CONJUNCTIVITIS A.K.A THE “RED EYES”

“You’ve got red eyes? Don’t come near me or it will “jump” to me!”

Let’s be honest, you’ve probably heard that before. I’m going to say that’s pure hoax, if not folklore my parents used to tell me. Mind you, it would be really scary if it is that contagious!

 

What is conjunctivitis?

Conjunctivitis commonly known as the ‘red eyes’ or ‘pink eyes’ is a form of inflammation affecting the mucous membrane that covers the front of the eye and lines the inside of the eyelids (conjunctiva). When inflamed, the conjunctiva which is generally transparent will turn red or pink which gives the condition its different layman names. The disease is generally benign although certain types of conjunctivitis can be detrimental to sights, by causing cornea scarring.

It is worth noting that patients with conjunctivitis will have red eyes but not all red eyes are conjunctivitis.  Psstt….when you are raging, your bloodshot eyes may be red, but we don’t generally call that conjunctivitis.

 

What are the causes of conjunctivitis?

There are numerous causes of conjunctivitis which include:

• Bacterial infection
• Viral infection
• Allergy reactions
• Irritants such as body wash, shampoo, smoke, chlorine in swimming pool etc.

Some species of bacteria that normally cause respiratory infections (such as Staphylococcus aureus and Moraxella catarrhalis) as well as some viruses which cause common cold are typically known to also result in conjunctivitis. Bacterial and viral conjunctivitis are fairly contagious and can spread through contact with the patient’s eye discharge; for instance, rubbing your eyes after touching contaminated surfaces/items.

It is interesting to note that, some sexually transmitted bacteria such as N. gonorrhoeae and  Chlamydia (commonly transmitted from genitalia to the hands and then eyes) can cause severe and sight-damaging conjunctivitis which require medical attention.

Meanwhile, some airborne allergens can also induce allergic conjunctivitis. Patients with seasonal allergy (such as hay fever), or specific allergy may have greater tendency to suffer from allergic conjunctivitis.

Patients with non-infectious, non-allergic type of conjunctivitis may have redness and discharge when irritants come into contact with the eyes. The symptoms may persist for hours after the removal of chemicals or foreign bodies from your eyes.

I think all of us can now heave a sigh of relief knowing that we won’t get conjunctivitis by just looking at those red eyes. Phew….!!

 

How do I know if I have conjunctivitis?

Bacterial, viral and allergic conjunctivitis are commonly associated with thick eye discharges of different colours such as green, yellow or white. Your eyes are usually “stuck shut” in the morning and the discharge generally persists throughout the day. Other concurrent symptoms which can last for days include:

• Red watery eyes
• Itchy and/or burning eyes
• Blurred vision
• Increased sensitivity to lights

 

Do I need treatment for my conjunctivitis?

The good news is, most cases of conjunctivitis are generally self-resolving and the condition is not difficult to manage if the underlying cause is known.

Bacterial conjunctivitis: It is self-limiting. Antibiotics in the forms of eye drops, ointments or oral pills/tablets are useful, particularly where the patients are infected by bacteria which also cause sexual transmitted disease. These species of bacteria may cause cornea scarring if left untreated. Make sure to complete the course of antibiotic prescribed based on doctor’s instruction.

Example of bacterial conjunctivitis. [By Tanalai at English Wikipedia, CC BY 3.0]

Viral conjunctivitis: Just like in common cold, symptoms should resolve within a week without treatment. If you develop blurred vision or if the symptoms persist, seek medical help immediately.

 

Allergic conjunctivitis: The symptoms will go away once you remove the known allergen. Antihistamines (oral formulations or eye drops) are useful to provide symptomatic relief

Irritant induced conjunctivitis: Rinse or wash your eyes with clean water for a few minutes to remove the irritant. Symptoms should resolve within few hours after the removal of irritants. Nevertheless if the irritants are chemical compounds known to be acidic or basic, seek immediate medical attention after a thorough rinse with clean water.

Example of allergic or irritant conjunctivitis. [By P33tr at English Wikipedia]

Over-the-counter ‘artificial tears’ eye drops are useful to soothe the burning and itching sensations. Do speak to your pharmacist for a good recommendation of artificial tears. Avoid using steroids which can cause sight-threatening complications in addition to worsening underlying infections.

 

  

‘Artificial tears’ eye drops may help to soothe burning and itching sensations.

Anything else I should take note?

The following is a list of things you can do to help yourself and others around you:

• Avoid potential irritants or allergens.
• Avoid wearing contact lenses and eye makeup.
• Wash your hands before and after applying eye ointments/drops.
• Do not apply the eye drops used on infected eye on non-infected eye.
• Keep an eye on the expiry date of the eye drops. Discard the eye drops one month after opening.
• Eye drops are preferred for those who have immediate need to drive or perform other tasks since ointments can blur vision for up to 20 minutes after administration.
• Ointments are generally preferred in children since the dose can be retained longer on the affected site compared to eye drops.
• Practice good personal hygiene and do not share your personal items such as towels, makeup and glasses with others.
• Make sure to wash your used bed linens, pillow cases and used towels in hot water and detergent.
• Those with bacterial or viral conjunctivitis are advised to stay at home until full recovery to prevent transmitting the contagious disease to others.
• If in doubts, please do not hesitate to consult your doctor or pharmacist.

 

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References

1. Friedlaender MH. A review of the causes and treatment of bacterial and allergic conjunctivitis. Clin Ther 1995; 17:800.
2. Martin M, Turco JH, Zegans ME, et al. An outbreak of conjunctivitis due to atypical Streptococcus pneumoniae. N Engl J Med 2003; 348:1112.
3. Ullman S, Roussel TJ, Culbertson WW, et al. Neisseria gonorrhoeae keratoconjunctivitis. Ophthalmology 1987; 94:525.
4. Cheng KH, Leung SL, Hoekman HW, et al. Incidence of contact-lens-associated microbial keratitis and its related morbidity. Lancet 1999; 354:181.
5. Sheikh A, Hurwitz B, van Schayck CP, et al. Antibiotics versus placebo for acute bacterial conjunctivitis. Cochrane Database Syst Rev 2012; :CD001211.
6. Wilkins MR, Khan S, Bunce C, et al. A randomised placebo-controlled trial of topical steroid in presumed viral conjunctivitis. Br J Ophthalmol 2011; 95:1299.