Conjunctivitis (Pink Eye): Symptoms, Causes, Therapy and Risks

In conjunctivitis, the eye reddens, runs and often hurts or itches. Behind it can be a bacterial infection, an allergy or a disturbing foreign body in the eye. Accordingly, the treatment methods are also different. You can read here how to recognize a conjunctivitis and how to treat it correctly.

Conjunctivitis: A brief overview

Common symptoms: reddened eyes, watery and (in the morning) sticky eye, swollen conjunctiva, foreign body sensation.

Treatment: Always see a doctor! Depending on the causes; antibiotics (for bacterial conjunctivitis), eye drops with different active substances to alleviate symptoms, also avoid allergens, remove foreign bodies, possibly use household remedies to support the symptoms.

Prevent infection: Bacterial and viral conjunctivitis are highly contagious! As an infected person, do not rub the eye, wash hands, use your own towel, avoid direct contact with other people.

Causes: bacteria, viruses, allergies, foreign bodies, dirty contact lenses, excessive exposure to light, eye strain

Conjunctivitis: Symptoms

The following symptoms are typical of conjunctivitis:

  • reddened eyes
  • watery eye, especially after the night purulent glued together eye
  • swollen conjunctiva (conjunctiva looks glassy swollen), swollen eyelid
  • Photophobic/glare sensitivity
  • Feeling of foreign bodies or pressure in the eye
  • spasmodic lid closure (with severe inflammations involving the cornea)

In addition to the general symptoms, the various triggers of conjunctivitis cause other symptoms that are characteristic of them.

Conjunctivitis: Treatment

The therapy depends on the causes of conjunctivitis. As with other eye diseases, a visit to an ophthalmologist is advisable. He can reliably determine the type of inflammation, recommend the correct treatment and thus prevent other structures of the eye from being affected and permanent damage from occurring.

Treatment of bacterial conjunctivitis

Bacteria can be fought with antibiotics. Ointments or drops containing antibiotics that are applied to the eye and thus act directly at the site of infection are suitable for this purpose. The symptoms should improve after two to three days. Important: Even if you have the feeling that the inflammation has disappeared – always carry out the treatment for as long as the doctor has recommended. Otherwise some bacteria remain, which then multiply again and cause another conjunctivitis.

Sometimes an additional antibiotic is administered in tablet form. This is necessary, for example, when physical infections with bacteria have spread to the eyes. For example, chlamydia, which is also known to cause venereal diseases, can also cause conjunctivitis. In this case, the partner should also be treated. The therapy of conjunctivitis can take longer.

Treatment of viral conjunctivitis

Unlike bacteria, there are no effective drugs against many viruses that can cause conjunctivitis. These include cold viruses or the highly contagious adenoviruses.

Home remedies help alleviate the symptoms. If you have serious symptoms, you can use eye drops containing corticosteroids for a short time. In the long term, however, they are not suitable for therapy because they suppress the body’s own defence system and thus run the risk of delayed healing or additional infection with bacteria. They are then combined with antibiotically effective eye drops.

In children, conjunctivitis often develops after initial contact with the herpes simplex virus (lip herpes virus) or during chickenpox. The active ingredient Aciclovir specifically fights these viruses. The drug is available in the form of eye drops or tablets.

Treatment of allergic conjunctivitis

You can use eye drops containing cortisone for a short time against the watery and swollen eyes. Antiallergic eye drops or drugs that reduce the overactive immune defence can also alleviate the symptoms. Some products are used, before contact with the allergens so that they can work.

Only so-called hyposensitisation can fight the cause of the allergy. The body is slowly accustomed to the allergen that triggers the disease.

Treatment of non-specific conjunctivitis

Whether foreign bodies, contact lenses or solar radiation are the causes of conjunctivitis – the therapy always consists of removing or avoiding the trigger. Rinse out foreign objects or corrosive substances as quickly as possible, remove rubbing contact lenses or avoid further sunlight.

The non-specific conjunctivitis usually heals itself within a few days.

If dry eyes are behind the complaints, tear substitutes help. They wet the eye and keep it moist. Eye drops with hyaluronic acid provide additional moisture because the substance binds water. Take care not to use eye drops containing cortisone as these increase the dryness of the eye.

Treating conjunctivitis with household remedies

Regardless of the triggers of conjunctivitis, you can support the healing process with home remedies. For example, cool compresses help against swelling, such as a quartz layer.

In addition, certain medicinal plants have an anti-inflammatory effect. These include eyebright and marigold.

Attention: Nevertheless, you should have the cause of your conjunctivitis clarified by a doctor. Bacterial or viral inflammation may require additional medication. This prevents worse damage to the eye.

Conjunctivitis: Prevent infection

A viral or bacterial conjunctivitis is very contagious. Patients rub their eyes because it itches and then bring the pathogens to door handles with their hands or pass them on to other people. You can reduce the risk of infection with the following tips:

  • Avoid rubbing your eyes: If the conjunctivitis has already affected one eye, the pathogens can be quickly transmitted to the other eye. Try to resist the urge to rub.
  • Wash your hands: Frequent, correct hand washing and disinfection of the hands reduce the bacterial count.
  • Own towel: Use your own towel or even better disposable towels, which you can dispose of directly after use. So protect family members who live in the same household.
  • No handshaking: Even if it looks unfriendly – do not shake hands if you have conjunctivitis. In this way you can effectively contain the transfer to others.

Conjunctivitis: Causes and Risk Factors

The conjunctiva is traversed by numerous fine blood vessels and thus also supplies the anemic cornea with nutrients. If it is irritated, the blood circulation of the otherwise colourless conjunctiva increases and it reddens.

