Infective conjunctivitis (pink eye): Symptoms, diagnosis, and treatment

Conjunctivitis, or “pink eye” happens when the conjunctiva of the eye becomes inflamed. The eye can become red or pink, swollen, and irritated, and there may be mucus. Infective conjunctivitis can be highly contagious.

The conjunctiva is a thin layer of cells, or membrane, between the inner surface of the eyelids and the whites of the eyes.

Inflammation causes tiny blood vessels, or capillaries, in the conjunctiva to become more prominent. This causes discomfort and a pink or red appearance that can last from a few days to several weeks.

Causes include irritation, allergy, and infection. This article will focus mainly on infective conjunctivitis.

Fast facts on conjunctivitis:

Here are some key points about conjuncitivitis, or pink eye. More detail is in the main article.

Pink eye can result from an allergy, an irriation, or an infection.

A virus or a bacteria can cause an infection. Sometimes it is linked to a sexually transmitted infection (STI).

Antibiotics are sometimes used, but they will not help if the cause is a virus.

Symptoms normally last up to 2 weeks, but they can persist for longer.

It is important to wash hands carefully and not to share personal items, such as towels, as this can spread the infection.

Symptoms

Inflammation can result from different kinds of bacteria or viruses.
Inflammation can result from different kinds of bacteria or viruses.

Signs and symptoms may include the following:

redness, because of irritation and widening of the tiny blood vessels in the conjunctiva

a shiny, watery eye, as the tear glands become overactive

a sticky or crusty coating on the eyelashes, especially on waking after a long sleep, because the infection produces mucus

soreness and “grittiness,” like sand in the eye

swelling, due to inflammation or rubbing

The redness and soreness may affect one eye first, then spread to the other.

Other symptoms

There may also be:

Swollen lymph nodes: The lymph node in front of the ear becomes swollen and slightly tender. It may feel like a button under the skin. The lymph node is part of the body’s immune system, which fights infection.

Respiratory tract infection: The person may have flu-like symptoms, such as fever, headache, aching limbs, and sore throat.

A person should see a doctor if:

the eye is very red and painful

vision is affected

the eye becomes very sensitive to light

These symptoms may indicate a more serious condition.

Newborns often develop pink eye. Symptoms include red, tender, and puffy eyelids. Urgent medical attention is needed to prevent complications and identify and treat any underlying conditions.

Treatment

Nearly half of cases of infective conjunctivitis resolve without medical treatment within 2 weeks, and a doctor may suggest watching and waiting.

They may prescribe eye drops with decongestants or antihistamine to reduce the symptoms of swelling and irritation.

Antibiotics for infective conjunctivitis

Antibiotics will not help if the cause is viral, and even a bacterial infection may last up to a month with antibiotics. Some studies show that for 1 in 10 patients, antibiotics may help speed up recovery.

Treatment may include eyedrops containing antibiotics or an antihistamine.
Treatment may include eyedrops containing antibiotics or an antihistamine.

However, antibiotics may be prescribed if symptoms are severe or have lasted more than 2 weeks. A doctor may give antibiotic eye drops just in case they will help.

The most commonly prescribed antibiotics for infective conjunctivitis are:

fluoroquinolones

tetracyclines

sulfonamides

chloramphenicol

These are eye drops or ointment, administered straight onto the eye. Dosage depends on the type. Ointments may be easier to use than eye drops with an infant or young child.

Vision can become blurry shortly after using eye drops. Make sure you can see clearly before driving or operating machinery. If symptoms do not improve or there is pain or blurry vision you should return to your doctor.

Self care

A number of home remedies can help ease symptoms and possibly speed up recovery.

Contact lenses: Avoid using lenses until at least 24 hours after antibiotic treatment finishes, then throw away and replace the lenses, lens case, and solution

Artificial tear eye drops can be bought over the counter (OTC) or online to help relieve soreness and stickiness.

A wash cloth soaked in warm water can be used several times a day, to gently clean away any sticky substances. Do this gently, to avoid irritating the eyes. Use a clean washcloth for each eye.

Regular handwashing with warm water and soap will help prevent spreading the infection.

Warm compresses can soothe discomfort. Soak a clean, lint-free cloth in warm water, wring it out, then apply gently to the closed eye.

The following symptoms may indicate a more serious condition. They require immediate medical help:

pain in the eye

sensitivity to light, or photophobia

loss of vision

very intense redness

Usually, when the eyes look and feel normal again, the condition is no longer contagious.

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