US Pharm. 2022;47(4):15-16.

Highly Contagious Eye Inflammation

Conjunctivitis, also known as pink eye, is a term used to describe a group of conditions related to inflammation of the eye’s conjunctiva. It affects nearly 6 million people annually in the United States and accounts for 1% of all visits to primary care doctors. Conjunctivitis is caused by viruses and bacteria but can also be an allergic response to an allergen in the environment. Sometimes, irritants in the environment, injuries to the eye, and blocked tear ducts are to blame. Both viral and bacterial conjunctivitis are highly contagious and are easily spread from one person to another.

An Infection of the Conjunctiva

The eye and the eyelid are covered by a thin membrane called the conjunctiva. The conjunctiva comprises two parts: The bulbar conjunctiva covers the visible part of the eye, and the palpebral conjunctiva lines the inside of the eyelids. During an episode of conjunctivitis, the conjunctiva becomes inflamed. The blood vessels dilate, resulting in visible blood vessels and eye redness. There may also be visible swelling of the conjunctiva and a thick, white-to-yellow discharge.

Viral conjunctivitis is the most common cause of infectious conjunctivitis, especially in adults during the summer months. The second most common is bacterial conjunctivitis, which is common in school-age children. Bacterial conjunctivitis is more prevalent from December through April. Also, frequently present in the spring and summer is allergic conjunctivitis caused by seasonal allergies. Only conjunctivitis caused by viruses or bacteria can be spread from person to person. The virus or bacteria spread via the hands when people touch their eyes.

Conjunctivitis May Require Topical Medications

Most people who see a doctor because of eye swelling and discharge will visit a primary care physician instead of an ophthalmologist. By asking questions about how and when symptoms started and examining the physical symptoms, the doctor can determine if the cause is infectious or noninfectious. For example, a thick discharge from the eye is usually associated with bacterial conjunctivitis. In contrast, a watery discharge may indicate viral conjunctivitis. Ophthalmologists may go one step further in examining the eye by using a slit-lamp microscope to look closely at the conjunctiva. To rule out a physical injury to the surface of the eye, the ophthalmologist may use a yellow dye called fluorescein.

Conjunctivitis, whether caused by infection, allergy, or injury, usually clears up on its own without treatment in 1 to 2 weeks. For infections caused by bacteria, topical antibiotics applied to the eye can reduce the duration of the illness. In some states, children cannot return to school without completing a topical antibiotics course for conjunctivitis. Specific infectious causes of conjunctivitis require special consideration because of the potential for serious complications. Eye infections caused by the sexually transmitted diseases chlamydia and gonorrhea require treatment with both topical and oral antibiotics. Both conditions have a high risk of corneal perforation and must be monitored closely. Allergic and chemical-induced conjunctivitis are treated by removing the source of the irritation and managing inflammation with nonsteroidal anti-inflammatory medications or steroids. Antihistamines and decongestants applied via eye drops can help to reduce itchiness and redness for those with allergic conjunctivitis. Be aware that if the cause of infection is suspected to be the herpes virus, steroids should be avoided as they can make the condition worse.

Reducing the Spread Is Key to Recovery

In rare instances, conjunctivitis can lead to vision disruption or blindness. People with suspected pink eye should see an ophthalmologist immediately if they start to experience vision loss, pain in the eye, severe discharge, scarring, or inflammation of the cornea, or if they have a recurring infection or a history of herpes simplex virus eye disease. Individuals who wear contacts will need to take special care to clean or dispose of their contact lenses to reduce the risk of spreading or reintroducing an infection.

The content contained in this article is for informational purposes only. The content is not intended to be a substitute for professional advice. Reliance on any information provided in this article is solely at your own risk.

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