Conjunctivitis (Pink Eyes)

Definition

The conjunctiva is a thin membrane covering the inner eyelid and the exposed anterior part of the eyeball. Inflammation of this membrane is called conjunctivitis or pink eye. The pink appearance of the eye is due to engorgement of the blood vessels of the eye due to inflammation. Inflammation can be allergic or infective. Infectious conjunctivitis is highly contagious and spreads rapidly and prompt treatment is necessary to prevent its spread. Usually, one eye is affected first and then the infection may spreads to the other eye.

Symptoms

  • Redness of the eyes.
  • Discomfort and foreign body sensation in the eyes.
  • Unable to tolerate light (photophobia).
  • Discharge from the eyes.
  • Sticking of the lid margins due to discharge usually when awakening in the morning.
  • Mistiness of vision due to thick layer of discharge.
  • Tearing of the eyes.
  • Obstruction of vision if cornea is involved.

Causes

Pink eye can be caused due to:

  • Bacterial, viral and sometimes fungal infections.
  • Allergies.
  • Chemical or mechanical injury to eye.
  • Conjunctivitis be associated with skin diseases affecting the eyelid.
  • In newborns due to infection (usually in a mother with a sexually transmitted infection)  during delivery or if tear duct obstruction is present.

Viral and bacterial conjunctivitis is quite common with presence of discharge which is thin in viral infection and thick and yellowish green in the case of bacterial infection. Allergic conjunctivitis involves inflammation of the conjunctiva due to allergic reactions to substances such as pollens, vegetable or animal dusts or drugs used in eyes such as penicillin, atropine and pilocarpine. The conjunctiva could also be inflamed due to exposure to chemicals or flying shards or tiny pebbles striking the conjunctiva. People who use contact lenses or spectacles are more prone to infections.

Treatment

A sample of the eye discharge can be collected and examined to determine the organism causing the infection. Eosinophils may be detected in the eye discharge if it is allergic conjunctivitis.

  • Bacterial infections are treated with antibiotic eye drops or ointment. The ointment is prescribed usually for children since it is easier to apply. The period of antibiotic administration varies depending on the severity of the infection and is to be carried out for an adequate time to prevent recurrence of infection.
  • Viral conjunctivitis heals on its own and only symptomatic treatment may be necessary. Specific infections of herpes simplex virus may require specific antiviral drugs.
  • Anti-allergic eye drops are prescribed in allergic form of conjunctivitis. These medications contain antihistamines which block allergic reactions thus allowing the inflammation of the conjunctiva to subside.
  • Corticosteroids are used in combination to the antihistamines in allergic conjunctivitis to help reduce the inflammation. The causative factor of allergy (allergen) is to be removed or avoided.
  • Analgesics and vasoconstrictor drugs may be given for symptomatic relief.

The eyes can be washed with warm water to wash away the discharge along with the organism to some extent. Frequent eye washes are not advised since these dilute the protective enzymes of the eye. Dark glasses are preferred to padding since the warmth caused by the pad aggravates the infection.

 

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