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Conjunctivitis or Pink Eye

More about Cornea

What is Conjunctivitis?

Conjunctivitis is an inflammation or infection of the mucous membrane lining the eyelids and eyeballs. This mucous membrane is known as the conjunctiva, and the condition is thus known as conjunctivitis.  It can be infectious or allergic. Infective conjunctivitis can be caused by bacterial or viral infections that spread by direct contact with an infected person's eyes, mouth or nose secretions.  On the other hand, allergic conjunctivitis can be caused by allergies to anything but most commonly dust or pollen.

Causes of Conjunctivitis or Pink Eye

Pink eye is a common term used to describe conjunctivitis.  The eye becomes congested or red or pink and thus the term. 

Acute conjunctivitis is usually infective and can sometimes be allergic.  Infective conjunctivitis can be bacterial conjunctivitis or more commonly viral conjunctivitis.  The most common viral conjunctivitis is acute adenovirus conjunctivitis.  

Allergic Conjunctivitis on the other hand is caused by allergies to certain substances.  It is not always easy to find out what the person is allergic to.  Most commonly, dust in the environment or pollen.  The blood tests for testing allergies are inconclusive about 50% of the time, and thus it is challenging to find out the allergens.

Chronic conjunctivitis is usually associated with chronic blepharitis, recurrent styes, or meibomitis.  These are conditions of the lid margin. The lid margin is in constant contact with the eyeball and thus the conjunctiva. Thus, if the lid margin is inflamed for whatever reason, it affects the conjunctiva too, causing irritation and redness.

Allergic conjunctivitis can also be caused by chronic contact lens wear.   Contact lens wear for extended hours can lead to dryness which aggravates allergic conjunctivitis.

Conjunctivitis Signs and Symptoms

  1. Eye Redness
  2. Eyelid Swelling - usually only in infective conjunctivitis
  3. Thick mucus-like discharge - usually only in infective conjunctivitis
  4. Watery Discharge
  5. Swollen or Puffy eyelids
  6. Stinging sensation in eyes 
  7. Foreign body sensation
  8. Itchy eyes
  9. Blurred Vision or Visual Acuity (in cases of corneal involvement)
  10. Light Sensitivity or bright light

Sometimes if the conjunctivitis is severe, the lymph nodes in the throat can be affected and this leads to pain while swollowing or lumpy feeling in the throat.

Types of Conjunctivitis


Viral Conjunctivitis

Most cases of pink eye are typically caused by adenovirus but can also be caused by herpes simplex virus, varicella-zoster virus, and various other viruses.

Viral Conjunctivitis can occur along with common colds or symptoms of a respiratory infection, such as a sore throat.

It is very contagious and usually spreads through direct or indirect contact with the liquid that drains from the eye of infected individuals. One or both eyes may be affected.  

Bacterial Conjunctivitis

Bacterial Infection can occur along with colds or symptoms of a respiratory tract infection, such as a sore throat. Wearing contact lenses that are not cleaned properly or are not yours can cause bacterial conjunctivitis.

The most common symptom of this type of conjunctivitis is a yellow discharge. It spreads through direct or indirect contact with the liquid that drains from the eye of someone infected, which is person to person. It can affect one or both eyes.

Chlamydial Conjunctivitis

Chlamydial conjunctivitis is a sexually transmitted disease. The incubation period is one to two weeks.

Neonatal Conjunctivitis

Neonatal conjunctivitis is defined as conjunctival inflammation occurring within the first 30 days of life. Implications include chemical conjunctivitis as well as viral and bacterial infections.  New born babies can have conjunctivitis right after birth and are started on eye drops right away.

Allergic conjunctivitis

Allergic conjunctivitis affects both eyes and is a response to an allergy-causing substance such as pollen. Allergy triggers your body to produce antibodies 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 histamine release can produce several 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.

Chemical Conjunctivitis

Chemical Conjunctivitis can be caused by irritants like air pollution, chlorine in swimming pools, and exposure to noxious chemicals.

