Consumer Information

Conjunctivitis

GENERAL INFORMATION:

What is conjunctivitis?

Conjunctivitis is inflammation (redness, pain, and swelling) of your conjunctiva. Conjunctivitis is also known as pink eye. Your conjunctiva is a thin and moist skin tissue that covers the front part of your eyeball. It also covers the back of your eyelids. Your conjunctiva contains cells that help fight infections caused by germs called bacteria or viruses. If your conjunctivitis is mild, then it may heal without treatment.
If your conjunctivitis is moderate or severe, then you may need treatment. Having your conjunctivitis treated may help you heal faster. You may be less likely to have eye problems from your conjunctivitis. Treatment may help many of your symptoms, including any redness, pain, and itching in your eye. You may become less likely to spread the infection to other people. This may help you go back to work or be around other people sooner than without treatment.

What causes conjunctivitis? The most common infections that cause conjunctivitis are from viruses or bacteria. Conjunctivitis is also commonly caused by allergies.

Allergies: You may have allergic conjunctivitis. This happens when the cells in your conjunctiva react to an allergen. An allergen is something that causes an allergy. Some common allergens that may appear during certain seasons include grass, dust, weeds, and mold. Allergens that commonly occur all year round include animal fur, feathers, and cockroaches. Eye medicine, mascara, or contact lens fluid may also cause allergic conjunctivitis. You may get allergic conjunctivitis once or it may happen again.
Bacteria: You may get conjunctivitis from bacteria. You may put bacteria in your eye by accident when you touch your eye with your hand. Things that touch your eye like contact lenses and contact lens fluid may also give you bacterial conjunctivitis. Bacteria from a sexually transmitted disease (STD) may also give you conjunctivitis.
Viral: You may get viral conjunctivitis by being around people with conjunctivitis or other infections. Some viruses that may cause conjunctivitis include adenovirus and varicella (the virus that causes chicken pox and shingles). If you are under a lot of stress, herpes simplex virus may cause conjunctivitis. Common places you may get viral conjunctivitis include work, school, and swimming pools. Viral conjunctivitis often gets better on its own without treatment.

What are the signs and symptoms of conjunctivitis? With allergic conjunctivitis, you will usually have symptoms in both eyes. You may also have signs of other allergic conditions such as asthma, a rash, or a runny nose. With bacterial conjunctivitis, you may have crusty eyelids when you wake up in the morning. You may also have tiny bumps on your conjunctiva. Discharge may be watery with allergic or viral conjunctivitis but is usually thick and sticky with bacterial conjunctivitis. If you have viral conjunctivitis, petechiae (small dots of blood) may appear on your conjunctiva. You may also have symptoms of your virus, such as sore throat and fever (high body temperature). Other common symptoms for all three of these types of conjunctivitis include:

Redness in the whites of your eye. Your eyes may also appear pale or milky.
Itching in your eye, throat, or skin around your eye.
Burning or stinging in your eye.
Watering (tearing) of your eyes.
Mucous or watery discharge from your eye.
Swelling of your eye.
Pain when you see bright light.
Feeling like there is something in your eye.

How is conjunctivitis diagnosed? Conjunctivitis may often be diagnosed with a physical exam and questions about your medical history and symptoms. Your caregiver may ask you if anyone you know has conjunctivitis or another type of infection. He will ask you if you or any of your family members have allergies. Your caregiver may ask you if you wear contact lenses or if you take any medicine. He may also ask you whether you have an STD. You may need any of the following:

Eye exam: Your caregiver will look at your eyes, eyelids, eyelashes, and the skin around your eyes. He will ask you to look in different directions. He may gently press on your eye or eyelid to see if there is discharge. He will also look for redness and swelling in your eyelids or conjunctiva. Your caregiver will also look for signs of infection or allergies.
Tests:
- Slit-lamp microscope: Your caregiver will use a special microscope with a bright light to look into your eye. He will look for signs of infection or inflammation. This microscope also helps your caregiver see if the different parts of your eyes are healthy.
- Visual acuity: Your caregiver may use this test to check your vision. He will see whether your eyesight is clear and sharp. You will read letters or look at images to test how well you can see.
- Fundus exam: Your caregiver will give you medicine that makes your pupils larger. Your pupils are black dots at the center of your eyes. Using a special tool, he will look inside your eye through the pupil. He will examine the different parts of the insides of your eye to see if they are healthy.
- Visual field: In a visual field test, your caregiver will have you look forward into a machine. He will then ask you to tell him when you see an image, such as a dot. This will help your caregiver see how wide your eyes can see.
- Lab tests: You may need to have blood tests to help your caregiver figure out what caused your conjunctivitis. Your caregiver may also take samples from your conjunctiva and send them to a lab for tests. The blood or tissue samples may be cultured (grown) or stained with chemicals. Your caregiver may also test your skin for allergies.

