Conjunctivitis

Overview

Casually referred to as “pink eye”, conjunctivitis involves swelling in the conjunctiva. Most often the reason behind the development of this condition is viral infection. The onset of this condition is accompanied by irritation in the eye, which is also a prominent symptom of conjunctivitis. Once you start noticing this symptom, visit a healthcare provider for immediate diagnosis and treatment.

What is Conjunctivitis?

Conjunctivitis is the swelling or inflammation of the conjunctiva of the eye. The conjunctiva is a transparent, thin layer located on the inner surface of the eyelids and the white part of the eyeballs. Since it offers a pinkish colour to the eyes, the disease is commonly known as pink eye. Although it rarely affects your vision, prompt treatments can ease the discomfort.

Types of Conjunctivitis

Conjunctivitis can be classified into different types based on their causes. These types are as follows:

Viral conjunctivitis

This happens to be the most common and contagious form of conjunctivitis caused by viruses responsible for the development of the common cold. Usually, adenovirus is the most common causal organism that includes variants like varicella-zoster virus, herpes simplex virus, etc.

Initially, it starts affecting one eye and gradually spreads to the other eye within 24 to 48 hours. This condition might lead to a swollen lymph under the jawbone or in front of your ear and the appearance of some common symptoms like sore throat, fever, and runny nose.

Some of its subtypes include Nonspecific Acute Follicular Conjunctivitis, Acute Hemorrhagic Conjunctivitis, Pharyngoconjunctival Fever, Epidemic Keratoconjunctivitis, Chronic Adenoviral Conjunctivitis, Systemic Viral Infections, and Herpes Simplex Virus Conjunctivitis.

Bacterial conjunctivitis

Bacterial pink eye is also a contagious type of conjunctivitis which is more prevalent in children than in adults. Usually, this disease develops more frequently between December and April. Similar to viral conjunctivitis, it starts with affecting one eye and gradually spreads to both eyes. However, with prompt treatment, it can be cured without causing eye problems.

Ophthalmia neonatorum is a type of bacterial conjunctivitis that is more common in newborn babies. If not treated at the right time, babies can experience complexities like permanent eye damage. The main reason behind the occurrence of this condition is the exposure to gonorrhoea to chlamydia when the baby passes through the birth canal.

Some of the subtypes of bacterial conjunctivitis include Acute Bacterial Conjunctivitis, Giant Fornix Syndrome, Chlamydial Conjunctivitis, and Trachoma.

Allergic conjunctivitis

This is more common in people with a medical history of seasonal allergies such as from pollens of seasonal flowers. As soon as the individual comes in contact with the trigger, the body produces an antibody called immunoglobulin E (IgE). The IgE stimulates the production of histamines in the mucus cells lining the eyes and airways, resulting in allergic symptoms like pink eyes. However, they are not contagious and can be easily controlled using eye drops.

Giant papillary conjunctivitis is a type of allergic conjunctivitis that develops due to the chronic presence of antibodies in the eye. This is more common in people who wear contact lenses, have sutures in the eye, or have a prosthetic eye.

Its subtypes include Acute Allergic Conjunctivitis, Seasonal Allergic Conjunctivitis, Perennial Allergic Conjunctivitis, Vernal Keratoconjunctivitis, and Atopic Keratoconjunctivitis.

Chemical conjunctivitis

Irritants such as pollutants, chlorinated swimming pool water, and other foreign objects upon coming in contact with your eye can lead to the development of conjunctivitis. However, chemical irritants like Iye upon being splashed into the eye severe eye damage. Hence, it would be prudent to visit a doctor at the earliest to minimise the corrosive effect of these chemicals.

The subtypes of non-allergic type of conjunctivitis include Factitious Conjunctivitis, Contact Allergic Blepharoconjunctivitis, Giant Papillary Conjunctivitis, Ligneous Conjunctivitis, Parinaud Oculoglandular Syndrome, Superior Limbic Keratoconjunctivitis, Mucus Membrane Pemphigoid, and Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis.

Symptoms of Conjunctivitis

Some common symptoms of conjunctivitis include green or white discharge from the eye, more tears than usual, burning sensation in the eyes, sensitivity to light, dryness or watery eyes, swollen eyelids, redness and itching in the eye, and so on.

The symptoms of conjunctivitis vary somewhat depending on the cause of inflammation of the conjunctiva.

