Conjunctivitis (Pink Eye)
What is conjunctivitis?
Conjunctivitis or “pink eye” is the inflammation or infection of the conjunctiva. The conjunctiva is the lining of the eyeball and eyelid that helps keep the eyelid and eyeball moist. When the conjunctiva becomes irritated or infected, the blood vessels get bigger and more noticeable giving the appearance of a “pink” eye. Conjunctivitis can also cause increased tearing, colorful drainage, itchy eyes, blurred vision, and swelling of the eyelid. Although some types of conjunctivitis are contagious, it is not a serious health risk and is short lived with proper treatment. Conjunctivitis is caused by allergies, irritants, viruses or bacteria:
Grasses, pollen, ragweed, and smoke are common allergens affecting the eye. Allergic conjunctivitis may cause itchy, watery, or bloodshot eyes. Allergic conjunctivitis due to the environment usually affects both eyes. The best treatment for allergies is to minimize your exposure to potential allergens. Washing hair at night to rinse away outside allergens and changing pillowcases frequently may help. Over the counter antihistamine agents, such as OpconTM used 3-4 x per day or Zatidor used 2-3 x per day, are very effective in relieving symptoms. In severe cases of allergic conjunctivitis, we would want to see you in the office and a prescription antihistamine drop may be needed.
Substances such as shampoo, dirt, chlorine, or detergents that get into eye may cause pain and inflammation. The best way to treat this type of irritation is to rinse the eye with cool tap water for at least 10 minutes. The easiest way to do this is to have your child lie down in an empty bathtub and pour water directly into the eye.
Viral conjunctivitis is the most common type of conjunctivitis. One eye is usually pink and the eye may have a small amount of clear, yellow, or green discharge. The discharge may appear only in the morning upon waking with minimal discharge during the day. In fact, if you are doing minimal wiping during the day you are probably dealing with viral conjunctivitis. Antibiotic drops will not help since this is a viral infection; antibiotics kill cell walls and viruses do not have cell walls. Viral conjunctivitis is sometimes seen with a cold and like most viruses, it will spontaneously resolve within 3-5 days. It is contagious, so good hand washing is recommended for family members and day care providers.
With bacterial conjunctivitis, the eye is usually bright red and there is a copious amount of purulent yellow or green drainage. The eyes are usually matted shut after sleeping and you find yourself wiping the drainage away every 30 to 60 minutes during the day. Bacterial conjunctivitis is contagious and antibiotic eye drops are generally effective. Occasionally, children with bacterial conjunctivitis also develop an ear infection. If there is significant pus noted, please schedule a visit to determine the cause.
What else can I do if my child has conjunctivitis?
The treatment will vary depending on your child’s symptoms. The treatment goal is to relive symptoms and prevent re-infection.
- Apply cool compresses to the affected eye to relieve the pain or discomfort. If the eyelids are swollen, try a peeled and grated fresh potato, wrap it with gauze, and place it over the eyes. It acts as an astringent and has a healing effect.
- Use disposable tissues to gently wipe discharge away and then throw the tissues away.
- Discourage eye rubbing, if the eye is very itchy it may feel good to use a cold compress on the eye or give a dose of Benadryl orally.
- If light is bothersome, try sunglasses.
- If your child wears contacts, he or she should disinfect them and wear glasses until the conjunctivitis is gone. If they are disposable, please dispose of the infected pair. If your child wears eye make-up, stop using it and throw it away. Replace it with new makeup once the conjunctivitis is gone.
- Don’t forget to wash your hands!
When can my child return to school or day care?
There is no need to restrict your child from day care for allergic, irritant, or viral conjunctivitis. (Yes, even kids with viral conjunctivitis should be allowed to attend day care.) Children should only be excluded from day care if they have “purulent conjunctivitis” which includes a bright red eye and consistent yellow or white drainage. Children with bacterial conjunctivitis may return to day care after using the antibiotic drops for 24 hours. However, some day cares will exclude your child for any type of conjunctivitis.
What if there is drainage from the eye but no redness?
In order to have pinkeye, your child must have an eyeball that is pink or red. If there is drainage coming from your child’s eyes, it is probably due to a cold or a blocked tear duct. Colds can cause drainage from the eye just as there is drainage from the nose. Usually there is drainage from both eyes and will resolve when the cold resolves. Under one year of age, if there is drainage from only one eye, your child probably has a blocked tear duct, a very common condition. The blockage usually resolves by itself.
If you are not sure what type of conjunctivitis your child has, if you have tried some of the techniques mentioned above without success, or if your child is younger than 4 weeks, please give us a call. It is important to remember that although conjunctivitis is a nuisance, it is short-lived and usually not serious.