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Conjunctivitis (commonly called "pinkeye") is an inflammation of the conjunctiva (the outermost layer of the eye and the inner surface of the eyelids), often due to infection. There are three common varieties of conjunctivitis, viral, allergic, and bacterial. Other causes of conjunctivitis include thermal and ultraviolet burns, chemicals, toxins, overuse of contact lenses, foreign bodies, vitamin deficiency, dry eye, dryness due to inadequate lid closure, exposure to chickens infected with Newcastle disease, epithelial dysplasia (pre-cancerous changes), and some conditions of unknown cause such as sarcoidosis.
Last Updated -13th December 2005
Types of Conjunctivitis
- Viral conjunctivitis is spread by aerosol or contact of a variety of contagious viruses, including many that cause the common cold, so that it is often associated with upper respiratory tract symptoms. Clusters of cases have been due to transfer on ophthalmic instruments which make contact with the eye (e.g., tonometers) and not adequately sterilised.
- Allergic conjunctivitis occurs more frequently among those with allergic conditions, with the symptoms having a seasonal correlation. It can also be caused by allergies to substances such as cosmetics, perfume, protein deposits on contact lenses, or drugs. It usually affects both eyes, and is accompanied by swollen eyelids.
- Bacterial conjunctivitis is most often caused by pyogenic bacteria such as Staphylococcus or Streptococcus from the patient's own skin or respiratory flora. Others are due to infection from the environment (eg insect bourne), from other people (usually by touch- especially in children), but occasionally via eye makeup or facial lotions. An example of this is conjunctivitis due the the bacteria Haemophilus influenzae biogroup aegyptius.
- Irritant, toxic, thermal and chemical conjunctivitis are associated with exposure to the specific agents, such as flame burns, irritant plant saps, irritant gases (e.g., chlorine or hydrochloric acid fumes), natural toxins (e.g., ricin picked up by handling castor oil bean necklaces), or splash injury from an enormous variety of industrial chemicals, the most dangerous being strongly alkaline materials.
- Xerophthalmia is a term that usually implies a destructive dryness of the conjunctival epithelium due to dietary vitamin A deficiencya condition virtually forgotten in developed countries, but still causing much damage in developing countries. Other forms of dry eye are associated with ageing, poor lid closure, scarring from previous injury, or autoimmune diseases such as rheumatoid arthritis, and these can all cause chronic conjunctivitis.
- Redness in the whites of the eyes
- Redness, irritation and watering of the eyes are symptoms common to all forms of conjunctivitis. Itch is variable.
- Red and swollen eyelids
- Lots of tears
- A sandy feeling in the eyes
- Discharge that causes the eyelids to stick together during sleep
- Acute allergic conjunctivitis is typically itchy, sometimes distressingly so, and the patient often complains of some lid swelling. Chronic allergy often causes just itch or irritation, and often much frustration because the absence of redness or discharge leads to accusations of hypochondria.
- Viral conjunctivitis is often associated with an infection of the upper respiratory tract, a common cold, or a sore throat. Its symptoms include watery discharge and variable itch. The infection usually begins with one eye, but may spread easily to the fellow eye.
- Bacterial conjunctivitis due to the common pyogenic bacteria causes marked grittiness/irritation and a stringy, opaque, grey or yellowish mucoid discharge (gowl or other regional names) that may cause the lids to stick together (mattering), especially after sleeping. However discharge is not essential to the diagnosis, contrary to popular belief. Many other bacteria (e.g., Chlamydia, Moraxella) can cause a non-exudative but very persistent conjunctivitis without much redness. The gritty feeling is sometimes localised enough for patients to insist they must have a foreign body in the eye. The more acute pyogenic infections can be painful. Like viral conjunctivitis, it usually affects only one eye but may spread easily to the other eye.
- Irritant or toxic conjunctivitis is irritable or painful. Discharge and itch are usually absent. This is the only group in which severe pain may occur.
- Do not share towels, handkerchiefs or washcloths with a person who has pinkeye.
- If a chemical or object gets into your eye, immediately flush with cool water.
- Keep contacts and anthing that touches them (hands, storage containers, solution bottles, makeup) very clean.
- Do not use homemade contact solution as it is easily contaminated with bacteria.
- Insert your contacts before applying eye makeup.
- Do not apply makeup to the inner rim of your eyelid.
- Replace eye makeup every 6 months to reduce the risk of contamination.
- Apply cold or warm compresses several times a day to relieve discomfort.
- Gently wipe the edge of the eyelid with moist cotton or a clean, wet washcloth to remove encrusted matter.
- Do not wear contact lenses until the infection or inflammation is gone.
- Discard disposable contact lenses or disinfect hard lenses that have been in infected eyes.
- Do not wear eye makeup until the infection or inflammation is gone.
- Discard eye makeup if used while infected.
- Make sure any non-prescription medicine you use is ophthalmic (for eyes) and not otic (for ears).
- Wash your hands thoroughly after treating pinkeye or touching your eye.
- Call an eye professional if there is pain in the eye (rather than irritation), blurring or loss of vision that is not cleared even momentarily by blinking.
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