Types of Conjunctivitis	Symptoms
Bacterial conjunctivitis	Mild pain and yellow or green discharge from the eyes
Viral conjunctivitis	Itching, tearing, sneezing, and watery nasal discharge
Allergic conjunctivitis	Watery eyes, and mucus discharge

In the early stage of this condition, some of the prominent symptoms include swollen conjunctiva, redness in the white portion of the eye or inner eyelids, itching in the eyes, thick discharge that accumulates in the corners of the eyes, and so on.

Causes of Conjunctivitis

The causes of different types of conjunctivitis vary among each other. These include:

Types of Conjunctivitis	Causes
Viral Conjunctivitis	Adenoviruses, Rubella virus, Herpesviruses, Picornaviruses, Rubeola (measles) virus
Bacterial Conjunctivitis	Staphylococcus aureus, Haemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis, Neisseria gonorrhoeae, Chlamydia trachomatis, etc.
Allergic Conjunctivitis	Pollen from plants, trees, grasses, weeds, dust mites, moulds, animal dander, contact lenses, cosmetics, reaction to eye drops
Chemical Conjunctivitis	Shampoos, smoke, dirt, and pool chlorine

Risk Factors of Conjunctivitis

Some risk factors associated with the development of conjunctivitis include interacting with a person suffering from bacterial or viral conjunctivitis, exposure to allergens, not washing hands regularly, or using the same contact lenses over a long duration. Furthermore, people who are in their 20s with a history of allergy-related conditions like eczema, and sharing personal items are more likely to develop this disease. Studies also show that people are prone to develop conjunctivitis in spring and summer and their infectious form is common during cold and flu seasons.

Diagnosis of Conjunctivitis

There are various tests that doctors prescribe to diagnose the occurrence of conjunctivitis. These diagnostic tests include:

Study of patient’s history: The doctor will ask you questions regarding the onset of the symptoms, the type of eye discharge, seasonal allergies, itching in the eye, and so on. This will help them get clarity about your eye’s condition.

Evaluation of eyes: The healthcare provider will use a bright light to evaluate the conjunctiva, external eye, and inner structures of the eye to learn about the spread of the condition.
Visual acuity measurements: These tests help doctors understand if your vision has been affected due to conjunctivitis.
Supplemental testing: These procedures include testing the smears of conjunctival tissue in case the disease is chronic in nature and is not responding to treatment.

Treatment for Conjunctivitis

The treatment procedure varies somewhat with the type of conjunctiva developed. The conjunctivitis treatment and medications include:

Conjunctivitis Type	Treatment Procedure
Bacterial conjunctivitis	Antibiotics (ointments, eye drops, or pills)
Viral conjunctivitis	Antiviral drugs
Fungal/parasitic conjunctivitis	Antifungal and antiparasitic
Immune-related conjunctivitis	Medicine to minimise damage to the immune system
Allergic conjunctivitis	Over-the-counter (OTC) antihistamines and decongestants
Irritant-related conjunctivitis	Washing eyes with water

Preventive Measures for Conjunctivitis

Although there are so many causes of this condition, there are no particular preventive measures that can protect you from developing conjunctivitis. All you can do is keep your hands clean, refrain from sharing bath towels, washcloths, pillowcases, and handkerchiefs, avoid allergy triggers, throw away infected items, and clean contact lenses carefully. Remember that the key to the prevention of conjunctivitis is strict adherence to cleanliness and maintaining a safe distance from allergens under all circumstances.

Myths and Facts Related to Conjunctivitis

Following are some myths and the associated facts for conjunctivitis:

Myth 1: Only children suffer from pink eye
Fact: Both children and adults can develop pink eye irrespective of their age group.

Myth 2: All types of pink eye is contagious
Fact: Only viral and bacterial conjunctivitis is contagious. Allergic and chemical conjunctivitis are noncontagious.

Myth 3: All home remedies are safe to treat pink eye
Fact: It is not safe to use redness-relieving eyedrops or breast milk for treating conjunctivitis.

Myth 4: It is okay to wear eye makeup and contact lenses when suffering from conjunctivitis
Fact: You should avoid wearing contact lenses and eye makeup when suffering from conjunctivitis

Myth 5: Antibiotic treatment is always needed when suffering from pink eye
Fact: Doctors prescribe antibiotics for conjunctivitis treatment only if the cause behind the development of this infection is bacteria.

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