids may be slightly swollen. There may also be a discharge that makes the eyelids stick together in the morning. Usually, the vision is not affected.
Conjunctivitis due to infection occurs at all ages, but some of the less common causes affect particular age groups. Conjunctivitis is common but is rarely sight-threatening.
There is one form of Conjunctivitis that can threaten sight. One that is due to Neisseria gonorrhoeae (gonorrhea.) The disease may spread to the eye by contact with genital secretions from a person who has a genital gonorrheal infection.
Viral Conjunctivitis
Conjunctivitis can be caused by several different viruses, but mainly by adenoviruses and enteroviruses.
Viruses are either RNA or DNA, the two types of nucleic acids that regulate cellular functions. Enteroviruses are single-stranded RNA viruses. Adenoviruses are double-stranded DNA viruses and one of the common causes of viral Conjunctivitis. Both are responsible for a range of diseases, including the common cold or flu-like symptoms.
Entero or Adenoviral Conjunctivitis is an epidemic form of Conjunctivitis that almost always affects both eyes. The patient may complain of a sensation of something being stuck in their eye with watering, discharge, redness, and swelling of the eyelids.
They may also complain that their eyes are sensitive to light, with blurred vision. While the eyes appear red, with discharge, the cornea and pupil are usually normal. In severe cases, there may be small hemorrhages in the conjunctiva.
Other symptoms may be upper respiratory tract symptoms and other generalized symptoms such as sore throat, fever, and headache. Viral Conjunctivitis will last 7-14 days and usually gets better on its own. However, the condition is very contagious.
Treatment: As the condition gets better on its own, there is no exact treatment for viral Conjunctivitis, Antibiotic eye drops can be applied to prevent secondary infection from bacteria, and tetracycline eye ointment can be soothing.
Bacterial Conjunctivitis
Acute conjunctivitis (acute – severe and sudden onset and short duration)
Conjunctivitis due to bacteria differs from infection due to viruses, as it is more likely to affect only one eye, and the amount of discharge and lid swelling is usually greater. The patient complains of irritation, a foreign body sensation, and the eyelids are stuck together in the mornings.
Treatment: Broad-spectrum topical antibiotic such as tetracycline eye ointment
Gonococcal Conjunctivitis
A severe form of bacterial Conjunctivitis is caused by the Gonococcus organism, which causes gonorrhea: Infection with Gonococcus can occur in:
- Newborn babies who get the infection during delivery
- Adults who are infected by sexual activity
The symptoms are very swollen eyelids, a thick and profuse discharge, and there may be an ulcerated or perforated cornea.
Treatment: Broad-spectrum topical antibiotic such as tetracycline eye ointment to the eyelids.
Chlamydia trachomatis is another sexually transmitted bacterial infection (STI) that can cause Conjunctivitis.
Chronic bacterial Conjunctivitis (chronic – develops slowly and may worsen over an extended period—months to years)
Chronic bacterial Conjunctivitis is typically due to Chlamydia and Gonococcus. The symptoms include sore eyelids and sore eyes with little discharge, while the eyes may look normal or slightly red.
Allergic Conjunctivitis
There are two types: acute and chronic.
- Acute allergic Conjunctivitis
Allergic Conjunctivitis is when the eyes are exposed to something the person is allergic to, like pollen or cats. An allergic reaction causes the eyelids and conjunctiva to become markedly swollen, and there is profuse watering of the eyes.
Although the eyes don’t usually become red, the adult or child will develop a sudden and severe itching of the eyes and eyelid. Because it is acute allergic, it is a short-term condition that can get better on its own quickly.
- Chronic allergic Conjunctivitis (vernal keratoconjunctivitis)
The conjunctiva is susceptible to irritation from allergens. Vernal keratoconjunctivitis (VKC) is an allergic disorder that’s caused by a hypersensitivity to airborne-allergens. It usually affects younger males ages 3-25. VKC is chronic, non-contagious, with seasonal recurrences generally appearing during the spring or warm weather.
The symptoms include chronic itching, a thick, clear, stringy discharge, light sensitivity, blurred vision, and discoloration of the eyes.
Treatment: Treatment is not easy at the primary level, and if the symptoms are severe or the cornea looks hazy, the management should be referred to an ophthalmologist.
Chemical Conjunctivitis
Different chemicals can get in the eyes that cause irritation and inflammation, and other symptoms of Conjunctivitis. They may be traditional remedies someone uses or a reaction to the preservatives in eye drops, or exposure to chemicals at work.
The symptoms may be similar to those seen in viral Conjunctivitis, so the patient’s history is essential to know the possible causes.
Treatment: First, it must be determined what chemical is causing Conjunctivitis before treatments can be given. Overall, it is best not to put anything in the eyes that have not been prescribed by an eye doctor.
Preventing the spread of pink eye (Conjunctivitis)
To control the spread of pink eye, use good hygiene:
- Avoid touching the eyes with your hands
- Wash your hands often
- Use a washcloth clean and towel daily
- Change pillowcases often
- Throw away eye cosmetics
- Don’t share personal eye care items
