Conjunctivitis

Conjunctivitis

Conjunctivitis is an inflammation of the conjunctiva. The conjunctiva is the thin clear tissue that lies over the white part of the eye and lines the inside of the eyelid.

What causes conjunctivitis?

Conjunctivitis has a number of different causes including:

• Viruses
• Bacteria (such as gonorrhoea or chlamydia)
• Irritants such as shampoos, dirt, smoke and swimming-pool chlorine
• Allergies such as dust and pollen, or a special type of allergy that affects some contact lens wearers

Conjunctivitis caused by some bacteria and viruses can spread easily from person to person, but it is not a serious health risk if diagnosed promptly.

What are the symptoms of conjunctivitis?

The symptoms of conjunctivitis differ depending on the cause of the inflammation, but can include:

• Redness in the white of the eye or inner eyelid
• Increased amount of tears
• Thick yellow discharge that crusts over the eyelashes, especially after sleep
• Green or white discharge from the eye
• Itchy eyes
• Burning eyes
• Blurred vision
• Increased sensitivity to light

Seek medical advice if you have any of these symptoms of conjunctivitis. You may be advised to attend for an examination of your eyes and a sample of fluid from the eyelid using a cotton swab may be taken to be analysed in a laboratory. Bacteria or viruses that may have caused conjunctivitis, including a sexually transmitted infection (STI), can then be identified and appropriate treatment prescribed.

How is conjunctivitis treated?

The treatment for conjunctivitis depends on the cause:

• Bacteria. Conjunctivitis caused by bacteria including STIs is treated with antibiotics in the form of eye drops, ointments or pills. Eye drops and ointments may need to be applied to the inside of the eyelid several times a day. Pills may need to be taken for several days. The conjunctivitis should improve within a week. Take the medicine as instructed by your doctor, even if the symptoms of conjunctivitis go away.
• Viruses. This type of conjunctivitis often results from the viruses that cause a common cold. Just as a cold must run its course, so must this form of conjunctivitis, which usually lasts from four to seven days.
• Irritants. For conjunctivitis caused by an irritating substance use water to wash the substance from the eye for five minutes. Your eyes should begin to improve within four hours after washing away the substance. If the conjunctivitis is caused by an acid or alkaline material such as bleach, seek urgent medical advice.
• Allergies. Allergy-associated conjunctivitis should improve once the allergy is treated and the allergen removed. Seek medical advice if you have conjunctivitis that is linked to an allergy.

Traditionally, home remedies are sufficient for soothing conjunctivitis associated with uncomplicated colds, minor infections, or  allergies. Treatment consists primarily of cleansing the eyes and preventing the condition from spreading.

How is conjunctivitis treated? continued...

To relieve the discomfort of conjunctivitis, apply a warm compress for five to 10 minutes, three to four times a day. Preservative-free artificial tears (lubricant eye drops) can be applied frequently. Never use steroid eye drops without a doctor's prescription.
For conjunctivitis that seems to be from an allergy, place a cool compress on your closed eye and use anti- allergy eye drops to relieve itching and burning. If the condition does not improve in three days, seek medical advice. If your conjunctivitis symptoms do not appear to be associated with a cold or allergy, you may want to see your doctor for a more comprehensive evaluation.
Viral conjunctivitis usually runs its course in one to two weeks. Because it is not caused by bacteria, viral conjunctivitis does not respond to antibiotics, and can be highly contagious. Artificial tears will also help relieve the symptoms of viral conjunctivitis.
Conjunctivitis caused by the  herpes virus can be treated with antiviral eye drops, ointment and/or antiviral pills.
For bacterial conjunctivitis antibiotic eye drops or ointment may be recommended, particularly if symptoms are severe or persist for more than two weeks. Always complete the full course of antibiotic therapy. Oral antibiotics and eye drops or ointment are routinely prescribed for conjunctivitis caused by  gonorrhoea or chlamydia. Sexual partners should also be treated.
Allergic conjunctivitis should respond to anti-allergy eye drops,  antihistamines or steroid eye drops. To repeat an earlier warning, you should never apply steroid drops for any eye symptoms without a doctor's prescription.

