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It’s Pink Eye! Or is It?

“Pink eye” is a common term often used when someone has redness of the white part of the eye which may or may not be accompanied by pain, discharge, or itching. The majority of cases are temporary in nature and rarely lead to vision loss. Some, however, can result in serious ocular complications and vision can be affected. It is always best to have an eye doctor rule out the cause as well as the risk to vision.


The clinical term for “pink eye” is conjunctivitis. This term describes the condition of the conjunctiva which is the clear tissue covering the white part of the eye. In conjunctivitis, the blood vessels in the conjunctiva are dilated, giving it a red appearance. There are different causes of this condition and it can affect patients of any age or socioeconomic status.


The three most common causes of conjunctivitis are allergies, bacteria, or viruses. About six million people are affected by conjunctivitis in America every year. Children between the ages of birth and seven years are affected more than adults. Women are affected slightly more than men within the adult group. Allergic conjunctivitis affects between 15-40% of the population during the spring and summer months. Bacteria represent the second most common cause of conjunctivitis and are most commonly seen between December and April.


Viruses are the third and most common cause of conjunctivitis and are often misdiagnosed as bacterial in nature. Viral cases present with a watery discharge, redness and bumps inside the lid known as follicles. Mild cases resolve on their own after seven to ten days. Moderate viral cases have additional symptoms such as fever, sore throat, and enlargement of the lymph glands in front of the ear as well as red eyes.


Some types of viral conjunctivitis are quite contagious. Adenovirus is one example in which the risk of transmitting it to others approaches 50%. It can spread through direct contact, personal items such as makeup, or swimming in the same pool as someone who has it. Hand washing is a must.


Treatment for viral cases of conjunctivitis include lubrication with artificial tears, cold compresses, and sometimes antihistamine eye drops. Antibiotics are not effective against viruses and should not be used in these cases.


Bacterial conjunctivitis is the second most common cause of conjunctivitis and is much more common in children than adults. This type of conjunctivitis can come on suddenly usually affecting one eye before the other. Redness, swelling, and a sticky greenish-yellow discharge are typical. The second eye is usually affected a few days later. Antibiotic drops and/or ointments are prescribed for five to seven days to speed up resolution.


Allergic conjunctivitis has increased significantly over the last ten years. Literature suggests that the increase in this condition is due to increased air pollution in urban regions, genetics, and pets. Contact lenses and ocular prosthesis (artificial eyes) can exacerbate this condition due to constant irritation of the surface of the eye. The hallmark sign of allergic conjunctivitis is itching, however, swelling and redness usually accompany this as well. Vision is rarely affected in this condition.


The skin around the eye can also be affected when it comes to ocular allergies. It will appear red, itchy, and tight. The first step in treating the skin is to try to avoid the agent that is causing the reaction, but sometimes that is difficult to identify. Oral antihistamines, cold compresses, and steroid ointments are effective in treating this area.


Avoiding the offending agent is also recommended in treating allergic conjunctivitis, if it can be determined. Artificial tears throughout the day also go a long way toward improving the patient’s comfort, and it helps to keep them in the refrigerator so that they stay cool. Artificial tears help to wash away the allergens that have settled on the ocular surface.


Drops specifically for allergies are recommended or prescribed for relief of symptoms. They usually relieve symptoms quickly, but in more advanced cases of allergic conjunctivitis, anti-inflammatory or steroid drops may be added to the regimen. The eye doctor will want to monitor the patient’s eye pressure in the event that steroid drops are needed for relief, as this type of drop can increase the pressure in the eye in a small number of cases.


Conjunctivitis can definitely affect a patient’s quality of life, especially when they have to miss work or school. Fortunately, it rarely leads to permanent loss of vision.


Importantly, COVID-19 can lead to conjunctivitis. If you think you may have conjunctivitis, we advise you to call our office to schedule a video exam with one of our doctors. If you have insurance that we accept, there may be little or no cost to you for this service.


Call 1-800-282-3937 to schedule an exam.


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