How is conjunctivitis treated? Your treatment depends on what is causing your conjunctivitis. Bacterial conjunctivitis is usually treated with antibiotics (germ-killing medicine). Allergic conjunctivitis is usually treated by removing the allergen. You also may be treated with anti-allergy medicines. If you have viral conjunctivitis, it will usually go away on its own. Supportive therapy may help decrease symptoms from any type of conjunctivitis. You may need any of the following:

Supportive therapy: Supportive therapy helps decrease your symptoms. Your caregiver may want you to put a cold compress on your eye to decrease swelling. Ask your caregiver about the proper way to use a cold compress. Your caregiver may also suggest you put artificial (fake) tears in your eye to help get rid of allergens. These tears also help to moisten your eye. Your caregiver may flush (wash) your eye with a special salt water to help decrease your symptoms.
Anti-allergy medicine: This medicine helps decrease symptoms from allergic reactions such as itching, redness, or swelling. This may be given as a pill or eye drops. You may also be given anti-allergy medicine to spray into your nose.
Antibiotic medicine: Once your caregiver determines what type of bacteria is causing your conjunctivitis, he may give you antibiotics. Many antibiotic medicines for conjunctivitis are given as eye drops or eye ointment. Antibiotic medicine may be given as a pill, as a shot into your muscle, or using an IV. An IV is a tube placed in your vein for giving medicine or liquids. This tube is capped or connected to tubing and liquid. Antibiotics may help decrease your symptoms and shorten the time that you are sick. Antibiotics may also help prevent you from getting conjunctivitis again.
Non-steroidal anti-inflammatory medicine (NSAIDs): NSAIDs may help decrease your itching, pain, redness, and swelling. NSAIDs may also help prevent conjunctivitis from spreading to your other eye.
Steroid medicine: Steroid medicine may be given to decrease inflammation. This medicine may be given to you as eye drops, by mouth, or as a nasal spray. Steroids can help a lot but may also have side effects. Be sure you understand why you need steroids. Do not take more steroids that your caregiver says to take. Do not stop taking this medicine without your caregivers OK. Taking too much steroids or stopping on your own can cause problems.

How do I avoid getting or spreading conjunctivitis?

Wash your hands often: Use soap and water every time you wash your hands. Wash your hands often, including after every time you touch your eyes. Avoid touching your eyes, nose, and mouth unless you have washed your hands first. Family members should also wash their hands often.
Avoid allergens: Try to avoid the things that give you allergies, such as pets. Dust and clean your home or work area often. Use cotton or synthetic (man-made) material for your bed covers. Use a cover for your mattress and pillows. If you are allergic to pollen, keep your bedroom windows closed. If possible, stay inside on days when there is a high pollen count in the air.
Avoid contact: If someone you know has conjunctivitis, try not to touch anything that he has used. If you have conjunctivitis, stay away from others as much as possible. Avoid public places with a lot of people, such as school, work, and swimming pools. Do not return to work or school until your caregiver says it is OK.
Do not share makeup: If you or someone you know has conjunctivitis, do not share makeup.
Use separate linens: Do not share sheets and towels with anyone else.

What are the risks of having conjunctivitis?

You may have a burning, itching, or stinging feeling in your eye when you use eye drops or ointment. Taking anti-allergy medicine may make you drowsy, or cause dryness of your eyes, nose, or mouth. Antibiotics may cause you to have a bad taste in your mouth. Your eyes may also become sensitive to light. Your eyes may water (tear) more than usual or become crusty. You may have an allergic reaction to your medicine and have trouble breathing. NSAIDs may make your eye swell or bleed. Parts of your eye may also become damaged.
Using steroid medicine may cause serious eye problems, such as glaucoma (increased pressure in the eye). Steroids may also cause you to have cataracts (clouding of the eye) and poor eyesight. Without treatment, you may get scars or sores in your eye. Bacteria in your eye may infect your sinuses (holes in your skull). Bacteria may also infect the other parts of your eye and the tissue lining your brain. Your eyesight may become worse or you may become blind. If you get a serious eyeball inflammation like ophthalmitis or cellulitis, you may die. Ask your caregiver if you have questions or concerns about your condition or care.

When should I call my caregiver? Call your caregiver if:

Your eye pain becomes worse, even after taking pain medicine.
You have a new rash on your skin that your caregiver has not seen.
Your eyesight becomes blurry.
You have tiny bumps or spots of blood on your eye.
You have your questions or concerns about your condition, treatment, or care.

When should I seek immediate care? Seek care immediately or call 911 if:

You suddenly have pain and swelling in your eyelids or around your eyes.
Your vision suddenly becomes worse or you cannot see anything at all.
Your eye begins to bleed.

Where can I find more information? You may feel worried about having conjunctivitis. Discuss your feelings with your caregiver, friends, or family. You may contact the following:

American Academy of Ophthalmology
7424
San Francisco, CA 941207424
Phone: 1-415-5618500
Web Address: http://www.aao.org/

National Eye Institute, National Institutes of Health
202 Vision Pl.
Bethesda, MD 20892-3655
Phone: 1-301-496-5248
Web Address: www.nei.nih.gov

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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