Conjunctivitis

Conjunctivitis is infection or inflammation of the conjunctiva, the protective membrane that lines the eyelids and covers exposed areas of the white of the eye.

Image of inflamed conjunctivaConjunctivitis is sometimes called 'pinkeye' and causes red, sore, gritty, watery, itchy eyes. There may be swelling of the eyelids and crusting on the eyelids overnight.

Conjunctivitis is caused by allergies (eg, hay fever) or a bacterial or viral infection. If there is a pus-like discharge, which makes eyelids sticky it is more likely to be a bacterial infection. Bacterial conjunctivitis is very common, and both bacterial and viral conjunctivitis are very infectious.

Conjunctivitis does not usually affect vision. If you have any reduced vision, or if there is pain in the eye, or other symptoms such as fever or severe infection, visit your doctor straight away. You can also phone Healthline for advice on 0800 611 116.

When to seek medical advice

Conjunctivitis does not usually affect vision. If you have any reduced vision, or if there is pain in the eye, or other symptoms such as fever or severe infection, visit your doctor straight away. You can also phone Healthline for advice on 0800 611 116.

If you have symptoms of conjunctivitis without any of the complications listed above, talk to your pharmacist. They will usually be able to advise on an appropriate product to use – or in some cases may refer you directly to the doctor.

For bacterial infection you may be given antibiotic ointments or drops. Eye drops may soothe viral infections and prevent further infection. For allergic conjunctivitis, you may need anti-allergy medicine or drops (in addition to trying to avoid the allergy triggers).

Allergic conjunctivitis

Allergic conjunctivitis is inflammation of the white part of the eye and inside lining of the eyelids due to allergies.

Allergies causing allergic conjunctivitis can be:

  • Airborne allergens, such as pollen (hay fever).
  • Direct eye contact with allergic triggers such as cosmetics or preservatives (even some in eye drops).

Symptoms

  • Itchy, watery eyes (most common).
  • Sometimes enlarged blood vessels, or swelling of the eyelids.
  • People often also have other allergic symptoms such as acute onset of a blocked or runny nose.

Duration

  • Seasonal at typical times of the year  when due to certain pollen, or grasses.
  • Continuous – occurs anytime with allergens such as dust mite or pets.
  • Sporadic – due to direct contact with an allergen such as cosmetics.

Treatment

  • Anti-allergy drops or antihistamine tablets to reduce the allergic response.
  • Identifying and avoiding allergic triggers.

Bacterial conjunctivitis

Bacterial conjunctivitis is caused by a bacterial infection and is common in infants and children.

Symptoms

  • Typical symptoms include a sticky yellow or green discharge, most noticeable on waking up.

Treatment

  • Sometimes it clears within a day or two of gentle eye washing.
  • If not, see your doctor in case you need antibiotic eye drops.
  • Bacterial conjunctivitis is highly contagious so take care to wash hands, use separate towels and avoid touching the face.

Viral conjunctivitis

Viral conjunctivitis is caused by a virus affecting the conjunctiva.

Symptoms

  • Tends to cause a thin watery or white mucous discharge.
  • Viral infection may be more painful and cause greater redness.

Treatment

  • There is no effective antiviral treatment for common viral conjunctivitis (often caused by the common cold virus).
  • It gets better on its own over 7 to 10 days.
  • Artificial tears can provide some relief from any discomfort.
  • Paracetamol and cool compresses can help.
  • Viral conjunctivitis is highly contagious, so take care to wash hands, use separate towels and avoid touching the face.

Self care

image of a woman using eye dropsWashing your eyes:

  • Before touching your eyes, wash your hands with soap and warm water.
  • Dry hands with a clean (or disposable) towel.
  • Clean away any pus, crust or discharge with a disposable cotton swab and a weak salt water solution (1 tsp of salt in 500ml of cooled, boiled water).
  • Wipe your eye once, from the end nearest your nose to the outside, then throw the swab away. Continue until your eye is clean. Wash and dry your hands again.

Cotton wool balls are not ideal because they can unravel, leaving cotton in your eye. Surgical swabs from your chemist, disposable eye make-up removal pads or tampons that have been opened and cut into thirds with clean scissors are best.

To apply drops:

  • Always wash your hands first.
  • Open the container.
  • Pull the lower eyelid gently down with your forefinger to form a pocket.
  • Tilt your head slightly back and look up.
  • Holding the bottle between the thumb and forefinger, gently squeeze the recommended number of drops in the lower eyelid pocket.

To apply ointment:

  • Always wash your hands first.
  • Hold the tube between the thumb and forefinger.
  • Rest your hand against your nose to position the tip of the ointment tube.
  • Apply a small strip of ointment into the lower eyelid pocket.

Points to remember:

  • Do not touch the eye with the dropper or tube tip.
  • Discard all drops, solutions and ointments one month after opening to avoid bacterial contamination.
  • Some eye drops/products should only be used for a few days, check packet instructions.
  • Single-dose lubricant eye drops remain sterile until opened, if used before the expiry date.

Prevention

How can I protect myself and others?

  • Try not to rub or touch your eye: you can spread infection to your other eye or someone else. If you do touch the eye, wash your hands well.
  • Use your own flannel, towels, pillowcases and bed linen (and change these regularly).
  • Do not send children or babies with conjunctivitis to preschool if the eye is weeping. To prevent reinfection, wash their hands often.
  • Contact lens wearers should follow lens hygiene and care procedures to avoid eye infection (and do not use contact lenses when you have conjunctivitis).

If your eyes do not improve with treatment or you feel they are getting worse, consult your doctor.

Learn more

Conjunctivitis in children  KidsHealth NZ
Conjunctivitis factsheet  KidsHealth NZ
Conjunctivitis Root Eye Dictionary 

Credits: Editorial team.