“Pink eye” is the term used by most patients to describe when their eyes are red. It is usually a case of the conjunctiva being inflamed but doesn’t always mean that the eye is infected. To better understand the condition, let’s first review what the conjunctiva actually is.
The white part of the eye is known as the sclera and it is covered by a thin mucous membrane known as the conjunctiva. This tissue provides protection, lubrication, and immunity to the surface of the eye. It can stretch and flex with eye movement and blinking. It also produces the innermost layer of the tear film, known as the mucous layer. This layer helps hold the tear film to the ocular surface.
When the conjunctiva becomes inflamed, most patients jump to the conclusion that they need antibiotic coverage for a bacterial infection. The reality is that most conjunctivitis cases are viral. Viral conjunctivitis usually starts in one eye and moves to the other within a few days.
Adenovirus is the most common type of viral infection in the eye. It usually presents about 4-10 days after exposure with symptoms lasting up to 12 days. Symptoms include redness, lid swelling, and watery discharge. Viral conjunctivitis often accompanies an upper respiratory infection.
Treatment consists of artificial tears and cool compresses twice a day. Antibiotics are not helpful and are usually avoided in these cases. Steroid drops can help to alleviate symptoms but can sometimes prolong the course of infection. Patients need to be aware that they should not touch their face and should wash their hands frequently. Towels and sheets should be washed often and not shared during this time.
Bacterial conjunctivitis is most common in children, although adults can be affected as well. Redness is a common sign, but the discharge is yellow-green and very sticky. The patient may complain of grittiness, burning, and sticky lids-especially upon awakening.
Bacterial conjunctivitis usually resolves within 10-14 days, but antibiotic drops can hasten the recovery and alleviate the patient’s symptoms. Antibiotic drops are a must if the patient is a contact lens wearer. Contacts should be discontinued until symptoms have completely cleared due to the risk of corneal infection.
Allergic conjunctivitis is yet a third cause of “pink eye”. Symptoms include, itching, redness, and foreign body sensation. Artificial tears and cold compresses are first line treatments to make the patient more comfortable. The eye doctor will recommend an allergy drop if artificial tears are not enough to alleviate the itching. Sometimes a steroid drop can also be used if symptoms are severe.
Signs and symptoms of each of these conditions can overlap each other. It is important to seek the help of your eye doctor if you experience any ongoing irritation of the eye’s surface. An accurate diagnosis is what will lead to an appropriate treatment plan.