Conjunctivitis

Symptoms Of Conjunctivitis

Conjunctiva refers to the mucous membrane that covers the outer surface of your eyes and is responsible for maintaining a healthy eye and vision. Conjunctivitis refers to the inflammation and infection of the conjunctiva. You may suspect conjunctivitis if you have: 

• Pink or red color in the white of the eyes

• Burning, irritation or itching in the eyes

• Discharge of mucus or pus from the eyes

• Swelling of the layer lining the white part of the eye and the eyelid(inside part of the eyelid)

• Increased production of tears

• A constant feeling of a foreign object in your eyes

• A constant urge to rub your eyes

• Thick mucous discharge that crusts over of lashes especially after waking up making the eye difficult to open

• Pain and tearing in eyes

• Increased sensitivity to light

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Causes Of Conjunctivitis

Conjunctivitis may be caused by pathogens such as bacteria,viruses or some allergens and irritants. Some of the most common causes of conjunctivitis are described below:

1. Infectious causes of conjunctivitis

These types of conjunctivitis are contagious ie. They can easily spread from an infected person or by something an infected person has touched, such as a used tissue. The various types of infectious causes are as follows:

• Bacterial conjunctivitis is very common in children and some of the common bacterias responsible for conjunctivitis are Staphylococcal species such as Staphylococcus aureus, H. influenza, S. pneumoniae, and Moraxella catarrhalis. Bacteria such as Streptococcus pneumoniae and Haemophilus influenzae cause conjunctivitis in adults.

• Viral conjunctivitis is also quite common in adults. This type of conjunctivitis is very contagious and often spreads in schools and other crowded places. Viruses such as Adenoviruses, Herpes simplex, Herpes zoster, and Enterovirus are known to cause conjunctivitis.

2. Non-infectious causes of conjunctivitis

These conjunctivitis are not contagious and are usually caused by some allergen or irritant:

• Allergic conjunctivitis is the body's reaction to allergens or allergic substances. It affects both eyes and is a response to an allergy causing substance such as pollens, dust mites, molds, dander from pets, medicines or cosmetics etc. Allergic conjunctivitis is more common in people with other allergic conditions, like hay fever, asthma, and eczema. One may also experience symptoms like sneezing and watery nasal discharge along with symptoms of conjunctivitis.

• Giant papillary conjunctivitis is a type of allergic conjunctivitis caused by the long term presence of a foreign body in the eye. People who wear inflexible contact lenses, use soft contact lenses that are not changed frequently or have a prosthetic eye are more prone to develop this kind of conjunctivitis.

• Irritant conjunctivitis is caused by irritants like smoke, dust, fumes. Toxins like chemicals from the chemical industry or the chemicals/gases used in a laboratory or caustic materials like bleach can cause conjunctivitis and in some cases a chemical splash can lead to permanent damage to the eye as well.  

Risk Factors Of Conjunctivitis

You are at a high risk of contracting conjunctivitis if you:

• Are exposed to people who are infected with conjunctivitis

• Share items such as towels, pillow cases, makeup products with the infected individual

• Have sinusitis

• Have certain immunodeficiency diseases, trauma, other eye diseases and exposure to congenital sexually transmitted disease increases your risk of this condition

• Wear contact lenses for extended hours particularly during their sleep which put you at a high risk of bacterial corneal infection

Diagnosis Of Conjunctivitis

Conjunctivitis is usually confirmed by a physical examination by your eye doctor or ophthalmologist. 

Lab tests such as eyelid cultures are rarely performed. Eyelid cultures are usually carried out when you are facing recurrent infections of conjunctivitis or the infection is not getting better with medications. In certain cases an RT-PCR test may be advised for conjunctivitis caused by the viruses. 

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Prevention Of Conjunctivitis

You can follow these easy tips to prevent conjunctivitis:

• Keep your hands clean by washing them often with soap and water for at least 20 seconds.

• It is advised to wash your hands thoroughly before and after cleaning, and before putting eye drops or ointment to your eye which is infected. 

• Do not share eye drops, or personal items such as makeup, sunglasses with the person infected to prevent the occurence of conjunctivitis.

• Do not touch or rub your eyes. This is responsible for spreading the infections and making it even worse. 

• Do not wear contact lenses for long-hours. 

