Viral or Bacterial Conjunctivitis

What is conjunctivitis?

Conjunctivitis is inflammation of the conjunctiva. The conjunctiva is the clear membrane that lines the inside of the eyelids and covers the white of the eye.

Viral conjunctivitis is sometimes called pink eye.

How does it occur?

Conjunctivitis can be caused by many things, including infection by viruses or bacteria. Viruses that cause colds may lead to conjunctivitis. Some bacteria that cause conjunctivitis are chlamydia, staphylococci, and streptococci. Severe conjunctivitis, such as that caused by the bacteria that cause gonorrhea, is rare, and can cause blindness.

Viral forms of conjunctivitis can be spread easily to other people. The same viruses that cause the common cold can cause viral conjunctivitis. They can be spread the same ways as the common cold: coughing or sneezing and can get in your eyes through contact with contaminated objects, including:

• hands
• washcloths or towels
• cosmetics
• false eyelashes
• soft contact lenses

What are the symptoms?

Symptoms may include:

• itchy or scratchy eyes
• redness
• sensitivity to light
• swelling of eyelids
• matting of eyelashes
• watery or pus discharge

How is it diagnosed?

Your healthcare provider will ask about your medical history and if you have been near someone who has conjunctivitis. Your provider will examine your eyes. He or she will also check for enlarged lymph nodes near your ear and jaw. Your provider may get lab tests of a sample of the pus to see what type of germs are present.

How is it treated?

Like a cold, viral conjunctivitis will usually go away on its own without treatment. However, your healthcare provider may prescribe eyedrops to help control your symptoms. Antihistamine pills may also relieve the itching and redness.

If you have bacterial conjunctivitis, your healthcare provider will prescribe antibiotic eyedrops. You can also help your eyes get better by washing them gently to remove any pus or crusts. Then dry them gently with a clean towel.

For very severe forms of conjunctivitis, antibiotics may need to be given by mouth or with a shot or an IV (intravenous line).

If you wear contact lenses, you will need to stop wearing them until your eyes are healed. The combination of contacts and conjunctivitis may damage your cornea (the clear outer layer on the front of your eye) and cause severe vision problems. Your provider may ask you to throw away your current contact lenses and case.

How long will the effects last?

Viral conjunctivitis usually gets worse 5 to 7 days after the first symptoms. It can get better in 10 days to 1 month. If only one eye is affected at first, the other eye may become infected up to 2 weeks later. Usually, if both eyes are affected, the first eye has worse conjunctivitis than the second.

Bacterial conjunctivitis should improve within 2 days after you begin using antibiotics. If your eyes are not better after 3 days of antibiotics, call your healthcare provider.

How can I prevent conjunctivitis?

To keep from getting conjunctivitis from someone who has it, or to keep from spreading it to others, follow these guidelines:

• Wash your hands often. Do not touch or rub your eyes.
• Never share eye makeup or cosmetics with anyone. When you have conjunctivitis, throw out eye makeup you have been using.
• Never use eye medicine that has been prescribed for someone else.
• Do not share towels, washcloths, pillows, or sheets with anyone. If one of your eyes is affected but not the other, use a separate towel for each eye.
• Avoid swimming in swimming pools if you have conjunctivitis.
• Avoid close contact with people until your symptoms improve. Depending on your job, you may be asked to take some time off from work.

When should I call my healthcare provider?

Call your provider if:

• You have any severe eye pain.
• Your symptoms do not improve after you have used your medicine for 3 days (if you have bacterial conjunctivitis).
• Your symptoms do not improve after 2 weeks (if you have viral conjunctivitis).
• Your eyes become very sensitive to light, even up to a few weeks after the redness is gone.