What can I do to relieve symptoms of conjunctivitis?

To relieve the symptoms of conjunctivitis:

• Protect your eyes from dirt and other irritating substances.
• Remove contact lenses, if you wear them.
• Try to keep the infection from spreading to the other  eye. Conjunctivitis can be very contagious, so be careful about your contact with other people until you are better.
• Carefully wash your hands every time you touch around your eye.
• Keep your own towels, flannels and pillows separate from others or use paper towels.
• Wash or change your pillowcase every day until the infection goes away.
• Do not touch your infected eye with your fingers. Use tissues to wipe.
• Do not wear eye makeup. Never share eye makeup.
• Do not wear your contact lenses until the infection is gone.
• Put a warm compress, such as a flannel soaked in warm water, on your eye for a few minutes, three to four times a day. This eases the  pain and helps break up some of the crust that may form on your eyelashes.
• Use over-the-counter artificial tears to help with itching and irritation. Do not share eye drops. You can spread the infection to anyone else who uses them.
• Do not put a patch over your eye. It may cause the infection to become worse.
• Do not use eye drops for more than a few days unless instructed to do so by your doctor. Worsening redness could result from repeated use of such products.

How long does conjunctivitis last?

Viral conjunctivitis usually runs its course in one to two weeks. Because it is not caused by bacteria, viral conjunctivitis does not respond to antibiotics. Artificial tears will help relieve symptoms.
With bacterial conjunctivitis you will probably need antibiotic eye drops or ointment. These usually clear up the symptoms within a few days.

How can I prevent spreading conjunctivitis?

If you or your child has conjunctivitis:

• Don't touch or rub the infected eye(s).
• Wash your hands often with soap and warm water.
• Wash any discharge from your eyes twice a day using a fresh cotton wool ball or paper towel. Afterwards discard the cotton wool ball or paper towel and wash your hands with soap and warm water.
• Wash your bed linen and towels in hot water and detergent.
• Avoid wearing eye make-up.
• Don't share eye make-up with anyone.
• Never wear another person's contact lenses.
• Wear glasses instead of contact lenses. Throw away disposable lenses and clean extended-wear lenses and all eyewear cases.
• Avoid sharing personal items such as unwashed towels and glasses.
• Wash your hands after applying the eye drops or ointment to your eye or your child's eye.
• Do not use eye drops that were used for an infected eye in a non-infected eye.

What are the complications of conjunctivitis?

Usually conjunctivitis is a self-limiting disease that either clears up on its own or after a course of antibiotics. However certain forms of conjunctivitis can become serious and can threaten your vision. They include conjunctivitis caused by gonorrhoea or chlamydia.

How is conjunctivitis diagnosed?

To diagnose  conjunctivitis, your doctor will look for the characteristic symptoms and may take a swab of the discharge to send to the laboratory to determine the cause. Often, the cause can be determined from your symptoms, your medical history, and the  eye examination findings. Usually, medical treatment, for example antibiotics, is not necessary for infective conjunctivitis. Treatment with antibiotics may be recommended for infective conjunctivitis if symptoms are severe, or last more than two weeks, or if lab test results indicate treatment would be advisable.

Seek medical advice about conjunctivitis if:

• You have physically injured your eye. Eye injuries can become infected and lead to corneal ulcers, which may lead to irreversible vision loss.
• Your eyes become red when you wear contact lenses. Remove the lenses immediately and seek medical advice; you may have a corneal infection.
• The redness in your eye is affecting your vision and is accompanied by severe pain or excessive yellow or green discharge. You may have a viral or bacterial infection.
• Your conjunctivitis frequently recurs or appears to be getting worse after three days of home treatment; you may have a bacterial or viral infection.
• A  newborn baby's eyes are red or produce a discharge. Ophthalmia neonatorum must be treated immediately to prevent permanent eye damage.