CONJUNGTIVITIS

Conjunctivitis is swelling of the thin, clear layer that covers the white of your eye and lines your eyelid (the conjunctiva). It’s sometimes called pink eye.

The two most common types of conjunctivitis are infective (viral and bacterial) and allergic conjunctivitis. Infective conjunctivitis makes up just over a third of all eye problems in the UK each year. Over half of all visits to the GP for eye problems are due to forms of conjunctivitis.

SYMPTOMS OF CONJUNGTIVITIS

Conjunctivitis can affect one or both of your eyes. The symptoms of conjunctivitis include:

• redness of the white of your eye
• pain in your eye, such as a burning sensation, throbbing or aching
• white or yellow discharge in your eyes – this may cause them to stick together in the morning and be difficult to open
• blurry vision that clears on blinking caused by discharge around your eye
• a gritty feeling in your eye that may cause an itching or burning sensation
• watery eyes
• sensitivity to light, though this is usually mild

If you have allergic conjunctivitis, you may have hay fever symptoms, such as sneezing, a runny, itchy nose and itchiness at the back of your throat.

If you have infective conjunctivitis, you may have cold-like symptoms, such as a fever and sore throat.

Some of these symptoms can be caused by problems other than conjunctivitis. If you have any of these symptoms, see your GP for advice.

DIAGNOSIS

Often the infection will clear up on its own and you can use self-help measures to ease any discomfort. However, if your symptoms persist or get worse, see your GP. He or she will ask about your symptoms and examine you, and may also ask you about your medical history. Your GP may take a swab of your eye. This will be sent to a laboratory to be tested and help identify the cause of your conjunctivitis. He or she may refer you to an ophthalmologist (a doctor who specialises in eye health), although this is rarely necessary.

If you think your baby has neonatal conjunctivitis, see you GP immediately.

TREATMENT

Treatment of your conjunctivitis will vary depending on what caused it.

Self-help

If you use contact lenses, don’t wear them until your conjunctivitis has completely cleared up. If they are disposable lenses, use a fresh set when it has cleared. It’s also important not to rub your eyes and to make sure you regularly wash your hands. Don’t share pillow cases, towels or go swimming until your conjunctivitis has completely cleared up. Don’t share your eye cosmetics and regularly replace products you use on your eyes.

If you have allergic conjunctivitis, try to steer clear of whatever is causing your allergic reaction. For example wearing sunglasses can reduce exposure to pollen, as can staying indoors when the pollen count is high. A cool compress, such as a facecloth soaked in cold water, may help to soothe your eyes.

Infective conjunctivitis usually settles without any treatment within about two weeks. You may find it helps to wipe away any discharge from your eyelids and lashes with cotton wool soaked in cooled boiled water or saline. To help ease the discomfort of infective conjunctivitis, you may find a warm compress, such as a facecloth soaked in warm water, soothing on your closed eyes.

Although infective conjunctivitis is contagious, you don’t necessarily need to take time off work. If your children have conjunctivitis, they can still go to school while it’s being treated. However, if there is an outbreak of infective conjunctivitis, the school may advise otherwise.

Medicines

If you have bacterial conjunctivitis, your GP may prescribe you antibiotic eye drops (or ointment for children). You can also buy these medicines over the counter from a pharmacist.

Antihistamine medicines or eye drops may help if you have allergic conjunctivitis. These will give you rapid relief from your symptoms.

Your GP may also prescribe a type of medicine called mast cell stabilisers, such as sodium cromoglicate or nedocromil sodium. These come in the form of eye drops. Mast cell stabilisers work by stopping allergy cells from releasing substances that cause swelling and inflammation. These are more effective for long-term relief of allergic conjunctivitis but may take a few days to start working. It’s important that you take them regularly as indicated. You can take antihistamines at the same time as mast cell stabilisers to give you immediate relief while you wait for the mast cell stabilisers to work.

Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist or GP for advice.

If your conjunctivitis is caused by a virus, it usually clears up on its own without the need for medicine. This usually takes no longer than two weeks.

CAUSES

Viral conjunctivitis

Viruses are a common cause of conjunctivitis. The virus most often associated with conjunctivitis also causes the common cold (adenovirus). You may have infective conjunctivitis if you have a cold or have come into contact with somebody who is coughing or sneezing. Viral conjunctivitis typically affects both eyes and may cause a lots of watery discharge too.

Bacterial conjunctivitis

You can get bacterial conjunctivitis by:

• coming into contact with somebody who already has conjunctivitis
• having recently had an upper respiratory infection, such as a common cold
• wearing contact lenses which have become infected
• touching your eyes with unwashed hands
• using eye make-up and facial lotions that are contaminated

Neonatal conjunctivitis affects newborn babies (within the first month of life). It’s different to conjunctivitis that babies may develop as they get older. One of the most common causes is by an infection passed on by the baby’s mother if she has chlamydia or gonorrhoea when giving birth. This can happen even if the mother has no symptoms of infection. Neonatal conjunctivitis can cause permanent eye damage if it isn’t treated quickly. See our FAQs for more information.

Allergic conjunctivitis

You’re more likely to get allergic conjunctivitis if you already have allergies.
If you’re allergic to plant pollens that are released at the same time each year, you may get seasonal allergic conjunctivitis. All year round (perennial) allergic conjunctivitis can be caused by house dust mites and animal fur.
You may get a form of allergic conjunctivitis called giant papillary conjunctivitis. This can occur if you use contact lenses and are allergic to them, or if you have had eye surgery. See our FAQs for more information.

Using eye drops and eye make-up can cause inflammation of your eyelids. This form of conjunctivitis is called contact dermatoconjunctivitis.

Irritant (chemical) conjunctivitis

Chemical conjunctivitis can be caused by a number of things including:

• irritant chemicals
• chlorine in a swimming pool
• air pollution
• contact lenses and their cleaning solutions

PREVENTION

There are a number of ways you can prevent the spread of conjunctivitis. Some examples are listed below.

• Change your pillow cases regularly.
• Use clean towels and washcloths, and don’t share them.
• Wash your hands regularly.
• Avoid contact with people that have conjunctivitis.
• Clean your contact lenses correctly.
• Replace your eye make-up products regularly.
• Try to not touch your eyes with your hands.