Conjunctivitis: Different Types of Causes and Prevention

Conjunctivitis: Different Types of Causes and Prevention

Pink eye (conjunctivitis) is an inflammation of the clear membrane that covers the white part of the eye and lines the inner surface of the eyelids. Your eyes also may itch, hurt or and discharge from the eye. Eye infections can occur in different parts of the eye and can affect just one eye or both.

Conjunctivitis can be caused by a virus, bacteria, irritating substances (shampoos, dirt, smoke, and especially pool chlorine), allergens (substances that cause allergies) or sexually transmitted diseases (STDs). Pink eye caused by bacteria, viruses, and STDs can spread easily from person to person, but is not a serious health risk if diagnosed promptly.

Conjunctivitis is most often the result of viruses, such as those that cause the common cold. Other causes can be bacterial infections, allergies, chemicals, irritation from contact lenses, or eye injury. Viral and bacterial conjunctivitis are very contagious.

Herbal medicines such as ginkgo biloba, echinacea purpurea which are used to treat tinnitus, asthma, tonsillitis, colds, coughs, fevers, urinary tract infections, burns, influenza and others reports of eye irritation and conjunctivitis have been associated with its topical use.

Atopic keratoconjunctivitis is seen in patients with underlying atopic dermatitis. Eye itching and rubbing are the predominant symptoms. Complications such as cataracts and corneal scarring may occur if the condition goes untreated. Allergic conjunctivitis and blepharitis are other common, more benign causes of "red eye" in children. Sudden onset of pain, visual loss or a "ciliary flush" on exam of the eye should raise the possibility of a more severe problem.

An infected mother can also pass chlamydia (STD) to her baby during childbirth. Babies born to infected mothers can get pneumonia or infections in their eyes, also called Trachoma (granular conjunctivitis). After repeated episodes, which begin in childhood, scarring occurs, and the eyelids turn inward causing damage to the cornea. If gonorrhea (STD) infects the eye, men and women might experience conjunctivitis (inflammation of the eyelid lining).

Acute hemorrhagic conjunctivitis (AHC) is an epidemic form of highly contagious conjunctivitis and is characterized by sudden onset of painful, swollen, red eyes, with conjunctival hemorrhaging and excessive tearing.

Allergic conjunctivitis is irritating and uncomfortable, but it will not hurt your eyesight. However, if a patient has pain in an eye that is red, you must take it seriously. The more intense the pain, the more serious the problem and the more likely that if nothing is done in good time, blindness may result. On the other hand, some painless eye conditions are “slow poisons” causing blindness when the patient still feels all is well.

In some regions, nearly half of all patients with acute infectious conjunctivitis presenting to a primary care provider or emergency room physician may receive unnecessary antibiotic treatment. Antibiotic resistance is also a problem in the eye. Unfortunately, current treatments for conjunctivitis are not targeted specifically to the virus, and currently there is no FDA-approved therapy for the treatment of adenoviral-mediated eye infections.

Analysis of survey data from 1832 students indicated that close contact with a student with conjunctivitis, wearing contact lenses, membership on a sports team, and attending parties at or living in a fraternity or sorority house were associated with conjunctivitis.

Studies shown that children with greater exposure to immune-challenging situations, such as day care or exposure to farm animals, develop less atopy than children kept in more sterile environments.

A new survey reveals that more than half (54 percent) of contact lens wearers who suffer from eye-related allergies find it very uncomfortable to wear their lenses while suffering from allergies, leading many to either change their contact lens wearing habits or abandon lens wear until allergy season passes; according to the Asthma & Allergy Foundation of America.

The occurrence of severe forms of allergy, including atopic keratoconjunctivitis (AKC) and vernal keratoconjunctivitis (VKC), is extremely rare and represents less than 5% of ocular allergy. Seasonal allergic conjunctivitis (SAC) and pan- seasonal (also called perennial) allergic conjunctivitis (PAC) are seen with much greater frequency and regularity by the clinician and are therefore the primary focus of diagnostic and treatment efforts.

Recently (Jan,2008) the American Medical Association will issue a new Current Procedural Terminology (CPT) code for "Infectious agent antigen detection by immunoassay with direct optical observation; Adenovirus" -- will cover the RPS Adeno Detector(TM) that is the first true point of care test available for conjunctivitis; Cleared by the Food and Drug Administration (FDA).

This test is highly sensitive and specific tool, and it provides a definitive result in 10 minutes to make an accurate laboratory confirmation of adenoviral conjunctivitis at the time of the patient exam.

Gamma globulin, a type of antibody isolated from blood samples that used to be routinely given to health care workers and international travelers to protect them from infectious diseases, is a highly effective treatment for pinkeye with little apparent toxicity, according to a study recently (Aug. 29, 2007) by researchers at the University of Pittsburgh School of Medicine.


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

Patients who do not get timely treatment may establish a “priming” of the antigen responsible. In other words, a smaller amount of antigen can create a harsher allergic reaction. Management of ocular allergy includes prophylactic treatment and avoidance of long-term damage from the allergic response. Cool compresses three times daily for 1 - 3 weeks. You may also use antihistamines to relieve inflammation.

If you are allergic to pollen or mold, stay indoors when pollen and mold levels are high. You can usually find out when allergen levels are high from the weather report. Warm or cool compresses may ease your child's discomfort. The virus will last about a week and there’s not much you can do except treat the cold symptoms.

Peter W. Rose, M.D., of the University of Oxford, and colleagues suggested to a randomized study "Parents should be encouraged to treat children themselves [with topical lubricants] without medical consultation, unless their child develops unusual symptoms or symptoms persist for more than a week."

An expert reported that replacing their contact lenses either once every one to two weeks or less frequently. A leading allergy expert says daily disposable contact lenses may be the best alternative for allergy sufferers.

To control outbreaks of AHC, prevention methods (e.g., frequent hand washing and avoidance of sharing towels and bedding) should be targeted to groups at highest risk, and information should be disseminated after the first report of AHC in the area.

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