Conjunctivitis, also called pink eye, is one of the most frequently seen eye diseases, especially in kids. It can be caused by viruses, bacteria or even allergies to pollen, chlorine in swimming pools, and ingredients in cosmetics, or other irritants, which touch the eyes. Some forms of conjunctivitis might be quite transmittable and quickly spread in school and at the office, others pose no risk of transmission.
Conjunctivitis is seen when the conjunctiva, or thin transparent layer of tissue covering the white part of the eye, becomes inflamed or irritated. You can identify conjunctivitis if you notice eye redness, discharge, itching or swollen eyelids and a crusty discharge surrounding the eyes upon waking. Pink eye can be roughly divided into three main types: Infectious(i.e. bacterial/viral), inflammatory(i.e. allergic, autoimmune) or toxic/chemical(i.e. smoke in the air).
Infectious Pink Eye has two main culprits: Viral and Bacterial. The viral type is usually highly contagious and can also can accompany common viral upper respiratory infections such as the common cold. Viral conjunctivitis usually will make your eyes red, sometimes itchy and produce a watery discharge. Typically the infection starts in one eye and quickly spreads to the other eye and can last from usually one to two weeks but is usually self limiting (meaning it will clear up without treatment) and in most cases will have no longer lasting affects. Unfortunately antibiotics will not work against viruses and no other eye drops or ointments are effective against the common viruses that cause viral conjunctivitis. Treatment is aimed mainly at reducing symptoms and ensuring no lingering inflammatory concerns. Treatment can involve antihistamines to reduce itching, decongestants to reduce swelling, vasoconstrictors to reduce redness, cold compresses to reduce swelling and artificial tears to sooth the surface. Remember hygiene is critical to stop the spread of the virus to the opposite eye and anyone around you or your children.
A bacterial conjunctivitis will produce a thick eye discharge or pus and can affect one or both eyes. It will usually be treated with antibiotic eye drops or cream unless very severe, with many different topical options available dependent on things like severity. One should usually notice an improvement in symptoms and signs within just a few days of treatment, but be sure to adhere to the full prescription regime to prevent it from relapsing.
An example of inflammatory pink eye is Allergic conjunctivitis which is not contagious. It is usually a result of a known allergy such as hay fever or pet allergies that sets off an allergic reaction in their eyes. First of all, to treat allergic pink eye, you should eliminate the irritant. Use cool compresses and artificial tears to relieve discomfort and wash away the allergens in mild cases. When the reaction is more severe, your eye doctor might prescribe a medication such as an anti-inflammatory or antihistamine dependent on your needs.
Chemical conjunctivitis can result from a variety of exposures such as chloramines in pool water to additives in makeup. Again the key is avoidance where possible and washing away the irritant with an eyewash or artificial tears drops. Symptoms can be mild but if severe can include vision changes, pain, light sensitivity together with the “pink eye” presentation which need immediate assessment from your eye doctor. Toxic conjunctivitis usually implies a reaction to a medication or preservative and in some cases can take years to develop. Recognition of the diagnosis of toxic conjunctivitis and stopping the toxic treatment is the most critical step. Changing to a preservative free medication or changing to oral delivery can help as well as using preservative free artificial tears and cold compresses but they need to be monitored by their eye doctor.
Pink eye should always be diagnosed by a qualified eye doctor in order to identify the type and best course of treatment. Never treat yourself! Keep in mind the sooner you begin treatment, the lower chance you have of giving pink eye to loved ones or prolonging your discomfort. If you have questions we are here to help. Call now or book your medical appointment online – all medical appointments are covered by Alberta Health Care.
Dr. Peter Roed