PINK EYE (CONJUNCTIVITIS): CAUSES, SYMPTOMS, AND TREATMENTS

Conjunctivitis, also termed Pink Eye, is a common eye inflammation affecting the thin membrane (Conjunctiva) that covers the eyeballs and eyelids, with an estimated worldwide prevalence of over 2%.

This condition can be caused by viruses, bacteria, allergens, irritants, foreign objects in the eye, or blocked tear ducts (in babies). Viral or bacterial pink eye is highly contagious, while other types are not. 

The majority of cases of pink eye are viral and heal spontaneously. Conjunctivitis caused by bacteria usually requires antibiotics in the form of an ointment, eye drops, or pills.

Continue reading to learn more about Pink Eye, what it looks like, and how you can treat or even prevent it.

What Is Pink Eye?

The thin, translucent membrane that lines the inside of your eyelids and the whites of your eyes becomes inflamed when you have pink eye. The condition is sometimes referred to as conjunctivitis because of this affected membrane, i.e., the conjunctiva. 

The conjunctiva keeps your eyes lubricated and protected by producing mucus and tears.

The small blood vessels of the conjunctiva become swollen and more visible when this protective layer is irritated by an infection or allergen, causing the eye to turn red or pink.

Although pink eye symptoms may vary depending on the cause of the eye inflammation, the most common ones include:

• Pink or red tinge in one or both the eyes
• Teary eyes
• Itchiness, irritation, or a burning sensation in one or both eyes
• A discharge (pus or mucus) coming out of one or both eyes
• Crusty eyes (crusting on the eyelashes or eyelids), especially in the morning (the crust is dried-out discharge and could prevent you from opening your eyes properly)
• The sensation of a foreign particle in your eye or feeling the urge to rub your eyes
• People who wear contact lenses may feel their contacts have become uncomfortable or would not stay in place

Although conjunctivitis rarely affects vision, it can be very irritating and contagious. Early diagnosis and treatment can help limit its spread.

What Causes Pink Eye Infection?

You can get pink eye from the following:

Viruses

Several viruses can cause viral conjunctivitis, including Adenoviruses, Herpesviruses, Picornaviruses, the Rubella virus, and the Rubeola virus (measles virus). 

If caused by a virus, pink eye can be highly contagious. These viruses typically spread through hand-to-eye contact after touching something contaminated with the virus.

You can get viral conjunctivitis if your hand touches your eyes after coming in contact with the following:

• The tears or eye discharge of someone with the infectious virus
• Fecal matter containing the infectious virus
• The respiratory discharge of an infected individual

Typically, pink eye starts in one eye and spreads to the other within a few days when caused by a virus. Adults with viral pink eye may experience the following additional symptoms:

• Symptoms of a cold, flu, or another respiratory infection
• A fever with a sore throat
• Watery eye discharge

Viral conjunctivitis can spread to others while you still have symptoms (usually lasting a week or sometimes two). 

Bacteria

Many bacterial species can cause conjunctivitis, including Haemophilus Influenzae, Chlamydia Trachomatis, Staphylococcus Aureus, Streptococcus Pneumoniae, Neisseria Gonorrhoeae, and Neisseria Meningitidis.

Bacterial pink eye can spread in several ways, such as:

• Hand-to-eye contact after touching something containing the pink eye causing bacteria
• When contaminated objects, such as contact lenses, glasses, pillows, clothes, etc., come in contact with the eyes
• During sexual encounters, when the eye comes in contact with the genitals of a person infected with the bacteria 
• Coming in contact with large respiratory tract droplets of a person infected with the bacteria
• From pregnant mother infected with the bacteria to baby (can cause bacterial pink eye in newborns)

People with bacterial conjunctivitis may experience the following additional symptoms:

• Swelling and pain in the eyelids
• A pus discharge from the eyes that can make your eyelids stick together and decrease your vision  
• An ear infection (sometimes)

Pink Eye caused by bacteria can spread to others for as long as there is discharge from the eyes or until after 24-48 hours of starting antibiotic treatment.

Allergens

Pink Eye can result from exposure to allergens, such as pollen, grass, dust, mold spores, and animal dander (tiny animal dandruff).

Allergic pink eye usually presents in both eyes simultaneously and is not contagious.

People with allergic conjunctivitis may experience additional symptoms of allergies, such as swelling in the eyes, sneezing, itchy nose, scratchy throat, or asthma.

Irritants

Conjunctivitis may also be caused by substances that cause irritation when it comes in contact with the eyes, such as shampoos, cosmetics, contact lenses, smoke, fumes, and pool chlorine.

You can also develop pink eye from a chemical splash if some of the chemicals get into your eye.

Conjunctivitis caused by irritants causes watery eyes with mucus discharge and is not contagious.

Foreign objects

You can get pink eye if you have a foreign body stuck in your eye, such as a loose eyelash, a wood chip, a piece of glass, metal shaving, or an insect.

This type of conjunctivitis is also not contagious.

Blocked tear duct

Blocked tear ducts can cause pink eye in babies.

Additional symptoms of conjunctivitis in babies or toddlers include a painful swelling near the inside corner of the eye and mucus or pus discharge from the eyelids and surface of the eye.

How Does Pink Eye Go Away?

Treatment of pink eye depends on what causes it. 

Since pink eye is viral in most cases, it usually goes away on its own – antibiotics do not help with viral infections or conjunctivitis caused by allergens, foreign objects, or irritants.

Treatment of non-bacterial pink eye usually focuses on relieving your symptoms using the following methods:

• Cleaning the eyelids with a wet cloth
• Using artificial tears
• Applying warm or cold compresses to the eyes several times a day
• Rinsing your eyes with warm water for a few minutes (especially for pink eye caused by irritating substances)
• Eye Drops containing antihistamines, anti-inflammatory drugs, or decongestants for pink eye caused by allergies

Antiviral medications could help treat pink eye if it is caused by the herpes simplex virus. 

For bacterial pink eye, the treatment usually involves prescription antibiotics in the form of eye drops, ointments, or pills.

Pink Eye Prevention

You can help prevent the spread of pink eye by staying at home and distancing yourself from others until you are no longer contagious.

Practicing the following good hygiene and eye care practices can also help limit the spread of conjunctivitis:

• Maintaining proper hand hygiene by washing them often with soap and water
• If you suspect you have conjunctivitis, refrain from touching or rubbing your eyes.
• Clean your hand properly with soap and warm water after removing discharge from your eyes or applying ointment or eye drops
• Safely dispose of any tissues, cotton swabs, or cotton balls used to remove discharge from your eyes (do not let anyone else touch those, and wash your hands well after using them)
• Do not share contact lenses, cosmetics, towels, or other personal items with others

Pink Eye usually resolves on its own without treatment within a week or two. Conjunctivitis can be treated if you or your child are diagnosed with it, so seek medical attention right away. Prompt medical care can help you speed up your recovery and limit the spread to others.

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Sources:

• Conjunctivitis - StatPearls - NCBI Bookshelf
• Bacterial Conjunctivitis - StatPearls - NCBI Bookshelf
• Conjunctivitis: A Systematic Review - PMC
• Viral Conjunctivitis - StatPearls - NCBI Bookshelf    
• Conjunctivitis: Overview - InformedHealth.org - NCBI Bookshelf

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