Q: I will be the first to admit that I don’t always take my contact lenses out before I go to bed. The only allergy I have is to gentamycin which was used to treat pink eye when I was just three years old. In the past four months, however, I’ve had what I think is conjunctivitis twice in the same eye. Should I be worried? It has cleared up within two days both times but I don’t know if this becoming a chronic problem. I am 29 years old and in generally good health. Any thoughts?
A: To begin with, pink eye is conjunctivitis, inflammation of the conjunctiva – the thin tissue that lines the inside of the eyelid and the white portion of the eyeball. It is so named because the inflammation present makes blood vessels easily visible, giving the eye a pink/red color. The primary causes for pink eye include a virus, an irritant such as chlorine from a swimming pool, pet dander, smoke from a cigarette, and bacteria. Signs and symptoms may include an increased sensitivity to light, burning eyes that are red or pink, crusting of the eyelids or lashes from the discharge that occurs, and a gritty feeling that makes a person want to rub their eyes. Keep in mind that there are other very serious causes for a red eye to include keratitis, angle closure glaucoma, or herpes keratitis that should be addressed as an emergency. Self-diagnosis is out of the question and any delays in treatment could be devastating.
Pink eye will commonly improve on its own without treatment if it is from an irritant or allergen. It will not, however, improve if it is caused by a virus or from bacteria. The latter two causes are extremely contagious. The best methods of avoiding the spread is through hand washing and not rubbing or touching the eyes which a person is inclined to do. While irritating, the condition rarely causes any visual changes, yet corneal inflammation does carry the risk and should be watched for and reported promptly to an ophthalmologist. The cornea is the central portion of the eye covering the colored iris and central pupil.
Those at an increased risk for pink eye include individuals who wear contacts, particularly extended-wear lenses. People who wear contacts will likely feel better if they discontinue their use once symptoms are present and until the pink eye clears but when those symptoms fail to diminish quickly, patients should be seen promptly by their eye doctor to rule out any possible eye infection that could be related to their use.
Viral and bacterial conjunctivitis may affect one eye, or it may affect both. If a virus is present, a patient may experience a watery discharge from the eye(s); generally, if it is from a bacteria, a yellow/green discharge may be present. The bacterial form of the condition is much more common in babies and children than it is in adults.
Treatment for a bacterial infection will likely be addressed with antibiotic eye drops. Ointments appear easier to administer to infants and young children than are eye drops. On the downside, the ointment may cause blurred vision for 15 or 20 minutes following the application but should clear following that.
A virus is a virus is a virus and there is no treatment. Thus, viral conjunctivitis will run its course in as long as two to three weeks with improvement following. The exception to this rule may be if the condition is caused by the herpes simplex virus. On the downside, viral conjunctivitis begins in one eye but may spread to the other within a short period of time.
Allergic conjunctivitis may respond well to antihistamines, decongestants, anti-inflammatory drops and steroids. And, it goes without saying that if the cause of the allergy is known or suspected, it should be avoided if at all possible.
On the home front, a cool compress applied to the eye(s) may lessen the symptoms. Remember, however, that if only one eye is affected, do not use a wash cloth or other material on both eyes because of the cross contamination.
I recommend you make an appointment with your ophthalmologist. Explain the presumed conjunctivitis and work with your specialist to determine if your contacts have contributed to your newest symptoms.
