Also called pink or red eye, conjunctivitis is a common condition. The conjunctiva, the membrane covering the white of the eye and the inside of the eyelids, becomes inflamed causing the eye to become red and sore.

Conjunctivitis may look alarming but it is rarely serious. One or both eyes may be affected, and in some cases it begins in one eye and then spreads to the other. Wearing contact lenses and using cosmetics or eye drops are risk factors.

Causes of Conjunctivitis

An inflammation of the outer surface of the eye, conjunctivitis may be bacterial, viral or allergic, or caused by a foreign body. Bacterial infections are common in children and often spread rapidly in schools and nurseries. They also occur after a foreign body – even a speck of dust – gets into the eyes. Babies often have sticky eyes after birth, having been infected via the birth canal. Viral conjunctivitis often arises in local outbreaks. It is resistant to standard antibiotics but is often self-limiting.

Conjunctivitis may be caused by a bacterial or viral infection. Bacterial conjunctivitis,
which is common, may be caused by any of several types of bacteria. Viral conjunctivitis can occur in epidemics and may be caused by one of the viruses responsible for the common cold. It may also be due to the herpes simplex virus that causes cold sores. Conjunctivitis due to a bacterial or viral infection can be spread by hand-to-eye contact and is usually highly contagious.

Conjunctivitis may result from an allergic reaction or irritation of the conjunctiva, for example by smoke, pollution or ultraviolet light. Allergic conjunctivitis is a common feature of hay fever and of allergy to dust, pollen and other airborne substances. The condition may also be triggered by chemicals found in eye drops, cosmetics or contact lens solutions. Allergic conjunctivitis often runs in families.

Newborn babies sometimes develop conjunctivitis. This occasionally happens if an infection is transmitted to the baby’s eyes from the mother’s vagina during birth. An allergy and an infection produce a similar appearance in the eye – the clue is the seasonal nature of the redness and its persistence. Sources of allergy are pollens, fumes and dust (see Hay fever).

Symptoms of Conjunctivitis

The eyes feel prickly and uncomfortable. Redness then spreads over the whites of the eyes as a result of the dilation of normally invisible blood vessels. The greatest redness is at the eye’s margins – this pattern is important in confirming diagnosis. Redness concentrated around the iris of the eye (the coloured portion) may be due to different diseases – iritis or an ulcer on the cornea. A yellow or green discharge sticks the eyelids together, which have to be gently bathed open.

The symptoms of conjunctivitis usually develop over a few hours and are often first experienced on waking. The symptoms generally include:

  • redness of the white of the eye
  • gritty and uncomfortable sensation in the eye
  • swelling and itching of the eyelids
  • discharge that may be yellowish and thick or clear and watery
  • crusts on the eyelashes and eyelid margins due to discharge that has dried out during sleep. As a result, the eyelids sometimes stick together on waking.

Viral conjunctivitis causes similar symptoms but lasts for weeks rather than the few days of bacterial infection. Allergic conjunctivitis leads to persistent irritation as well as redness. The eyes stream tears and the person keeps sneezing or has a persistent runny nose. In all types of conjunctivitis the under surface of the eyelids, seen by flicking down the eyelid, is red and inflamed. In allergic conjunctivitis the under surface has many small cysts that give a ‘cobblestoned’ appearance.

Warning:
If an eye becomes painful and red, you should consult your doctor as soon as possible to rule
out the possibility of a more serious condition.

Treatment of Conjunctivitis

Tears contain a natural antiseptic that cures most minor infections within a day or two. Where there is a lot of discharge and redness, an antibiotic is used in the form of drops or an ointment. Drops need to be used four to six times a day, ointments two to four times a day – the choice is a matter of personal preference and convenience.

Drops are easier for treating children, because they are simply dripped on to the eyelids and allowed to soak through on to the eyeball. Viral conjunctivitis will not respond to antibiotic drops and will take several weeks to settle down. Treatment for allergic conjunctivitis depends on its severity and the associated symptoms. Use antiallergic eye drops or ointments such as cromoglycate three to five times a day. Try an antihistamine first; it is often enough to relieve itching and redness as well as any other symptoms of hay fever. The sticky eyes in newborn babies respond to bathing with salt water or antibiotic drops; a swab should be taken first to confirm Treatment for allergic conjunctivitis depends on its severity and the associated symptoms. Use antiallergic eye drops or ointments such as cromoglycate three to five times a day. Try an antihistamine first; it is often enough to relieve itching and redness as well as any other symptoms of hay fever. The sticky eyes in newborn babies respond to bathing with salt water or antibiotic drops; a swab should be taken first to confirm diagnosis.

The sticky eyes in newborn babies respond to bathing with salt water or antibiotic drops; a swab should be taken first to confirm Treatment for allergic conjunctivitis depends on its severity and the associated symptoms. Use antiallergic eye drops or ointments such as cromoglycate three to five times a day. Try an antihistamine first; it is often enough to relieve itching and redness as well as any other symptoms of hay fever. The sticky eyes in newborn babies respond to bathing with salt water or antibiotic drops; a swab should be taken first to confirm diagnosis.

Complementary Treatment

Warning: Never use aromatherapy oils near the eyes. Western and Chinese herbalism – anti-inflammatory herbs can supplement, not replace, orthodox treatments.

Homeopathy – make an eyewash using a level teaspoon of salt and ten drops of euphrasia mother tincture in 300 ml pint boiled, cooled water.

Nutritional therapy – zinc supplements may help; seek advice. Ayurveda – try herbal eyewashes and drops. Other therapies to try: acupuncture; chakra balancing.

Measures

The symptoms of conjunctivitis can be relieved by bathing the eye with artificial tears, “comfort” drops, from the pharmacy. To avoid spreading infection, wash your hands after touching the eye and do not share towels or flannels. Once the conjunctivitis has cleared up, vision is rarely affected.
If you are susceptible to allergic conjunctivitis, avoid exposure to triggering substances. Ant-allergy eye drops can be used to ease the symptoms.

Warning signs about Red Eyes

Seek medical opinion if, as well as redness, the following occurs:

  • Only one eye is red
  • The redness is concentrated around the coloured part of the eye
  • There is blurred vision
  • The eye feels painful, rather than itchy
  • The redness follows any injury to the eye
  • There is profuse watering of the eye and light irritates intensely

Such features could indicate iritis, an ulcer of the cornea, injury of the cornea or glaucoma.

What might the doctor do?

  • If infection is suspected, a sample of the discharge may be taken to identify the cause.
  • Bacterial conjunctivitis is treated by applying antibiotic drops or ointment. In such
    cases, the symptoms usually clear up within 48 hours. However, the treatment should be
    continued for 2-10 days, even if the symptoms improve, to ensure the infection is eradicated.
  • Viral conjunctivitis that occurs because of a herpes infection may be treated with eye
    drops containing an antiviral drug. Although other types of viral conjunctivitis cannot be
    treated, their symptoms usually clear up within 2-3 weeks.
  • Your doctor may prescribe eye drops or oral anti-allergy drugs for allergic conjunctivitis.