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since April 1998



All About Pink Eye, or As We Docs Say, Conjunctivitis

by Dr. Abdullah Brooks, 9 Dec 1998

Pink eye (conjunctivitis - for people who like big words) is typically a self-limited infection (that's what we doctor-types call an infection that goes away by itself even though you get billed).

The most common causes, in some studies are bacterial (for those who must know, a study in children in Charlottesville, Virginia, showed the following breakdown of all conjunctival infections in children, two bacteria: Haemophilus aegyptius 42% and Streptococcus pneumoniae 12% [yes, it usually causes pneumonia and other nasty diseases], and a virus, Adenovirus, was 20%, making it the second-most common cause of infection. However, when conjunctivitis is accompanied by sore throat (we like to call it pharyngitis. sounds impressive) and fever the prevalence is 65%. We call this combination "pharyngoconjunctival fever" (next time you don't want company, tell them you have this and you won't have visitors for months).

How do you know you have it? Well, besides the looks of horror and revulsion you will receive, it usually begins with itching and watering of one eye. Often people feel that they have something in their eye. Usually some good Samaritan who tries to look into that person's eye for a foreign body, touches the infected area and becomes the next poor devil to come down with it. [The moral of the story - It's okay to look into someone's eye, just wash your hands immediately afterward.]

Shortly after this irritation comes the inflammation (the pinkness). Frequently the eyelids are stuck shut in the morning with goop. There may or may not be sensitivity to bright light or some blurring of vision (because of all the eye discharge). Commonly, the infection spreads to the other eye, typically because you put it there. [The moral of the story - If you touch the bad eye, wash your hands before you touch the good eye.]

Okay, so you know you or your kid have it, now what do you do? Nothing. Usually. Well, not exactly nothing. First PREVENTION. Meticulous hand washing is essential for both the infected and non-infected parties. Eye secretions find their way onto hands, and the most commonly touched items are the most dangerous. People with conjunctivitis are not to be trusted. (They always tell you that they tried not to touch anything, but they lie.) In the home or office, watch out for telephones, keyboards, bathroom door knobs and faucet handles (toilet handles too), towels and wash cloths (never share wash cloths with someone with pink eye) and refrigerator door handles. (After an infected person touches one of these things, we doctors like to call that thing a "fomite" - neat, hunh?)

Infectious secretions may persist for hours on indoor items. Out of doors, they dry up sooner, but still take no chances. The bottom line - Anything you touch, they touch. Always wash your hands before sticking them in your mouth or eyes. Or nose (yes you do). Sharing plates and eating utensils is okay as long as they are washed in between uses. Kids! The biggest littlest (and cutest) culprits in the spread of infection. If yours have the infection, make them wash their hands frequently (you too), and don't invite people over until you can see the whites of their eyes. Keep them out of school and/or cancel play group (if you're the host, that is). And if you are a grown up, and your superiors don't send you home, stay home anyway.

TREATMENT. You can call your doctor, who will tell you it is a self-limiting infection and send you a bill. Or, use a warm moist cloth in the morning to remove the goop. Warm compresses on the infected eye may be soothing, 4 or 5 times a day for 10 - 15 minutes. In most cases, even if it is a bacterial infection, it goes away with no treatment in 4 or 5 days.

If you need (or want) to treat with antibiotics, consult your doctor first. He or she will probably advise you to use one of the following topical preparations. These cover most of the infectious bacterial organisms, and most are available at local pharmacies: 10% sulfacetamide, sulfisoxazole, trimethoprim-polymixin (my personal favourite), or gentamicin. Place 1 - 2 drops in the infected eye three times daily. Continue treatment for 5 days or for two days after the redness is gone. If it is not gone by 5 days, consult your doctor.

And ALWAYS see your doctor IMMEDIATELY if:

  • there is redness and eye discharge in a newborn
  • there is pain in the eye
  • there is a green discharge from the eye
  • the eye became pink or red after an injury
  • the area around the eye, including upper and/or lower eyelid, becomes red, swollen or painful, with or without fever.