Conjunctivitis

Conjunctiva refers to the mucous membrane that covers the outer surface of your eyes and is responsible for maintaining healthy vision. Conjunctivitis refers to the inflammation and infection of the conjunctiva. You may suspect conjunctivitis if you experience:

• Pink or red color in the white of the eyes
• Burning, irritation, or itching in the eyes
• Discharge of mucus or pus from the eyes
• Swelling of the layer lining the white part of the eye and the inside of the eyelid
• Increased production of tears
• A constant feeling of a foreign object in your eyes
• A constant urge to rub your eyes
• Thick mucous discharge that crusts over the lashes, especially after waking up, making the eye difficult to open
• Pain and tearing in the eyes
• Increased sensitivity to light

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Conjunctivitis may be caused by pathogens such as bacteria, viruses, or some allergens and irritants. Some of the most common causes of conjunctivitis are described below:

1. Infectious causes of conjunctivitis

These types of conjunctivitis are contagious; they can easily spread from an infected person or by something an infected person has touched, such as a used tissue. The various types of infectious causes are as follows:

• Bacterial conjunctivitis: This is very common in children. Some of the common bacteria responsible for conjunctivitis include Staphylococcal species such as Staphylococcus aureus, H. influenza, S. pneumoniae, and Moraxella catarrhalis. Bacteria like Streptococcus pneumoniae and Haemophilus influenzae can cause conjunctivitis in adults.
• Viral conjunctivitis: This type is also quite common in adults. It is very contagious and often spreads in schools and other crowded places. Viruses such as Adenoviruses, Herpes simplex, Herpes zoster, and Enterovirus are known to cause conjunctivitis.

2. Non-infectious causes of conjunctivitis

These types of conjunctivitis are not contagious and are usually caused by allergens or irritants:

• Allergic conjunctivitis: This is the body's reaction to allergens or allergic substances. It affects both eyes and is a response to allergy-causing substances such as pollens, dust mites, molds, dander from pets, medicines, or cosmetics. Allergic conjunctivitis is more common in individuals with other allergic conditions like hay fever, asthma, and eczema. Symptoms may include sneezing and watery nasal discharge along with conjunctivitis symptoms.
• Giant papillary conjunctivitis: This type of allergic conjunctivitis is caused by the long-term presence of a foreign body in the eye. People who wear inflexible contact lenses, use soft contact lenses that are not changed frequently, or have a prosthetic eye are more prone to develop this condition.
• Irritant conjunctivitis: This is caused by irritants such as smoke, dust, and fumes. Toxins from the chemical industry, laboratory chemicals, or caustic materials like bleach can lead to conjunctivitis, and in some cases, a chemical splash can cause permanent damage to the eye.

• Are exposed to individuals infected with conjunctivitis
• Share items such as towels, pillowcases, and makeup products with an infected person
• Have sinusitis
• Have certain immunodeficiency diseases, trauma, or other eye diseases, and exposure to congenital sexually transmitted diseases increases your risk
• Wear contact lenses for extended hours, particularly during sleep, which increases the risk of bacterial corneal infection

Conjunctivitis is usually confirmed by a physical examination by your eye doctor or ophthalmologist.

Lab tests such as eyelid cultures are rarely performed. Eyelid cultures are usually carried out when you are experiencing recurrent infections of conjunctivitis or when the infection is not improving with medications. In certain cases, an RT-PCR test may be advised for conjunctivitis caused by viruses.

You can follow these easy tips to prevent conjunctivitis:

• Keep your hands clean by washing them often with soap and water for at least 20 seconds.
• Wash your hands thoroughly before and after cleaning, and before applying eye drops or ointment to the infected eye.
• Avoid sharing eye drops or personal items such as makeup and sunglasses with the infected person to prevent the occurrence of conjunctivitis.
• Do not touch or rub your eyes, as this can spread the infection and worsen the condition.
• Avoid wearing contact lenses for long hours.

The treatment of conjunctivitis depends on the cause of the symptoms. There are mainly three types of conjunctivitis: viral, bacterial, and allergic conjunctivitis. Different treatment options for these types of conjunctivitis are as follows:

1. Antibiotics

   These are effective against bacterial conjunctivitis, which causes red and itchy eyes. Antibiotics can be administered in the form of drops, ointments, or orally. Examples of this class of drugs include:

   • Chloramphenicol
   • Ciprofloxacin
   • Moxifloxacin
2. Corticosteroids

   Corticosteroids are mainly prescribed to relieve conjunctivitis caused by allergens such as dust or irritants. They are also used to ease inflammation and pain associated with the infection. Commonly prescribed steroids for conjunctivitis include:

   • Loteprednol etabonate
   • Fluorometholone
3. NSAIDs

   As conjunctivitis can cause pain in the eyes along with redness and swelling, non-steroidal anti-inflammatory drugs (NSAIDs) are commonly recommended to alleviate pain and inflammation. Your doctor may recommend ophthalmic NSAIDs such as ketorolac.

Note: For viral conjunctivitis, cold compresses are recommended as it usually does not respond to antibiotic treatment and typically resolves on its own.

Here are some easy at-home tips that can help you recover faster from conjunctivitis:

• Keep your hands clean to prevent worsening the infection.
• Wash away any discharge from or around your eye(s) with the help of cotton or a clean, wet washcloth. Discard cotton balls after use, and wash the used cloth with detergent and hot water.
• Do not use the same eye drop for your non-infected eye.
• Wash your personal belongings such as bedsheets, pillowcases, sheets, washcloths, and face towels with hot water and detergent. Make sure to clean your hands after handling these items.
• Do not wear contact lenses until your ophthalmologist advises you to start wearing them again.
• Do not use contaminated objects such as towels shared by others.
• Make sure to clean your eyeglasses before using them.
• Avoid using swimming pools or watching television for extended hours.

If you have conjunctivitis, there are steps you can take to avoid reinfection once the infection goes away:

• Throw away and replace any eye or face makeup or makeup brushes you used while infected.
• Throw away disposable contact lenses and cases that you used while your eyes were infected.
• Throw away contact lens solutions that you used while your eyes were infected.
• Clean extended wear lenses as directed.
• Clean eyeglasses and cases that you used while infected.

Though complications arising from acute conjunctivitis are rare, certain cases may lead to complications.

• Patients suffering from Herpes Zoster Virus conjunctivitis are at the highest risk of complications such as uveitis.
• Conjunctivitis caused by gonorrhea, chlamydia, or certain types of adenovirus can be serious and detrimental to eyesight, as they may scar the cornea or cause secondary corneal perforation.
• If you do not show any improvement after 5 to 7 days of treatment, it is essential to visit an ophthalmologist.

Some of the common home and herbal remedies for treating conjunctivitis include:

• Indian Gooseberry: Indian gooseberry, or amla, is beneficial for the treatment of conjunctivitis. Mix a cup of amla juice with two teaspoons of honey and consume this mixture twice a day.
• Vegetable Juice: Raw juices from vegetables such as spinach, parsley, or carrot can aid in recovery from conjunctivitis. These juices can be taken separately or combined for maximum benefits.
• Vitamin-Rich Foods: Certain vitamins, such as Vitamin A and Vitamin B2, are helpful in managing conjunctivitis. Include Vitamin A-rich foods like carrots, pumpkin, tomatoes, and green leafy vegetables, as well as Vitamin B2-rich foods such as milk, almonds, citrus fruits, and bananas in your diet.
• Coriander: A decoction of coriander can be prepared by soaking dried coriander in water. This serves as an excellent eyewash that provides relief from conjunctivitis.

All herbal remedies or home treatments should be undertaken only after consulting your doctor.