Conjunctivitis

Symptoms: Pink or red colour in the white of eyes, increased tear production, gritty feeling in eyes, itching in the eyes, thick or watery discharge that accumulates in the eyes at night

Causes: Bacteria, viruses, allergens, chemicals

Risk Factors: Contact lenses, exposure to someone infected with bacterial or viral conjunctivitis.

Prevalence: 1% worldwide. 6.29% in India

Severity: Mild to severe

Which doctor to consult: Ophthalmologist, General Physician

Overview:                                                            

Conjunctivitis, or Pink eye, is an inflammation of the transparent membrane of the eyelid and the conjunctiva (outermost layer of the white portion of the eye). It gives the appearance of a pink or reddish eye. The blood vessels in the conjunctiva get inflamed, causing the whites of the eyes to appear pink or reddish.

Conjunctivitis is mostly caused by a viral infection. Also, it can be caused by bacterial infection, an allergic reaction, or in babies due to an incompletely opened tear duct.

Conjunctivitis may cause itching, burning, pain or scratchiness. The affected eye can be stuck shut in the morning or have increased tears. Itching is more prevalent when allergies are to blame. One or both eyes may be affected by conjunctivitis.

Conjunctivitis rarely impairs vision, though it can be annoying. Treatments can help reduce the discomfort of pink eye. Getting an early diagnosis and adopting specific precautions will help minimize the spread of Conjunctivitis because it can be contagious.

Types of Conjunctivitis:

There are various types of conjunctivitis, which include the following:

Viral conjunctivitis: Eye infection caused by various viruses such as adenoviruses. It is extremely contagious. Depending on the virus, it can occasionally cause widespread outbreaks. 

Bacterial conjunctivitis: Eye infection caused by certain bacteria. It can result from wearing contact lenses that haven't been properly cleansed or aren't your own. It can spread easily through coming into contact, either directly or indirectly, with the fluid that drains from an infected person's eye. One eye or both may be affected. It is more common in children than in adults. More often observed from December to April.

Allergic conjunctivitis: It is a response to allergens such as dust mites, moulds, pet dander, medications, cosmetics, and pollen from trees, plants, grasses, and weeds. It is not contagious. It affects both eyes. It is more common in those with additional allergic conditions, including eczema, asthma, or hay fever. It can cause symptoms such as intense itching, tearing, inflammation of the eyes, sneezing, or watery nasal discharge. The majority of allergic conjunctivitis can be controlled with allergy eye drops.

Chemical conjunctivitis: When an acidic or alkaline material gets in the eye, it can cause chemical eye damage. Mild burns produce conjunctivitis.

Symptoms:

People with anxiety may experience excessive worry or fear about a particular situation. The common symptoms of anxiety include:

• Pink or red colour in the white of eyes

• Increased tear production

• Gritty feeling in eyes

• Urge to rub the eyes

• Irritation, itching or burning in the eyes

• Thick or watery discharge that accumulates in the eyes at night

• Swelling of the conjunctiva (the thin layer lining the white portion of the eye and the interior of the eyelid) and/or eyelids

Causes:

The most common causes are:

Viruses: Mostly common cold viruses such as adenoviruses and rarely other viruses such as varicella-zoster or herpes simplex virus.

Bacteria: Moraxella catarrhalis, Haemophilus influenzae, Streptococcus pneumoniae, Staphylococcus aureus, or, less frequently, Neisseria gonorrhoeae and Chlamydia trachomatis.

Allergens: Pollen from plants, grasses, weeds and trees; moulds; dust mites; pet dander; medications; or cosmetics.

Other causes include:

• Chemicals

• Foreign bodies in the eye

• Fungi

• Amoeba and parasites

• Contact lenses

• Air pollution, both indoors and outdoors, from sources including dust, smoke, fumes, or chemical vapours

Risk Factors:

Risk factors for conjunctivitis include:

• Exposure to a person infected with bacterial or viral conjunctivitis.

• Exposure to an allergen, in the case of allergic conjunctivitis.

• Wearing contact lenses, especially extended-wear lenses.

Possible Complications:

Conjunctivitis can cause corneal inflammation in both adults and children, which can affect vision. Early evaluation and treatment by your doctor can reduce the risk of complications.

Prevention:

Preventing the spread of Conjunctivitis: Viral or bacterial conjunctivitis are highly contagious. They can easily spread among individuals. You can lower your chance of contracting conjunctivitis or infecting someone else by following some simple steps of good hygiene:

• Wash your hands frequently for at least 20 seconds using warm water and soap. Wash them especially before and after cleaning or administering eye drops or ointment to your infected eye.

