Conjunctivitis

Introduction

Conjunctivitis is the inflammation of the conjunctiva, the thin, transparent membrane covering the white part of the eye and the inside of the eyelids. It is a common condition that can affect one or both eyes. There are several types of conjunctivitis, including viral, bacterial, allergic, and chemical, each with different causes, treatments, and risks. It is a condition often associated with discomfort and redness of the eye. It can also be caused by contact lenses.

Signs and Symptoms

• Redness of the eye(s), due to inflammation and enlargement of the blood vessels in the conjunctiva.

• Discharge: Watery discharge in viral conjunctivitis or thicker, yellow/green pus in bacterial conjunctivitis.

• Itching or a gritty feeling in the eyes, especially in allergic conjunctivitis.

• Tearing (excessive watering of the eyes) and possible crusting of the eyelids, particularly upon waking.

• Burning sensation or discomfort, which can be more pronounced in viral or bacterial types.

• Swollen eyelids and sometimes sensitivity to light (photophobia).

• Symptoms can affect one or both eyes, with viral and bacterial types often starting in one eye and spreading to the other eye (or to another person).

No eyeballs were harmed in the making of this picture.

Diagnosis

Conjunctivitis is diagnosed primarily through a clinical examination by a professional - in an eye clinic, we assess your symptoms, visual acuity (how well you can see), and the eye's appearance using a slit lamp biomicroscope that allows us to see the eye structures up close.

History-taking is essential to determine the onset, associated symptoms (e.g., cold symptoms in viral cases), and possible exposure to allergens, chemicals, or infectious agents.

In certain cases, swabbing of eye discharge may be performed to identify bacterial pathogens, particularly in severe or unusual cases.

Differentiation from other causes of red eye, such as uveitis, corneal ulcers, or acute glaucoma, is important, as these conditions will require different treatments.

Viral conjunctivitis typically resolves on its own, while bacterial forms may require antibiotics.

Allergic conjunctivitis is diagnosed based on symptoms and the patient's allergic history.

Treatment

Viral Conjunctivitis:

Most cases are self-limiting and require no specific treatment. Supportive measures like artificial tears, warm or cold compresses, and good hygiene are recommended. It can take 1–2 weeks for symptoms to resolve.

Bacterial Conjunctivitis:

Treated with antibiotic eye drops or ointments. Many mild cases improve without antibiotics, but treatment can shorten the infection duration and prevent the spread.

Allergic Conjunctivitis:

Treatment focuses on avoiding allergens and may involve antihistamines, mast cell stabiliser eyedrops, and cool compresses to relieve symptoms. In more severe cases, steroid drops may be prescribed.

Chemical Conjunctivitis:

Promptly flush the eye with saline or water to remove the irritant. Treatment depends on the severity of exposure.

In all types, patients are advised to avoid rubbing eyes, practice good hygiene, and stop any contact lens wear until the condition resolves.

Prognosis

The prognosis for most cases of conjunctivitis is generally good, with most cases resolving without significant complications.

Viral Conjunctivitis:

Typically resolves within 1–2 weeks with no lasting effects.

Bacterial Conjunctivitis:

If treated properly, the infection usually clears up in a few days.

Allergic Conjunctivitis:

May persist as long as the allergen is present. Treatment can help manage symptoms, though recurrence is common during allergy season.

Complications such as keratoconjunctivitis (inflammation involving the cornea) can occur in severe cases, but they are rare.

Severe forms of conjunctivitis caused by gonococcal or chlamydial infections may require more intensive treatment to prevent complications. The gonococcal bacteria is highly aggressive and cause severe keratitis and corneal ulcers, leading to blindness.

Conclusion

Conjunctivitis is a common, typically self-limiting condition that causes eye redness, irritation, and discharge. Treatment varies depending on the underlying cause (viral, bacterial, allergic, or chemical), with most cases resolving without complications. Preventative measures like good hygiene and avoiding allergens or irritants can help reduce the risk of conjunctivitis. While most cases are mild, more severe or persistent forms should be evaluated to prevent sight-threatening complications.

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