Other Types: Gonococcal conjunctivitis

Prevention of Pink Eyes

It is essential to take precautions when you are around someone who has pink eyes, or you think may have pink eyes:

  1. Avoid Eye Makeup ( to maintain eyelid hygiene)
  2. Avoid touching your eyes
  3. Wash your hands frequently
  4. Always use separate towels or napkins during an ongoing infection

How to prevent spread of conjunctivitis to others

If you have onjunctivitis and want to avoid spreading it to others at home and work these are the things one should do

  1. Dont itch or scratch your eyes
  2. Dont use a napkin to clean your eyes.  Instead use a tissue paper and throw the tissue after use
  3. Dont splash water into your eyes to clean them
  4. Use eye drops as advised by your doctor
  5. Do not share pillows or bed sheets with others at home

How much time does conjunctivitis last for?

In the case of Viral conjunctivitis, it will usually clear up in 7 to 14 days with treatment and any long-term consequences. However, viral conjunctivitis can take 2 to 3 weeks or more to clear up in some cases.

In bacterial conjunctivitis, it often improves in 2 to 5 days with treatment but can take 2 weeks to completely disappear.

Can conjunctivitis clear on its own without treatment?

Mild cases of pink eye usually don't require treatment and clear on their own within a few days (for bacterial infections) to about 14 days (for viral infections).  However, most of the time doctors would treat so as to avoid complications of conjunctivitis.

Antibiotics for pink eye caused by bacteria reduce the length of your symptoms and the amount of time you are contagious.

Conjunctivitis vs Stye

Both pink eye and a stye share some common symptoms, including redness, sensitivity to light and crusting along the eyelids. However, these two conditions are different and have different causes.

A stye is a red, painful bump that forms either on or inside the eyelid near the edge of the eyelashes. Pink eye is an inflammation of the lining of the inside surface of the eyelid and outer coating of the eye. Pink eye doesn't cause bumps in your eyelid or around your eye.

Styes are caused by an infection in the oil glands on your eyelid. Pink eye is caused by viruses, bacteria, allergens and other causes different than what causes styes.

Pink eye usually isn't serious and the good news is it's highly treatable and preventable. Unless your case of pink is severe, pink eye can heal on its own without treatment. The best thing you can do is take the necessary steps to avoid spreading pink eye to others or getting a repeat case of it.

Is conjunctivitis contagious?

Pink eye that is caused by bacteria or viruses can very easily spread from person to person (contagious). If you get pink eye from bacteria, you can spread pink eye while you have symptoms or until about 24 to 48 hours after starting antibiotic treatment. If you get pink eye from a virus, you can spread it for as long as you have symptoms and even before you develop symptoms. This could be for several days.

Pink eye caused by an allergy is not contagious.

Conjunctivitis Treatment

Treatment for pink eye includes avoiding contact with things that might irritate your eyes, like smoke, dust, pollen, and pets. You should also avoid touching your eyelids if you have any discharge.

In the case of Viral conjunctivitis, most cases are mild. Your doctor can prescribe antiviral medication to treat more serious forms of conjunctivitis.  Even though viral your doctor would usually prescribe antibiotic eye drops to prevent a secondary bacterial infection from occuring.

In bacterial conjunctivitis, anitbiotic eye drops are prescribed.

Your doctor or healthcare provider may prescribe antibiotic eye drops or an antibiotic ointment depending on the eye infection. This helps shorten the length of infection, reduce complications, and reduce the spread to others.  Your doctor may also prescribe lubricants to give patients comfort while they have the conjunctivitis

Allergic conjunctivitis, as it is caused by an allergen (such as pollen or animal dander), usually improves by removing the allergen from the person’s environment. This is easy to say but once we know, we can reduce it to whatever extent possible.

Allergy medications and certain eye drops (vasoconstrictor and antihistamine eye drops) can also relieve allergic conjunctivitis. In some cases, your doctor may recommend a combination of drugs to improve symptoms.

Complications of conjunctivitis

Most of the times conjunctivitis resolves with or without treatment in a week or two.   However, sometimes a conjunctivitis may lead to corneal involvement.  The cornea is the front most layer of the eye and is supposed to be transparent.  Sometimes, white opacities develop on the cornea during conjunctivitis.  These are called infiltrates.   If these infiltrates are located in the center of the cornea then they do cause blurrying of vision.  Usually these white spots go away in some time.  Very rarely, one can also develop long standing corneal opacities which blur vision for long periods of time.

It is thus important to treat conjunctivitis even though we know that most of the time it would get better on its own.


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