Conjunctivitis: The Pink Eye

Conjunctivitis also known as pink eye is actually inflammation of the outermost layer of the eye known as conjunctiva and inner surface of eyelids. The most probable cause is viral infection but in some cases it may be caused due to bacterial action or some allergic manifestations. Viral and bacterial forms of conjunctivitis are common in childhood but they also occur in adults. Pink eye can crop up in an individual of any age and at any time. Many factors can be lead responsible for the occurrence of pink eye and they may be classified as either infectious or non-infectious. This infection does not bring any alteration in the vision of an individual. On the basis of factors that are responsible for pink eye it may be classified as allergic, bacterial, viral, chemical and neonatal conjunctivitis. On the basis of involvement conjunctivitis may be classified as blepharoconjuctivitis which is the result of dual combination of conjunctivitis with blepharitis. Keratoconjuctivitis is the combination of conjunctivitis and keratitis. Episcleritis is an inflammatory state which resembles conjunctivitis but lacks discharge.

The common symptoms of the pink eye include hyperaemia also known as red eye followed by irritation and watering. The pupils remain normally reactive and the vision acuity is also normal and it is not impaired. The main agents that are responsible for causing pink eye is virus but bacteria, allergens, other irritants and dryness can also cause this clinical manifestation. Both bacterial and viral infections are contagious and can be transmitted from one person to another. Conjunctivitis can also be transmitted by the use of contaminated objects and water. Adenoviruses are chiefly responsible for causing conjunctivitis. Herpetic keratoconjuctivitis is a serious form of infection that requires treatment with acyclovir. Acute hemorrhagic conjunctivitis is a very serious form of pink eye caused by eneteroviruses namely, Enterovirus 70 and Coxsackievirus A24. These two viruses were isolated in 1969 from Ghana during an outbreak and are now worldwide in distribution occurring in epidemic form in many parts of world.

Viral infection is the most imperative cause of pink or red eye and adenoviruses are the causative agents for this clinical condition of the eyes. The symptoms include watery discharge that is neither green nor yellow. The majority of incidences of pink eye are observed during the late fall and early spring. Other symptoms include sinus congestion and running nose. Eyelids may be swollen and sometimes looking at the bright light may be painful. As this form of conjunctivitis is associated with the infection of the cornea of the eye no antibiotic is prescribed by the medical expert for treatment. This infection can be detected with greater accuracy and can be effectively treated. This form of conjunctivitis is highly contagious and the symptoms may last for 1-2 weeks. The preliminary symptoms take about 3-5 days to appear. The bacterial species that can be responsible for the pink eye include Staphyloccus and Streptococcus and the symptoms include eye pain, itching, swelling, redness and a moderate to large amount of discharge of yellow or green colour. The discharge usually accumulates during sleeping and this type of pink eye infection can be treated by the use of warm washcloths and application of ointments or antibiotic uptake.

An unusual form of red eye caused by Chlamydia is uncommon in the United Kingdom but is of common occurrence in the Middle Eastern countries and Africa. Chlamydia can cause pink eye in both adults and neonates. This form of pink eye can be sexually transmitted in the adults. This type of pink eye is usually treated with erythromycin and oral doses of tetracycline but is not recommended for children less than 8 years of age as it can result in discoloration of teeth. Pink eye caused by allergic manifestations can be identified by intense itching, tearing and swelling of the eye membranes. Pain may be absent or minimal. The frequent causes for this type of pink eye include pollens, animal dander and dust. This type of infection is generally seasonal and other typical allergic symptoms include sneezing, itchy nose and scratchy throat. Use of cold, moist washcloths and eye drops can help in relieving symptoms. The doctor prescribes stronger medication when the home remedies fail to give the desired result. Chemical red eye is generally caused when any irritating substance enters the eyes and the common irritants include household cleaners, use of any kind of spray, smoke, foreign objects in the eye, smog and industrial pollutants. Washing of the eyes with profuse amounts of water is recommended when any foreign particle enters the eyes. If conditions become uncontrollable then a medical expert must be contacted.

Presence of a persistent pink eye depicts about the underlying illness in the body and these diseases include rheumatic disorders like rheumatoid arthritis and systemic lupus erythematosus. Conjunctivitis is of wide occurrence in the Kawasaki's disease and certain inflammatory bowel diseases like ulcerative colitis and Crohn's disease. Bright redness in the whites of the eyes can also occur when the tiny blood vessels covering the whites of the yes rupture as a result of trauma or changes in the pressure within the head. This condition is designated by the term subconjuctival hemorrhage although the name appears frightening but it is a harmless condition. This condition is different from the inflammation of the conjunctiva caused in the pink eye. It causes the local white area of the eye to become reddened. It does not affect the colored portion of eye as well does not impairs vision of the individual. Diagnosis of conjunctivitis can be done by cultures as most cases of pink eye are treated empirically and successfully. Swabs for bacterial culture are necessary if history indicates signs of bacterial conjunctivitis but no response against topical antibiotics is observed. Viral cultures are generally carried out in cases of epidemic case clusters.

Conjunctivitis in general resolves in 65% cases within 2-5 days and so no antibiotic dosage is needed. As infectious forms of pink eye are highly contagious direct contact with the infected individuals must be avoided. Touching of the eyes with dirty hands must be avoided and regular washing of eyes with cold water is a good practice. Use of ointments and antibiotics can also be of great help.