Conjunctivitis ( pink eye)

What Is Pinkeye?

Conjunctivitis, also known as pink eye, is inflammation of the outermost layer of the white part of the eye and the inner surface of the eyelid. It makes the eye appear pink or reddish. Pain, burning, scratchiness, or itchiness may occur. The affected eye may have increased tears or be “stuck shut” in the morning. Swelling of the white part of the eye may also occur. Itching is more common in cases due to allergies. Conjunctivitis can affect one or both eyes.

The most common infectious causes are viral followed by bacterial. The viral infection may occur along with other symptoms of a common cold. Both viral and bacterial cases are easily spread between people. Allergies to pollen or animal hair are also a common cause. Diagnosis is often based on signs and symptoms. Occasionally, a sample of the discharge is sent for culture. Prevention is partly by handwashing. Treatment depends on the underlying cause. In the majority of viral cases, there is no specific treatment. Most cases due to a bacterial infection also resolve without treatment; however, antibiotics can shorten the illness. People who wear contact lenses and those whose infection is caused by gonorrhea or chlamydia should be treated. Allergic cases can be treated with antihistamines or mast cell inhibitor drops.

What Are the Signs and Symptoms of Pinkeye?

Signs and symptoms may include the following:

• redness, because of irritation and widening of the tiny blood vessels in the conjunctiva
• a shiny, watery eye, as the tear glands become overactive
• a sticky or crusty coating on the eyelashes, especially on waking after a long sleep, because the infection produces mucus
• soreness and “grittiness,” like sand in the eye
• swelling, due to inflammation or rubbing

The redness and soreness may affect one eye first, then spread to the other.

Other symptoms

There may also be:

Swollen lymph nodes: The lymph node in front of the ear becomes swollen and slightly tender. It may feel like a button under the skin. The lymph node is part of the body’s immune system, which fights infection.

Respiratory tract infection: The person may have flu-like symptoms, such as fever, headache, aching limbs, and sore throat.

A person should see a doctor if:

• the eye is very red and painful
• vision is affected
• the eye becomes very sensitive to light

These symptoms may indicate a more serious condition.

Newborns often develop pink eye. Symptoms includeTrusted Source red, tender, and puffy eyelids. Urgent medical attention is needed to prevent complications and identify and treat any underlying conditions.

What Causes Pinkeye?

Causes of pink eye include:

• Viruses
• Bacteria
• Allergies
• A chemical splash in the eye
• A foreign object in the eye
• In newborns, a blocked tear duct

Viral and bacterial conjunctivitis

Most cases of pink eye are caused by a virus.

Both viral and bacterial conjunctivitis can occur along with colds or symptoms of a respiratory infection, such as a sore throat. Wearing contact lenses that aren’t cleaned properly or aren’t your own can cause bacterial conjunctivitis.

Both types are very contagious. They are spread through direct or indirect contact with the liquid that drains from the eye of someone who’s infected. One or both eyes may be affected.

Allergic conjunctivitis

Allergic conjunctivitis affects both eyes and is a response to an allergy-causing substance such as pollen. In response to allergens, your body produces an antibody called immunoglobulin E (IgE). This antibody triggers special cells called mast cells in the mucous lining of your eyes and airways to release inflammatory substances, including histamines. Your body’s release of histamine can produce a number of allergy signs and symptoms, including red or pink eyes.

If you have allergic conjunctivitis, you may experience intense itching, tearing and inflammation of the eyes — as well as sneezing and watery nasal discharge. Most allergic conjunctivitis can be controlled with allergy eyedrops.

Conjunctivitis resulting from irritation

Irritation from a chemical splash or foreign object in your eye is also associated with conjunctivitis. Sometimes flushing and cleaning the eye to rid it of the chemical or object causes redness and irritation. Signs and symptoms, which may include watery eyes and a mucous discharge, usually clear up on their own within about a day.

If initial flushing doesn’t resolve the symptoms, or if the chemical is a caustic one such as lye, you need to be seen by your doctor or eye specialist as soon as possible. A chemical splash into the eye can cause permanent eye damage. Persistent symptoms could also indicate that you still have the foreign body in your eye — or possibly a scratch over the cornea or the covering of the eyeball (sclera).

Risk factors

Risk factors for pink eye include:

• Exposure to something for which you have an allergy (allergic conjunctivitis)
• Exposure to someone infected with the viral or bacterial form of conjunctivitis
• Using contact lenses, especially extended-wear lenses

Complications

In both children and adults, pink eye can cause inflammation in the cornea that can affect vision. Prompt evaluation and treatment by your doctor for eye pain, a feeling that something is stuck in your eye (foreign body sensation), blurred vision or light sensitivity can reduce the risk of complications.

Prevention

Preventing the spread of pink eye

Practice good hygiene to control the spread of pink eye. For instance:

• Don’t touch your eyes with your hands.
• Wash your hands often.
• Use a clean towel and washcloth daily.
• Don’t share towels or washcloths.
• Change your pillowcases often.
• Throw away your eye cosmetics, such as mascara.
• Don’t share eye cosmetics or personal eye care items.

Keep in mind that pink eye is no more contagious than the common cold. It’s okay to return to work, school or child care if you’re not able to take time off — just stay consistent in practicing good hygiene.