Irritations of various kinds can lead to conjunctivitis. Doctors distinguish between infectious conjunctivitis caused by bacteria or viruses and non-infectious conjunctivitis caused by allergies or mechanical stimuli. The former are very contagious. Here you should adhere to the strictest hygiene measures and in any case be treated by a doctor.

Symptoms of Bacterial Conjunctivitis

Bacterial causes of conjunctivitis

  • Staphylococci, pneumococci and streptococci: These pathogens are the most common cause of bacterial conjunctivitis in adults and children.
  • Bacteria in cosmetics: The germ Pseudomonas aeruginosa can grow in broken eye drop bottles, cosmetics or contact lens solutions. It leads to conjunctivitis, which spreads at lightning speed, spreads to the cornea and can have dramatic consequences.
  • Chlamydia: Chlamydia transmitted during sexual intercourse easily reaches the eye via the hands. In rare cases, people in the swimming pool also become infected with the pathogens. They cause conjunctivitis, which doctors call inclusion body conjunctivitis. Particularly in countries with poor hygienic conditions, this conjunctivitis can develop into trachoma, which spreads to the cornea and leads to long-term blindness. Chlamydia conjunctivitis is still the main cause of blindness in developing countries.
  • Conjunctivitis in newborns: During birth, infected mothers can transmit bacteria such as gonococci or chlamydia to the newborn. The bacteria are literally pressed into the baby’s eyes in the narrow birth canal and cause severe conjunctivitis after a few days. Newborns, on the other hand, are usually treated preventively.
Symptoms of Viral Conjunctivitis

Viral causes of conjunctivitis

  • Adenoviruses: The subtypes 8 and 19 of adenoviruses cause a highly contagious form of conjunctivitis. At first only one eye is affected, but after only a few days the virus usually spreads to the other eye. In addition, the lymph nodes in the face are swollen. The conjunctivitis is contagious for about two weeks after the second eye is affected. Thorough hygiene measures are important here!
  • Herpes simplex: Especially when children are first infected with the herpes simplex virus, conjunctivitis and small herpes blisters at the edge of the eyelid can occur.
  • Other viruses: influenza, measles, rubella and chickenpox also cause repeated irritation of the conjunctiva. The Enterovirus 70 and the warts virus also cause conjunctivitis.

Other Causes of Infectious Conjunctivitis

  • Fungal infections: They are very rarely the cause of conjunctivitis.
  • Parasites: The simulium fly transmits a parasite that triggers onchocerciasis. This form of conjunctivitis is the most common cause of blindness in tropical Africa. The eye worm, which can also trigger inflammation of the conjunctiva, also occurs frequently in this area.

Causes of allergic conjunctivitis

In allergic conjunctivitis there is a connection with the excessive reaction of the immune system against an actually harmless substance. The following allergies can also affect the conjunctiva:

  • hay fever
  • dust mite allergy
  • animal hair allergy
  • Allergy to cosmetics
  • atopic diseases, such as neurodermatitis or psoriasis

Nonspecific causes of conjunctivitis

  • External stimuli: dust, smoke or sand, but also dry air or UV light can irritate the conjunctiva.
  • Dry eyes: Extensive screen work, hormonal changes during menopause, autoimmune diseases (Sjögren’s syndrome), contact lenses and other causes can limit the function of the tear glands. The consequence of the dry eye is a stronger friction and reduced defence. A conjunctivitis is often the result.
  • Insect spines: A rare but possible cause of persistent conjunctivitis is the penetration of insect spines or caterpillar hairs into the mucous membranes. These can persistently attach themselves to the conjunctiva and thus penetrate deeper with every blink of the eye. In areas populated by the oak processionary moth, for example, there is an increased risk.
  • uncorrected vision problems: Curvatures of the cornea, reduced vision or incorrectly adjusted glasses often lead to conjunctivitis.
  • Deformities of the eyelids
  • inward growing eyelashes
  • Overexertion: overnight stay or strenuous eye work
  • Contact lenses: If they have stayed in the eye too long or are dirty

Conjunctivitis: Examination and Diagnosis

Tearing red eyes belong in the care of the ophthalmologist. He gets to the bottom of the cause of conjunctivitis and determines the appropriate treatment. In addition, conjunctivitis can be contagious – here it is important to take the right measures to prevent infection of fellow human beings.

In a personal conversation (anamnesis), the ophthalmologist first asks about allergies, foreign bodies in the eye, injuries or the use of contact lenses. Often the reason for the red eyes can already be narrowed down in this way.

Afterwards the eyes are closely examined: By looking into the eyes with a lamp, doctors can already see the first changes in the otherwise transparent and shiny conjunctiva. The redness of the eyes also tells the doctor whether the inflammation originates in the conjunctiva or whether the iris and the ciliary body may be affected. If these deeper layers are affected, the eye appears bluish-red especially at the edge of the iris. Since the vessels lie in the layer under the conjunctiva, they cannot be moved either.

Careful folding of the eyelids can reveal inflammations – they leave typical traces on the inside of the eyelids. In this way, foreign bodies can also be found. This examination is rarely really unpleasant for the patients.

Finally, the causative bacteria, viruses, fungi or parasites can be determined using a pathogen smear.

Conjunctivitis: Risks

The conjunctiva is also known as the “lymph node of the eye”; – many inflammations are mild or are already suffocated in the germ. Nevertheless, conjunctivitis can take on stubborn, serious forms, especially in people with a weak immune system. In the poorer regions of the world, these still often lead to blindness.

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