Conjunctivitis

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Overview

Conjunctivitis, also known as pink eye, is an inflammation of the conjunctiva. This is a protective membrane that covers the visible white part of the eye and the inner side of the eyelid. Conjunctivitis makes the affected eye(s) turn red.


The inflammation is commonly caused by germs such as viruses or bacteria (infectious conjunctivitis). But it is also often caused by an allergy (allergic conjunctivitis).


It often affects both eyes because the infection can easily spread from one eye to the other. To prevent this from happening, it's important to avoid touching an infected eye. If you do touch it, be sure to wash your hands right away. It is also a good idea to use your own towels and washcloths, and not share them with other people.

Symptoms

Bacterial conjunctivitis makes your eyes red and watery. The conjunctiva produces a yellowish-white discharge that makes your eyelids stick together. This is especially noticeable when you wake up in the morning. The conjunctiva can also become sore and hurt when you move your eye, and you may have an itching and burning sensation in your eyes.


Viral conjunctivitis has similar symptoms, but the eyes typically secrete a more watery fluid.


If conjunctivitis is caused by an allergy, both eyes are always affected. Here, too, the eyes water. Itching is a typical sign of an allergy. Allergic conjunctivitis is often accompanied by other allergy symptoms such as a runny nose.


Poor vision, increased sensitivity to light, the feeling that you have something in your eye, or a severe headache together with nausea are rare, but may be signs of a more serious problem. It is important to see a doctor if you have any of these symptoms.

Causes

Conjunctivitis is often caused by viruses or bacteria. Viral and bacterial conjunctivitis are both contagious. The germs are often transferred by touch, and the infection can spread from one eye to the other – for instance, if you touch both eyes with your fingers. But it can also spread through contact with objects such as eye drop bottles, tissues, washcloths or binoculars.

Another common cause of conjunctivitis is allergic reactions – for instance, to pollen, animal fur or dust mites. Conjunctivitis can also be caused by dust or dirt, dry air, irritating liquids or damage to the conjunctiva. Sometimes the eye isn't kept moist enough with tear fluid, and that can lead to conjunctivitis too. If conjunctivitis is caused by an allergy or another external factor, it is not contagious.

Risk factors

Common risk factors in the development of infective conjunctivitis include:[2][3][4]


Poor hygiene

Contact lens misuse

Contaminated personal articles

Crowded living or social conditions (elementary schools, military barracks)

History of ocular diseases including dry eye, blepharitis, and anatomic abnormalities of the ocular surface and lids

Recent ocular surgery, exposed sutures, or ocular foreign bodies

Chronic use of topical medications

Immune compromise

Winter/Summer months (bacterial conjunctivitis peaks in the winter and viral conjunctivitis peaks in the summer)

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Complications

Most cases of conjunctivitis are relatively mild and will not cause eye damage of any sort. In rare cases, complications may develop that can be serious and even life-threatening.


Among some of more commonly seen complications of conjunctivitis:


Punctate epithelial keratitis: This is characterized by an infection of the cornea (keratitis) accompanied by the formation of tiny holes in the conjunctiva. The recurrence of a herpes infection is a common cause. In addition to eye pain, extreme light sensitivity can occur as the tiny perforations cause light to diffuse abnormally. While distressing, the symptoms tend to resolve within several weeks with the use of topical antivirals.

Ophthalmia neonatorum: This is commonly avoided today due to the routine screening of sexually transmitted infections in mothers and the use of neonatal antibiotics in newborns. Babies left untreated are at risk of vision loss and blindness. Moreover, around 20 percent of babies with chlamydial conjunctivitis will develop pneumonia, a potentially life-threatening complication in newborns.

Prevention

Avoid touching your eyes with unwashed hands. Do not share items used by an infected person; for example, do not share pillows, washcloths, towels, eye drops, eye or face makeup, makeup brushes, contact lenses, contact lens storage cases, or eyeglasses.

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.