Introduction:

Conjunctivitis, or pinkeye, is an inflammation of the membrane covering the inside of your eyelids and the outer part of your eye. It is generally not serious but can be highly contagious. Conjunctivitis often feels like you have something in your eye that you can’t get rid of. The condition can be caused by bacteria or a virus, or by an allergic reaction or exposure to a chemical irritant.

Signs and Symptoms:

Conjunctivitis causes the following symptoms in one or both eyes:

• Redness and tearing
• Itching
• Swollen eyelid
• Discharge (watery or thick)
• Crust that forms overnight
• Sensitivity to light
• Gritty feeling

What Causes It?:

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.

What to Expect at Your Provider's Office:

If you have conjunctivitis in both eyes, with itching and a clear discharge, allergies are likely the cause. Viral or bacterial conjunctivitis usually begins in one eye and then spreads to the other. Swollen glands and a watery or mucous discharge usually indicate a virus, while a thick, crusty discharge may be a sign of a bacterial infection.

Your doctor may diagnose conjunctivitis from looking at your eye and asking you about your symptoms. Your doctor may also use a slit lamp for closer examination, or gently swab a stain across the surface of your eye.

Treatment Options:

Conjunctivitis is generally not a serious problem and often will go away by itself. You should still, however, see your doctor. Chronic conjunctivitis, if left untreated, can cause permanent eye damage.

Treatment varies depending on what is causing the inflammation. Bacterial conjunctivitis is generally treated with antibiotic eyedrops or ointment. Viral conjunctivitis does not respond to antibiotics, but antihistamines and anti-inflammatory medications may help relieve your symptoms. Warm or cool compresses may help reduce itching and swelling.

Drug Therapies

Viral conjunctivitis: Generally, your doctor will let the virus run its course. Your doctor may prescribe antiviral eyedrops, such as acyclovir (Zovirax) or trifluridine (Viroptic). Warm compresses applied three times daily for 1 - 3 weeks may relieve discomfort.

Allergic conjunctivitis: Your doctor may recommend allergy shots over several months, to reduce your sensitivity to the allergen. Antihistamine eyedrops, such as over-the-counter antazoline phosphate (Vasocon-A) or prescription olopatadine ophthalmic (Patanol), may reduce swelling or itching. A cool compress may help relieve symptoms, too.

Bacterial conjunctivitis: is treated with antibiotic eyedrops, such as sodium sulfacetamide (Cetamide, Bleph-10), or ointment such as erythomycin (E-Mycin), bacitracin, or neomycin.

Complementary and Alternative Therapies

Alternative therapies can help relieve your symptoms. But you must make sure that any solution or compress you put on your eye is sterile. Remember, too, that you can spread conjunctivitis from one eye to another, so don’t touch your other eye while treating the affected eye. If you have a mild case of conjunctivitis, start with compresses. For a moderate case, use a compress and an eyewash.

Nutrition and Supplements

Doses listed are for adults. Decrease by one-half to two-thirds for children, and use only under your doctor's supervision.

• Many people find relief with a boric acid eyewash or compress. Boil 1 tsp. boric acid in 1 cup water, cool, and apply with a sterile eye cup or washcloth.
• Vitamin A (10,000 IU per day), vitamin C (250 - 500 mg two times per day), and zinc (30 - 50 mg per day) can strengthen your immune system and help you heal faster.

Herbs

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, herbs should be taken with care, under the supervision of a health care provider. Compresses and eye washes are external treatments.

• Use the herbs below by themselves or in combination: Mix equal parts together then steep 1 tsp. herb in 1 cup boiling water for 5 - 10 minutes, strain, and cool. Or use five drops of a tincture in ¼ cup boiling water. Soak clean cloth, cotton balls, or gauze pads in solution, and apply over closed eyes for 10 minutes, three to four times a day.
  • Eyebright (Euphrasia officinalis): helps fight infection and dry up excess fluid
  • Chamomile (Matricaria recutita): helps fight infection
  • Fennel seed (Foeniculum vulgare): helps fight infection
  • Marigold (Calendula officinalis): soothes irritation
  • Plantain (Plantago lanceolata, P. major): astringent and soothing. The fresh leaves are the most effective plant part.
• Flaxseed (Linum usitat issimum): as a soothing poultice made with 1 oz. of bruised flaxseed steeped for 15 minutes in 4 oz. of water, wrapped in cheesecloth, then applied directly to the affected eye.
• Grated fresh potato has astringent (drying and disinfecting) properties. Wrap in cheesecloth and apply.
• Eyewash: goldenseal (Hydrastis canadensis) and boric acid: 10 drops of goldenseal tincture with 1 tsp. of boric acid in 1 cup of boiling water; strain, and cool. You can apply eye washes with an eye cup or a sterile dropper. With any eyewash, make sure the materials you are using are clean. Goldenseal can be irritating to the eye, so start with a very small amount (dilution) and gradually increase strength if desired.

Homeopathy

Although very few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of conjunctivitis based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account your constitutional type -- your physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual.

• Euphrasia -- for conjunctivitis with large volumes of watery tears that burn the face and may in time become a thick discharge. Despite the production of watery tears, the individual may complain of a dry, gritty sensation in the eyes.
• Argentum nitricum -- for red, swollen eyes with pus-like discharge and splintering pains.
• Pulsatilla-- for conjunctivitis with yellow-green discharge and itchy eyes that may accompany or immediately follow a cold. The eyelids tend to stick together, and symptoms generally improve with cold compresses. This remedy is most appropriate for individuals who tend to be irritable and have mood swings.
• Belladonna -- for the first stages of conjunctivitis, including the sudden onset of burning, bloodshot eyes, swollen eyelids, and hypersensitivity to light. The eyes are generally hot and throbbing to the touch.
• Sulphur -- for burning, pain, and redness of the eyes accompanied by a yellow discharge with foul odor. The eyes are often crusted together, and the individual is usually very hot and thirsty.
• Apis mellifica -- for red, burning eyes and excessive swelling that feel better with cold applications.

Following Up:

Viral and bacterial conjunctivitis are both very contagious. Family members should use separate towels. Wash your hands often. Keep children home from school and day care.

Be sure to follow your doctor’s advice about using any medications, especially if you have been given antibiotics or corticosteroids. If you wear contact lenses, keep them clean to avoid further irritation and future infections. Do not wear them until your eyes have healed.

People with allergic conjunctivitis sometimes develop a severe form with a stringy discharge, swollen eyelids, scaly skin, and significant discomfort. This needs aggressive treatment to prevent scarring of the cornea.

Special Considerations:

In most U.S. hospitals, a medication such as silver nitrate is routinely administered to the eyes of newborns to prevent conjunctivitis from developing from bacteria in the birth canal.

Alternative Names:

Pink eye