Treatment of Conjunctivitis

Conjunctivitis

Introduction 1

Conjunctivitis is an infection or inflammation of the conjunctiva. The conjunctiva is a transparent membrane that covers the white part of the eyeball. This condition presents most commonly in emergency departments and primary care centers.  It can affect people of any age or region. It is usually self-limiting but should be assessed thoroughly. 

Conjunctivitis may be acute (lasts only a week or two) or chronic (lasting more than 4 weeks) depending upon the duration of symptoms. It can lead to irritation but does not commonly affect vision. Early diagnosis and treatment help to limit the transmission of disease. 

What Are The Causes And Risk Factors Of Conjunctivitis? 1

Conjunctivitis is the most common cause of redness and discharge from the eyes. It can be categorized into the following depending upon etiology:

• Viral conjunctivitis

• Most acute conjunctivitis cases are viral. 

• Bacterial conjunctivitis 

• It is rare overall but more common in young age groups. 

• Allergic conjunctivitis

• Irritants, drugs, and toxins can lead to noninfectious conjunctivitis. 

The common risk factors for developing conjunctivitis are:

• Contact with infected persons through their body fluids or eyes

• Exposure to someone's bacterial flora

• Exposure to chemicals and irritants

• Wearing contact lenses for longer durations than suggested 

What Are The Signs And Symptoms Of Conjunctivitis? 2

Its signs and symptoms are:

• Itching

• Associated more with allergic cases

• Burning sensation

• Foreign body sensation

• Redness

• Diffuse redness of the conjunctiva

• If redness is localized then consider other alternative causes

• Swelling or puffiness

• Discharge from affected or both eyes

• Purulent discharge in bacterial conjunctivitis 

• Watery discharge in viral and allergic conjunctivitis 

• Excessive tearing

• Blurry vision

• Photosensitivity

Diagnosis Of Conjunctivitis

The diagnosis of conjunctivitis is mainly based on history and physical examination by an ophthalmologist. The bacterial, viral, or allergic causes can be ruled out by a systematic approach of history and examination. The following questions may be asked by an ophthalmologist:

• Duration of onset of symptoms

• Associated signs and symptoms e.g morning matting of eyelids

• Involvement of unilateral or bilateral eyes?

• History of such symptoms?

• Type of discharge

• History of recent upper respiratory tract infection?

• Previous history of allergy or asthma?

He or she may examine the eyes to rule out other conditions and look at the following:

• Visual acuity

• Ocular and extraocular movements

• Shape and condition of eyelids

• Clarity of the cornea

• Intraocular pressure

Blood tests and cultures are not usually performed and reserved for severe, recurrent, or treatment-resistant cases. 

Treatment Of  Conjunctivitis 1 2

The treatment of conjunctivitis is targeted at stopping its transmission and patient education. 

• Conservative management

• Cool compresses

• Artificial tears as needed

• Hand hygiene 

• Medical management

• Bacterial conjunctivitis, although self-limiting, needs antibiotic drops or ointments for a speedy recovery. Antimicrobial drops are usually advised for 5 to 7 days. 

• Viral conjunctivitis due to adenovirus does not need any treatment. General measures e.g cool compresses and artificial tears prove beneficial for relief of symptoms. Herpes simplex and herpes zoster, which are much less common etiologies, may require antiviral medications and topical steroids. 

• Topical steroids are not recommended for common viral conjunctivitis. They may prolong the recovery if used.

• The treatment of allergic conjunctivitis is the removal of irritants, application of cold compress, and artificial tears. Topical antihistamines or topical steroids are reserved for refractory symptoms. 

Prevention of Conjunctivitis 3

Conjunctivitis is an easily treatable and preventable disease of the eye. Its complications are rare. Infectious conjunctivitis spreads from person to person and its spread can be reduced by the following measures:

• Wash your hands before touching the face and eyes.

• Use clean towels and do not share towels if you have symptoms 

• Do not rub the infected eyes

• Follow the recommended guidelines about the use of contact lenses 

References

1. NCBI - WWW Error Blocked Diagnostic. (n.d.-b). NCBI. Retrieved April 7, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK541034/

2. Conjunctivitis: What Is Pink Eye? (2022, January 6). American Academy of Ophthalmology. Retrieved April 7, 2022, from https://www.aao.org/eye-health/diseases/pink-eye-conjunctivitis

3. Roth, E. (2022, February 17). What You Need to Know About Conjunctivitis. Healthline. Retrieved April 7, 2022, from https://www.healthline.com/health/conjunctivitis#treatment

Author

Eye Surgeons Associates Drs. Meiraj A. Siddiqui, Zuhair H. Peracha, Manal H. Peracha-Riyaz, Eric Zuckerman and Leila Siblani are dedicated to excellence in eye care and service. We utilize the latest treatment methods and procedures, including routine eye care, cataract surgery, glaucoma treatment, retinal disease management, diabetic eye treatment, and eyelid surgery.