Symptoms and Complications
Signs and symptoms of conjunctivitis include:
- burning, scratchy, or gritty feeling
- pus-like discharge
- sensitivity to light
Serious complications of conjunctivitis are very rare.
Making the Diagnosis
If someone's eye is bloodshot and inflamed, they may have conjunctivitis. If a person has a cold and suddenly develops red eyes with little or no discomfort, it may be viral conjunctivitis. If the eyes get red and itchy at the onset of pollen season, it is probably due to allergic conjunctivitis.
Both viruses and bacteria tend to start in one eye and make their way across to the other after 2 to 5 days. However, if the irritation stays in one eye only, it's possible that a foreign body or chemical is causing the irritation.
A doctor or health care professional should be consulted if:
- there is pain, altered vision, severe redness, or unusual sensitivity to light
- self-treatment for more than 2 to 3 days does not clear the irritation
- the irritation worsens or has been present for more than 2 days
- the condition recurs
- you have an underlying condition, such as diabetes
- it is a child who has conjunctivitis
Treatment and Prevention
Treatment of conjunctivitis depends on the original cause. Applying cool or warm compresses 3 to 4 times a day and using eye drops such as artificial tears can help viral conjunctivitis. Anyone with suspected viral conjunctivitis should see their doctor.
Artificial tears or antihistamine eye drops can relieve allergic conjunctivitis. Antihistamine eye drops include levocabastine* and emedastine. Eye drops containing mast cell stabilizers (medications which prevent the release of histamine) have also been found effective in preventing and treating allergic conjunctivitis. Examples of these medications include nedocromil, sodium cromoglycate, and lodoxamide.
Eye drops containing olopatadine or ketotifen have antihistamine, anti-inflammatory, and mast-cell stabilizing properties. Steroid eye drops such as dexamethasone, prednisolone, or fluorometholone can be used sparingly for extreme allergic reactions. Antihistamines taken by mouth may be useful in the treatment of allergic conjunctivitis. Ask your pharmacist or doctor for appropriate recommendations.
If bacteria are the cause of conjunctivitis, antibiotic eye drops or ointments are usually given. Non-prescription products can include a combination of polymyxin B, bacitracin, and gramicidin as eye drops or eye ointment. Talk to your pharmacist before using this medication and make sure you consult your doctor if the condition worsens or does not improve within 2 days.
Many prescription products are available for treatment of bacterial conjunctivitis. Examples of prescription antibiotic eye drops or ointments that may be used to treat bacterial conjunctivitis include gentamicin, erythromycin, ciprofloxacin, gatifloxacin, fusidic acid, moxifloxacin, and ofloxacin. All children with conjunctivitis should see a doctor before any medication is used.
People who are around someone with infectious conjunctivitis should avoid touching the person's face, hands, or any items they have handled. They should wash their hands frequently and avoid sharing towels, pillowcases, washcloths, or soap with anyone who is infected. People with conjunctivitis should wash their hands, towels, washcloths, and pillowcases frequently; this will help the conjunctivitis clear up faster. For people who use eye makeup, they should throw it out and buy a fresh supply – makeup is likely to cause a reinfection.
Children should be taught to blow their noses carefully and to cover their nose and mouth when coughing or sneezing. Some children have a habit of wiping their nose with an upward motion of the palm. Try to discourage this.
Conjunctivitis caused by allergens or irritants isn't contagious but it's difficult to avoid. People can't anticipate everything that might bother their eyes. Steering clear of obvious irritants is the best solution; for example, wearing goggles when swimming or avoiding smoke-filled rooms. Prevention of allergic conjunctivitis is best achieved by avoiding the offending allergens. Keep windows closed over the warmer months to keep out pollens and molds.
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For more information on brand names, speak with your doctor or pharmacist.
Jeffrey Heit, MD, Internist with special emphasis on preventive health, fitness and nutrition, Philadelphia VA Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.