Conjunctivitis

Conjunctivitis can be of different types depending on the underlying condition:

• Viral conjunctivitis is the most common type. It usually causes redness, watering, and irritation in the eye. It can last 2-3 weeks and is very contagious.
• Bacterial conjunctivitis is caused by bacteria and leads to red eyes with sticky yellow or green discharge. It can spread from mother to baby at birth.
• Allergic conjunctivitis happens when the eyes react to substances like pollen, dust, or pet dander. It usually causes itching, redness, and watering, and can be seasonal or year-round.
• Other types of conjunctivitis can be caused by irritants such as smoke, chlorine from swimming pools, cosmetics, or contact lenses. 

Conjunctivitis can affect one eye or both eyes. Common symptoms include:

• Swelling and redness of the whites of the eyes.
• Gritty, watery, or sticky eyes, especially in the mornings.
• Blurred vision due to tears or the formation of a sticky discharge.
• Flu-like symptoms, such as general malaise, sore throat, muscle aches, and fever.

Conjunctivitis can occur due to:

• Viruses, especially those belonging tothe adenovirus family are a common cause. Other viruses, such as the measles or mumps viruses, viruses that cause eye herpes, enteroviruses or coxsackieviruses (cause hand, foot, and mouth disease), or SARS-CoV-2 can also cause pink eye.
• The most common bacteria that cause conjunctivitis are Staphylococcus species, Streptococcus species, Haemophilus influenzae and bacteria that cause sexually transmitted infections, such as chlamydia, gonorrhoea, and syphilis.
• Allergens such as pollen, dust, or animal fur.
• Irritants such as chlorine, smoke, or eye products.
• Injuries that cause conjunctival damage.
• Underlying health conditions such as immune disorders that affect the eye, and conjunctival tumours or cancers.

An eye specialist can diagnose conjunctivitis through an eye examination. Diagnosis may include:

• Asking about symptoms, and recent exposure to people with conjunctivitis, or eye irritants.
• Checking the eye with a special light (slit-lamp examination).
• Testing vision to see if it is affected.
• Taking a sample from the eye in rare cases to confirm the cause. 
   

Most cases of conjunctivitis get better on their own within a few days to a few weeks. Treatment depends on the cause:

• Antibiotic ointments or eye drops may be helpful in managing bacterial conjunctivitis. However, viral infections do not respond to antibiotics and may last for two to three weeks until the natural immunity of the host eliminates the virus.
• Lubricating ointments, eye drops, or gels help in reducing discomfort and grittiness but not the duration of the illness.
• Over-the-counter and prescription painkillers, such as paracetamol or ibuprofen, can help manage discomfort and flu-like symptoms associated with conjunctivitis.
• Warm-water washes can be performed routinely to clean the sticky discharge from the eyes.
• Steroidal eye drops are used to reduce inflammation in severe cases.

Treatment options include:

• Avoiding rubbing of the eyes as it worsens symptoms.
• Cold compress to help reduce eyelid swelling.
• Application of lubricating ointments or eye drops may help reduce discomfort but will not treat the allergy.
• Over-the-counter anti-allergy drops need to be used daily and may take up to two weeks to work. Some people need them only for a few weeks in the summer, others require them throughout spring and summer, and those with more severe symptoms, may need them year around.
• Antihistamine tablets.
• Steroid eye drops (used in severe cases).
   

See an eye doctor if:

• Symptoms are severe or not improving after a week.
• Vision becomes very blurry.
• There is intense pain in the eyes.
• A baby or young child develops conjunctivitis.

As bacterial and viral conjunctivitis are very contagious, they spread very easily via droplets (coughing or sneezing) or contact with fomites, such as tissues, towels, or pillowcases. To avoid the spread of infection, the following measures are recommended: 

• Frequently washing hands.
• Covering the mouth while coughing or sneezing.
• Disposing tissues after use.
• Not sharing contagious belongings.

The following measures may be used to prevent allergic and other forms of non-contagious conjunctivitis:

• Allergy testing to identify potential triggers.
• Wash your face after being exposed to allergens like dust or pollen.
• Keep windows closed during seasons when pollen or fungal spores are abundant.
• Wash your hands after petting animals.
• Frequently cleaning the house.
• Washing bedding/pillows using detergents and hot water.
• Careful use of medications, cosmetics, and apparatus along with regular consultation with the physician.
• Monitoring exposure to different activities (such as swimming) and environments (such as polluted areas).

Occasionally, viral conjunctivitis may lead to keratitis (corneal inflammation) or conjunctival scarring, both of which can affect vision.

An ophthalmologist (eye specialist) is the right doctor to diagnose and treat conjunctivitis. In mild cases, a general practitioner can also provide care and guidance.