Q. I was just informed that my child has conjunctivitis. What exactly is that and what can I do if I catch it from him?
A. Conditions that end in “itis” more often than not are describing inflammation and this is no exception. The conjunctiva is a thin, translucent membrane that protects the eye and when it gets inflamed it is termed conjunctivitis. This often presents as a red eye (hence it is commonly referred to as “pink eye”) with or without discharge, some itchiness and possibly some additional symptoms such as fever, sore throat and lymphadenopathy (swollen lymph nodes). Either one eye or both eyes may be affected.
Since conjunctivitis may be contagious, it is important to focus on infection control to reduce spreading it throughout the home. There are a few do’s and don’ts to adhere to:
· Whenever possible, avoid hand-eye-contact
· Use proper handwashing techniques especially before and after administering eye drops if prescribed
· Have a separate towel for the infected family member
· Disinfect household surfaces
· Avoid direct contact with others
· Discard cosmetics and routine prescribed eye drops (if using) to avoid contamination
There are a variety of types of conjunctivitis and they are classified according to the cause of the inflammation. How do you know which type of conjunctivitis you or your child may have? That is often difficult to ascertain but getting some background information can certainly help.
Viral conjunctivitis: This is the most common type of conjunctivitis (it accounts for about 80% of all cases of pink eye) and can be caused by any number of viruses (the vast majority are caused by the adenovirus). Since antibiotics work to get rid of bacteria and not viruses, antibiotic eye drops are not helpful in these cases. Viral conjunctivitis sufferers often complain of a sudden onset of generalized redness, watery discharge, burning, itching and a sensation of having something in the eye (known as a foreign body sensation).
There is no proven treatment for most viral eye infections (the exception is Viroptic but it is only effective in treating infections caused by the herpes simplex virus such as when an outbreak of shingles enters the eye). Therefore, treatment of viral conjunctivitis is aimed at relieving the symptoms and reducing the spread of the infection to other close contacts. To alleviate the symptoms, you may consider using cold compresses (such as a washcloth soaked in cold water) and/or instilling chilled artificial tears or antihistamine eye drops which may help reduce the itching and/or burning. Decongestant eye drops may help to reduce redness but it is important to only use them for less than 4 consecutive days or you may risk rebound eye redness when you try to come off of them. It is also not advised to use decongestant eye drops if you have glaucoma.
Bacterial conjunctivitis: The winter months are a prime time for children to be inflicted with a bacterial infection of some sort or another. For some children, this may progress to bacterial conjunctivitis when they cough into their hands/ rub their nose and then touch their eye(s). Some helpful measures to reduce discomfort from bacterial conjunctivitis are to apply warm compresses several times a day. This is especially useful if you are waking up in the morning with your eyelids stuck together. Remember to put the used cloth directly in the wash pile and wash your hands afterwards.
Using a sterile saline wash may help remove the “guck” from the eyes. Parents in helping care for their child’s eye frequently wind up infected themselves, not a surprise given how contagious this can be. Rest assured, most cases of bacterial conjunctivitis cases are self-limiting, meaning they will resolve without treatment, within 7-10 days. For those who would like to speed up the resolution however, they may go to the ER, call their doctor or, as of January, book an appointment with a pharmacist.
Treatment for mild cases of bacterial conjunctivitis (where there is only a little discharge or tearing and mild burning) is usually the over-the-counter eye drop polymyxin B/gramicidin (better known as Polysporin). There are prescription eye drops that can be prescribed for more significant cases (and due to the long-term supply issue with Polysporin they are frequently used for mild cases these days as well) that work the vast majority of the time. Note: that pharmacists can only prescribe antibiotic eye drops for adults at this time.
Allergic conjunctivitis: As the name implies, this type is secondary to symptoms of allergies and is often associated with an itchy eye, redness, mucoid discharge and eyelid swelling. This type of conjunctivitis usually presents itself in both eyes rather than just one. If you usually suffer from seasonal allergies and you are in the midst of that allergen (trees, grass, ragweed etc.) or if you have a pet allergy and are exposed to them then you quite likely have allergic conjunctivitis. This type is not contagious so you do not have to focus too much on the above suggestions to reduce transmission. To help reduce some of the symptoms, you may try using artificial tears or a saline solution. There are also a number of both over the counter and prescription eye drops that can relieve your symptoms so contact your pharmacy for a consult.
Hyperacute bacterial conjunctivitis: This type of eye infection has a very rapid onset and worsens very quickly. It is associated with a lot of eye discharge and also reduced vision. Most often this type of eye infection is caused by neisseria gonorrhea OR chlamydia trachomatis which are bacteria commonly associated with sexually transmitted infections (STI’s). Due to the rapid deterioration and the seriousness of this type, it is imperative to consult a physician as soon as possible.
For more information on this or any other health topic, contact your pharmacist.