Written by Dr. Eamonn Fahy, MB, BCh, BAO, Ph.D.
Conjunctivitis is an inflammation of the conjunctiva, which is the outer clear skin of the eye that overlies the white part of the eye. Conjunctivitis causes redness of the conjunctiva, which some refer to as ‘pink eye’. The two main causes of conjunctivitis are infections and allergies. The main infectious causes of conjunctivitis include viral and bacterial infections. Allergic conjunctivitis usually occurs in the context of hay fever (seasonal allergy causing watery eyes, runny nose, itchy throat and/or difficulty breathing).
The following sections will briefly outline the global problem of conjunctivitis, what causes conjunctivitis, its signs and symptoms, and some insights into its treatment and prevention.
Conjunctivitis is a very common problem. It accounts for approximately 1% of all care visits in the United States (US) and is estimated to cost the US healthcare system between US$377 and US$857 million annually. Data from other healthcare settings would suggest a similar burden is present in other countries.
The causes of conjunctivitis can be divided into infectious and allergic causes.
Viral conjunctivitis is the most common type of conjunctivitis and is usually caused by a virus called ‘adenovirus’. Adenoviral conjunctivitis is very contagious and can be spread from person to person easily.
Bacterial conjunctivitis is the second most common type of infectious conjunctivitis and is caused by bacteria. It is less contagious than viral conjunctivitis but can still be passed on to others.
Allergic conjunctivitis is an allergic response to allergens such as pollen and animal dander. People who suffer from allergic conjunctivitis tend to also suffer from hay fever (seasonal allergy causing watery eyes, runny nose, itchy throat, and difficulty breathing) or other allergies.
Conjunctivitis can affect one or both eyes and its common signs and symptoms include:
If you experience any of these signs and symptoms, schedule an appointment with an eye health professional to get your eyes checked. It is also important to note that the development of eye conditions may even start before symptoms appear, which makes going for regular and timely eye checks that much more essential.
In severe cases of conjunctivitis, inflammation can have an impact on vision temporarily or permanently. For example, severe adenoviral conjunctivitis can cause scarring of the cornea (the transparent thin layer that covers the front portion of the eye), which can affect vision in some cases.
Conjunctivitis is diagnosed by an eye care professional based on a comprehensive eye check. A slit lamp examination (microscope used to examine structures of the eye under high magnification) is used to examine the eye in detail.
An eye swab may be done to distinguish between viral and bacterial causes of conjunctivitis and to identify a specific virus or bacteria. The eye care professional will use a cotton swab to take a sample of the cells inside the eyelids and send it to a laboratory to be examined by a specialist.
Treatment for conjunctivitis depends on the underlying cause.
In most cases of viral conjunctivitis, there is no specific treatment needed for adenoviral conjunctivitis. Lubricant eye drops may be prescribed to aid with comfort. In severe cases, steroid eye drops may be prescribed as a short-term treatment.
Other rarer causes of viral conjunctivitis such as herpes simplex virus and shingles have specific treatments, which are dealt with by treating the cause itself.
Antibiotic eye drops are used to treat bacterial conjunctivitis. Other rarer causes of bacterial conjunctivitis such as sexually transmitted infections usually require antibiotic tablets and eye drops used in conjunction.
Conjunctivitis can be prevented by avoiding contact with people who have infectious conjunctivitis. Careful hand hygiene is another important way to reduce the chance of developing infectious conjunctivitis. Allergic conjunctivitis can be prevented by avoiding the allergens as described above.
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