Preventing pink eye in newborns

Newborns’ eyes are susceptible to bacteria normally present in the mother’s birth canal. These bacteria cause no symptoms in the mother. In rare cases, these bacteria can cause infants to develop a serious form of conjunctivitis known as ophthalmia neonatorum, which needs treatment without delay to preserve sight. That’s why shortly after birth, an antibiotic ointment is applied to every newborn’s eyes. The ointment helps prevent eye infection.

When to Call Your Doctor

Make the call if:

• There’s a lot of yellow or green discharge from your eye, or if your eyelids are stuck together in the morning
• You have severe pain in your eye when you look into a bright light
• Your vision is obviously affected by pinkeye
• You have a high fever, shaking chills, face pain, or vision loss. (These are very unlikely symptoms.)

Call your doctor right away if your newborn has pinkeye, as it could permanently harm their vision.

What’s the Treatment for Pinkeye?

The treatment depends on the cause.

Allergies . Conjunctivitis tied to allergies should improve once you get your allergy treated and avoid your allergy trigger. Antihistamines (either oral or drops) can give relief in the meantime. (But remember that if you have dry eyes, taking antihistamines by mouth can make your eyes even drier.) See your doctor if you think your pinkeye is due to an allergy.

Your eye doctor may have you return in several days to make sure your pinkeye is improving with the medication prescribed.

What Can I Do to Relieve Symptoms of Pinkeye?

A lot of it comes down to cleanliness.

Wash your hands often with soap and warm water, especially before eating.

Keep your eyes clean. Wash any discharge from your eyes several times a day using a fresh cotton ball or paper towel. Afterward, discard the cotton ball or paper towel and wash your hands with soap and warm water.

Wash or change your pillowcase every day until the infection goes away. When you do the laundry, clean your bed linens, pillowcases, and towels in hot water and detergent. Keep your own towels, washcloths, and pillows separate from others, or use paper towels.

Don ’t touch or rub your infected eye with your fingers. Use tissues to wipe.

Don ’t wear, and never share, eye makeup, eyedrops, or contact lenses. Wear glasses. And throw away disposable lenses, or be sure to clean extended-wear lenses and all eyewear cases.

Use a warm compress, such as a washcloth soaked in warm water. Put it on your eye for a few minutes, 3 to 4 times a day. This eases the pain and helps break up some of the crust that may form on your eyelashes.

Limit eyedrops. Don’t use them for more than a few days unless your eye doctor tells you to. It could make the redness worse.

Don’t put a patch over your eye. It may worsen the infection.

Protect your eyes from dirt and other things that irritate them.

What Are the Complications of Pinkeye?

Usually, pinkeye clears up on its own or after you take any medicines your doctor prescribes, with no lasting problems. Mild pinkeye is almost always harmless and will get better without treatment.

Frequently asked Questions

What is conjunctivitis?

Conjunctivitis, or pink eye, is an inflammation of the conjunctiva, the clear mucous membrane that covers the white part of the eyeball and the inside of the eyelid. Cases may vary from a mild redness with watery eyes to serious infections where vision is impaired or even lost.

How does conjunctivitis spread?

Conjunctivitis is most often spread through direct contact with the eye by hands or objects that are contaminated with the virus or bacteria. It can also spread via respiratory tract droplets. Allergic conjunctivitis is not contagious.

Who is at risk for contracting conjunctivitis?

Persons who are most at risk for contracting conjunctivitis are those with exposure to someone infected with viral or bacterial conjunctivitis, contact with a known allergic irritant, and contact lens wearers. Outbreaks of conjunctivitis are common with children in daycare and school settings.

What are the symptoms of conjunctivitis?

Conjunctivitis can occur in one or both eyes. Symptoms of conjunctivitis include: redness, itchiness, a gritty feeling, excessive tearing, or a discharge that forms a crust that may prevent your eye or eyes from opening in the morning.

How is conjunctivitis treated?

Treatment for conjunctivitis is typically focused on symptom relief. Artificial tears and eye compresses may alleviate symptoms. Contact lens wearers may need to stop wearing contacts until the infection resolves. Antibiotic eye drops are typically not needed as most cases of conjunctivitis are caused by a virus; however, they may be prescribed for infections suspected to be caused by bacteria or herpes simplex virus. Allergic conjunctivitis may be treated with medications that help control allergic reactions, such as antihistamines and mast cell stabilizers, or drugs that help control inflammation, such as decongestants, steroids, and anti-inflammatory drops. While conjunctivitis can cause unpleasant symptoms and unsightly discharge, it is typically not a serious infection and resolves without long term effects.

How can you prevent conjunctivitis?

Conjunctivitis can be prevented by practicing diligent hand hygiene, avoiding touching your eyes with your hands, using a clean towel and washcloth daily, avoiding sharing of towels or washcloths, washing or changing pillowcases often, and avoiding sharing eye cosmetics or personal eye care items.

Using conscientious hand hygiene when handling contact lenses and discarding disposable contact lenses as recommended can also prevent conjunctivitis. It is also important to stay home from school and work until eye discharge has resolved to prevent spreading the infection to others.