Specialist To Visit 

It is a must to visit your doctor at the earliest in the case of the following conditions:

• Pain in the eye

• Increased sensitivity to light or blurry vision, which remains even after wiping the tears or discharge from the eyes 

• Bloodshot or intense redness in the eyes

• If your symptoms don’t improve or get worse, which includes pink eyes that do not improve even after 24 hours of taking antibiotics

• If your newborn is suffering from conjunctivitis

• If you have a weakened immune system for example an HIV infection or if you are undergoing a cancer treatment, or other medical conditions and are suffering from conjunctivitis

To get relief from the symptoms, you can visit 

• General Physician

• Ophthalmologist

If you can't go for an in-person visit, you can do a "video visit" instead. Online consultations are becoming more and more popular.

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Treatment Of Conjunctivitis

The treatment of conjunctivitis depends on the cause of the symptoms. There are mainly three types of conjunctivitis namely viral, bacterial and allergic conjunctivitis. Different treatment options for these types of conjunctivitis are as follows:

1. Antibiotics

These are effective against bacterial conjunctivitis which causes red and itchy eyes. These can be given either in drops, ointment or oral form. Example of this class of drugs include:

• Chloramphenicol

• Ciprofloxacin

• Moxifloxacin

2. Corticosteroids

These are mostly prescribed to relieve conjunctivitis caused due to an allergen such as dust or irritant. It is also used to ease inflammation as well as pain due to the infection. Some of the commonly prescribed steroids for conjunctivitis include: 

• Loteprednol etabonate

• Fluorometholone

3. NSAIDs

As conjunctivitis can cause pain in the eyes along with redness and swelling, painkillers such as non-steroidal anti-inflammatory drugs (NSAIDs) are commonly recommended to get rid of pain as well as inflammation in the eyes. Your doctor may recommend ophthalmological NSAIDS such as ketorolac.

Note: For viral conjunctivitis, you just need to use cold compress. It usually does not respond to the antibiotic treatment and runs its course before it starts getting better.

Home-care For Conjunctivitis

Here are some of the easy at home tips that can help you recover faster from conjunctivitis: 

• Keep your hands clean to prevent worsening the infection. 

• Wash away any discharge from  or around your eye(s) with the help of cotton or a clean, wet washcloth. Discard cotton balls after use, and wash the used cloth with detergent and hot water. 

• Do not use the same eye drop for your non-infected eye. 

• Wash your personal belongings such as bedsheets, pillowcases, sheets, washcloths, and face towels with hot water and detergent; Make sure to clean your hands after you handle these items.

• Do not wear contact lenses until your ophthalmologist advises you to start wearing them again.

• Do not use contaminated objects such as towels shared by others. 

• Make sure to clean your eyeglasses before using them. 

• Avoid using swimming pools or watching television for extended hours. 

If you have conjunctivitis, there are steps you can take to avoid reinfection once the infection goes away:

• Throw away and replace any eye or face makeup or makeup brushes you used while infected.

• Throw away disposable contact lenses and cases that you used while your eyes were infected.

• Throw away contact lens solutions that you used while your eyes were infected.

• Clean extended wear lenses as directed.

• Clean eyeglasses and cases that you used while infected.

Complications Of Conjunctivitis

Though complications arising due to acute conjunctivitis are rare, there may be certain cases in which complications may occur. 

• Patients suffering from Herpes Zoster Virus conjunctivitis are at the highest risk of complications such as uveitis

• Conjunctivitis caused by gonorrhea, chlamydia, or certain types of the adenovirus can can be serious and lethal to eyesight, because they can scar the cornea or cause secondary corneal perforation

If you fail to show any improvement even after 5 to 7 days of the treatment then you must visit an ophthalmologist.

Alternative Therapies For Conjunctivitis

Some of the common home/herbal remedies for treating conjunctivitis are:

Indian gooseberry: Indian gooseberry or amla is useful in the treatment of conjunctivitis. You can mix a cup of amla juice with two teaspoons of honey and consume this mixture two times in a day. 

Vegetable juice: Raw juices of some vegetables such as spinach, parsley or carrot can help you recover fast from conjunctivitis. You can take these juices separately or combine these juices for maximum benefits. 

Vitamin rich foods: Certain vitamins such as Vitamin A and Vitamin B2 are quite useful in conjunctivitis. You can include Vitamin A rich foods such as carrots, pumpkin, tomatoes, green leafy vegetables and Vitamin B2 rich foods such as  milk, almonds, citrus fruits and bananas in your diet. 

Coriander:  A decoction of coriander can be made by soaking dried coriander in water. This makes for excellent eyewash that gives relief in conjunctivitis. 

All the herbal remedies or home treatments should be taken only after consulting your doctor.