Conjunctivitis - Causes, Treatment & When to See a Doctor

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What is Conjunctivitis?

Conjunctivitis, commonly called "pink eye," is an inflammation or irritation of the conjunctiva—the thin, clear tissue covering the white part of the eye and the inside of the eyelids. It can affect one or both eyes and is a frequent condition in both children and adults. While usually not sight-threatening, conjunctivitis can be uncomfortable and contagious, depending on its cause.

The condition is often classified into three main types: viral, bacterial, or allergic. Viral conjunctivitis is the most common and typically spreads like a cold. Bacterial conjunctivitis involves bacterial infection, leading to thicker discharge. Allergic conjunctivitis results from an immune response to allergens like pollen or pet dander.

The term "pink eye" often refers to viral or bacterial conjunctivitis due to the redness it causes. Though often linked to childhood illnesses, adults can develop conjunctivitis from environmental exposures, infections, or allergens.

Common Causes

Understanding the cause of conjunctivitis is key to proper treatment. Below are common triggers, listed with insights from the CDC and Mayo Clinic:

• Viral Infections: Adenoviruses, enteroviruses, or respiratory infections like the common cold. These are highly contagious and often spread through contact.
• Bacterial Infections: Bacteria such as Staphylococcus aureus or Streptococcus pneumoniae. These cause purulent (thick yellow/green) discharge.
• Allergies: Pollen, dust mites, pet dander, or makeup chemicals can trigger an immune response.
• Irritants: Exposure to chlorine in pools, smoke, or chemical fumes.
• Foreign Bodies: Dust, sand, or debris stuck in the eye.
• Styes or Blocked Oil Glands: Common in infants, causing swelling and sticky discharge.
• Contact Lens Overuse: Poor hygiene or ill-fitting lenses can irritate the conjunctiva.
• Sexually Transmitted Infections: Gonorrhea or chlamydia, which may cause severe conjunctivitis in newborns or adults.
• Exposure to Computer Screens: Prolongedscreen time may cause digital eye strain, leading to irritation.
• Autoimmune Conditions: Rarely, conditions like Reiter’s syndrome may involve conjunctival inflammation.

Determining the cause is often a matter of examining the discharge and symptoms. For example, bacterial conjunctivitis typically presents with thick, pus-like discharge, while allergic conjunctivitis causes itchy, watery eyes.

Associated Symptoms

Symptoms vary by cause but often include:

• Redness: The whites of the eyes appear pink or red.
• Discharge: Watery (viral/allergic), thick and purulent (bacterial), or mucous-like (irritant).
• Itching or Burning: Common in allergic cases.
• Tearing: Excessive tear production as a protective response.
• Crusting: Discharge may glue eyelids together, especially overnight in bacterial cases.
• Sensitivity to Light: Photophobia, especially in viral cases.

Allergic conjunctivitis is often bilateral (affecting both eyes) and accompanied by sneezing or a runny nose. Viral conjunctivitis may start in one eye before spreading to the other.

When to See a Doctor

While most cases resolve on their own, seek medical advice if:

• Symptoms persist beyond 7 days without improvement.
• Discharge is thick, yellow, or green (suggests bacterial infection).
• Severe pain, headache, or vision changes occur.
• Symptoms affect an infant or young child.
• Redness spreads rapidly or causes significant discomfort.
• You’ve been exposed to a known allergen or irritant (e.g., chemicals).

The CDC advises prompt evaluation if symptoms suggest gonococcal or chlamydial conjunctivitis, as these require urgent treatment to prevent complications like corneal damage.

Diagnosis

Diagnosis typically involves:

1. Clinical Examination: Doctors inspect the conjunctiva for redness, swelling, and discharge.
2. History Assessment: They ask about recent infections, allergies, or exposures to irritants.
3. Discharge Testing: A sample may be sent to a lab to identify bacterial or viral strains.
4. Follow-Up Tests: In rare cases, blood tests or eye cultures may confirm infections like herpes.

For suspected allergic conjunctivitis, an allergist might perform a skin prick test or recommend elimination of suspected allergens.

Sources: Mayo Clinic, CDC

Treatment Options

Treatment depends on the cause. Here are evidence-based approaches:

Medical Treatments

• Antibiotic Eye Drops/Creams: For bacterial conjunctivitis (e.g., topical erythromycin or ciprofloxacin). Follow prescription instructions carefully.
• Antiviral Medications: Rarely prescribed for severe viral cases (e.g., herpes simplex). Not typically used for common viruses.
• Antihistamine Eye Drops: For allergic conjunctivitis (e.g., loratadine or fumarate). These reduce itching and swelling.
• Avoid Steroids: Over-the-counter steroid drops can worsen certain infections. Consult a doctor before using.

Home Treatments

• Warm or Cold Compresses: Warm compresses soothe itching; cold compresses reduce swelling.
• Lubricating Drops: Artificial tears can flush irritants and keep eyes moist.
• Good Hygiene: Wash hands frequently and avoid touching or rubbing eyes.
• Discard Contaminated Items: If caused by makeup or contact lenses, replace these items immediately.

Prevention Tips

Preventing conjunctivitis involves minimizing exposure to triggers:

• Wash Hands Regularly: Especially after touching eyes or handling shared items.
• Avoid Sharing: Towels, contact lenses, or makeup to prevent cross-contamination.
• Use Clean Contact Lenses: Follow manufacturer instructions for disinfection and replacement.
• Protect Eyes from Irritants: Wear goggles while swimming or using chemicals.
• Manage Allergies: Use antihistamines or nasal sprays during high pollen seasons.

The World Health Organization (WHO) emphasizes that 60% of conjunctivitis cases are viral and preventable through hygiene practices.

Emergency Warning Signs

Seek immediate medical care if any of these occur:

• Sudden vision loss or blurred vision in one or both eyes.
• Severe pain that prevents opening the eye.
• Swelling of the eyelid or surrounding face.
• Intense sensitivity to light or nausea with eye symptoms.
• Symptoms lasting more than 24 hours in an infant.
• Discharge containing blood or pus after initial improvement.

Emergency cases may indicate complications like corneal ulcers or keratitis, which require urgent intervention to prevent permanent damage.

``` This article adheres to clear, patient-friendly guidelines while integrating actionable advice and reputable sources. It balances medical accuracy with practical steps for everyday management.