• Avoid rubbing or touching your eyes with your hands.

• Do not share washcloths or towels.

• Every day, use a clean washcloth and towel.

• Change your pillowcases frequently.

• Throw away old eye cosmetics, such as mascara.

• Do not share personal eye care products or eye cosmetics.

• Avoid using swimming pools.

Preventing Conjunctivitis in newborns:

Bacteria from the mother's delivery canal might affect a newborn's eyes. Mothers are generally asymptomatic when these bacteria are present. These bacteria may occasionally cause ophthalmia neonatorum, a serious form of conjunctivitis in infants that requires prompt medical attention to prevent blindness. For this reason, an antibiotic ointment is applied to every newborn’s eyes shortly after birth. The ointment helps prevent infection in the eyes.

When to see a doctor?

Consult a doctor if you have conjunctivitis along with any of the following:

• Eye pain

• Light sensitivity or blurred vision that does not get better once the discharge is wiped from the eye

• Extreme redness in the eyes

• A weakened immune system, as a result of cancer treatment, HIV infection, or other illnesses or treatments.

• Symptoms that worsen or don't get better, including conjunctivitis, which is believed to be caused by bacteria which does not improve after taking antibiotics for a day.

When a newborn exhibits conjunctivitis symptoms, they should be seen by a doctor immediately.

Diagnosis:

Your doctor can typically diagnose conjunctivitis by looking at your eyes, asking about your recent health history, and evaluating your symptoms.

In rare instances, your doctor might take a sample of the fluid that drains from your eye for laboratory analysis, known as a culture. A culture might be necessary if you have severe symptoms or your doctor suspects a high-risk cause, such as:

• A serious bacterial infection.

• A sexually transmitted infection.

• A foreign body in your eye.

Treatment:

There are instances where getting medical attention for conjunctivitis (pink eye) is important. This is not always required, though. You can use over-the-counter, prescription-free artificial tears and cold compresses to help reduce some of the dryness and inflammation caused by conjunctivitis. Also, you must stop wearing contact lenses until your ophthalmologist says it’s ok to start wearing them again. If you do not require medical attention, wait to use your contacts until you no longer have conjunctivitis symptoms.

The treatment of conjunctivitis depends on its cause.

Viral Conjunctivitis: Mostly viral conjunctivitis is caused by common cold viruses. Although there isn't a cure for these cold viruses right now, symptoms are often mild and usually resolve on their own in 7 to 14 days. In rare cases, if conjunctivitis is caused by a varicella-zoster virus or herpes simplex virus, antiviral medicines may be prescribed by your doctor.

Bacterial Conjunctivitis: Mostly, antibiotics in the form of topical eye drops or ointment are given to treat bacterial conjunctivitis. For mild bacterial conjunctivitis, antibiotic treatment is not necessary. It usually gets better in 2 to 5 days without therapy, but it might take up to 2 weeks to go away entirely. Antibiotics are needed in the following cases:

• When conjunctivitis occurs in people with weakened immune systems.

• With discharge (pus).

• When certain bacteria are suspected.

Allergic Conjunctivitis: When an allergen (such as pollen or animal dander) is removed from a person's surroundings, their allergic reaction to conjunctivitis normally improves. Allergic conjunctivitis can also be relieved by allergy drugs and specific eye drops (topical antihistamines and vasoconstrictors), including some prescription eye drops. To relieve symptoms, your doctor can recommend a combination of drugs in some cases.

Home Remedies:

Apply a compress to your eyes: To create a compress, soak a clean, lint-free cloth in water and squeeze it out before applying it gently to your closed eyelids. In general, a cool water compress will feel the most relaxing, but if you like, you can also use a warm compress. Avoid using the same towel on both eyes if conjunctivitis is limited to one. By doing this, the chance of conjunctivitis spreading from one eye to the other is decreased.

Try eye drops: Artificial tears, a non-prescription eye drops, may help relieve symptoms. Some eyedrops that treat allergic conjunctivitis include antihistamines or other medications.

Stop wearing contact lenses: You might need to remove your contact lenses until your eyes feel better. The duration of non-use of contact lenses depends upon the cause of your conjunctivitis. Ask your doctor if it is appropriate to discard your disposable contact lenses, cleaning solution and lens case. If your lenses are not disposable, make sure they are completely clean before using them again.