Eye Infections Exposed: Understanding and Treating Conjunctivitis

Causes of Conjunctivitis

Conjunctivitis can be classified into several types based on its cause:

Viral Conjunctivitis

Causes: This is the most common type and is usually caused by adenoviruses. It can also be associated with other viral infections such as the common cold, measles, or COVID-19. Transmission: Viral conjunctivitis spreads through respiratory droplets, direct contact with an infected person, or contact with contaminated surfaces such as towels, tissues, or hands. Characteristics: It often starts in one eye and can spread to the other. Symptoms may worsen for 3-5 days before gradually improving.

Bacterial Conjunctivitis

Causes: Caused by bacteria such as Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, and in some cases, Neisseria gonorrhoeae or Chlamydia trachomatis. Transmission: Bacterial conjunctivitis spreads through direct contact with an infected person or contaminated objects, such as makeup applicators or contact lenses. Characteristics: Bacterial conjunctivitis is characterized by a thick, yellow-green discharge that can cause the eyelids to stick together, especially after sleep. It can affect one or both eyes.

Allergic Conjunctivitis

Causes: Triggered by allergens such as pollen, dust mites, pet dander, or mold. Seasonal allergic conjunctivitis is related to specific allergens present at certain times of the year, while perennial allergic conjunctivitis occurs year-round due to constant exposure to allergens. Transmission: Allergic conjunctivitis is not contagious. Characteristics: Symptoms include severe itching, redness, and watery eyes. Patients often have other allergic conditions such as hay fever, eczema, or asthma.

Irritant Conjunctivitis

Causes: Exposure to irritants such as smoke, chlorine in swimming pools, or harsh chemicals. Transmission: Irritant conjunctivitis is not infectious and does not spread from person to person. Characteristics: Symptoms resolve once the irritant is removed. Common symptoms include redness, burning, and tearing.

Symptoms of Conjunctivitis

The symptoms of conjunctivitis can vary depending on the cause but generally include:

• Redness: The white of the eye becomes red or pink due to inflammation of the blood vessels in the conjunctiva.
• Itching or Burning: A persistent urge to rub the eyes or a burning sensation is common, especially in allergic conjunctivitis.
• Discharge: Viral and bacterial conjunctivitis can produce a watery or thick discharge that may cause the eyelids to stick together, particularly after sleeping. Allergic conjunctivitis typically causes a clear, watery discharge.
• Swelling: The conjunctiva or eyelids may swell, leading to puffy eyes.
• Sensitivity to Light (Photophobia): Bright lights may cause discomfort or pain.
• Gritty Feeling: Patients often describe a sensation of having sand or grit in their eyes.

Diagnosis

Diagnosis of conjunctivitis is usually made based on a patient’s history and a clinical examination by an eye care professional. In some cases, additional tests may be necessary:

• Patient History: The healthcare provider will ask about recent illnesses, exposure to allergens, use of contact lenses, and any other relevant information.
• Clinical Examination: The eye will be examined for signs of redness, discharge, and swelling. A slit-lamp examination may be performed to get a detailed view of the eye structures.
• Laboratory Tests: In cases where the diagnosis is unclear or if the conjunctivitis is severe, a swab of the discharge from the eye may be taken and sent to a laboratory to identify the specific cause (bacterial, viral, or allergic) and to rule out more serious conditions.

Treatment

The treatment of conjunctivitis depends on its underlying cause:

Viral Conjunctivitis

• Supportive Care: There is no specific antiviral treatment for most cases of viral conjunctivitis. Symptoms usually resolve on their own within 1-2 weeks. Supportive care includes the use of artificial tears to relieve dryness and discomfort, cold compresses to reduce swelling, and good hygiene practices to prevent spread.
• Hygiene: Patients should wash their hands frequently, avoid touching their eyes, and refrain from sharing towels or pillows. Disposing of tissues after use and cleaning surfaces can help reduce the spread of the virus.

Bacterial Conjunctivitis

• Antibiotics: Antibiotic eye drops or ointments are prescribed to treat bacterial conjunctivitis. Common antibiotics include erythromycin, bacitracin, or a combination of polymyxin B and trimethoprim. It is important to complete the entire course of antibiotics even if symptoms improve to prevent recurrence and antibiotic resistance.
• Hygiene: Similar to viral conjunctivitis, good hygiene practices are crucial. Patients should avoid sharing personal items and ensure proper hand hygiene.

Allergic Conjunctivitis

• Avoiding Allergens: The best way to prevent allergic conjunctivitis is to avoid exposure to known allergens. This may involve using air purifiers, keeping windows closed during high pollen seasons, and frequently cleaning to reduce dust mites and pet dander.
• Medications: Antihistamine or anti-inflammatory eye drops can provide relief. Over-the-counter options include ketotifen and olopatadine. In severe cases, oral antihistamines or corticosteroids may be prescribed. Mast cell stabilizers, such as cromolyn sodium, can also be used to prevent allergic reactions.

Irritant Conjunctivitis

• Removing the Irritant: The primary treatment is to remove the irritant and provide symptomatic relief. For chemical exposures, immediate flushing of the eyes with water is essential.
• Supportive Care: Artificial tears can help soothe the eyes, and cold compresses can reduce inflammation and discomfort.

Prevention

Preventing the spread and occurrence of conjunctivitis involves several measures:

• Good Hygiene: Frequent hand washing with soap and water is essential. Avoid touching the eyes with unwashed hands and refrain from sharing personal items such as towels, washcloths, and eye cosmetics.
• Contact Lens Care: Properly clean and store contact lenses according to the manufacturer's instructions. Avoid wearing contact lenses while experiencing symptoms of conjunctivitis and dispose of any lenses used during an infection.
• Avoiding Allergens and Irritants: Identify and minimize exposure to allergens and irritants. Use air purifiers, maintain a clean environment, and avoid known triggers.
• Immunization: For certain types of bacterial conjunctivitis, such as those caused by Haemophilus influenzae type b, vaccination can reduce the risk of infection.

Conjunctivitis is a common eye condition that, while often mild, can cause significant discomfort and is highly contagious in some forms. Understanding the causes, symptoms, and appropriate treatments can help manage the condition effectively and prevent its spread. Practicing good hygiene, avoiding known allergens and irritants, and seeking medical advice when necessary are essential steps in managing conjunctivitis. If symptoms persist or worsen, it is important to consult a healthcare professional to rule out more serious conditions and receive appropriate care.