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What is "Pink Eye” ?

· Happy Eyes
eye redness; conjunctivitis; pink eye;  Eye Dogtor Julie; @carmel.md

Winter is coming soon... which means the season for coughs, colds, and pink eye is upon us!

What is "pink eye"?

"Pink eye", also known as 'conjunctivitis' in medical terms, is when the eyes look pink/red and may also produce discharge.

The eyes look pink/red because the thin clear membrane that covers the white part of the eye (called the 'conjunctiva') gets inflamed and bloodshot. This membrane can get swollen and make the eye look like it has a big blister on it. The eyelid skin around the eyes often also become very swollen and red.

Symptoms can include a burning sensation, stinging, irritation, tearing, light sensitivity, itching, and crusting of the lashes from the discharge. Usually itching is more specific to eye allergies rather than other causes of eye redness.

Kids often cannot voice these specific symptoms. Instead, a child may starting rubbing his or her eyes, rolling the eyes, blinking frequently, or complaining of something in the eye.

conjunctiva; eye; anatomy; @carmel.md; Eye Dogtor Julie

The conjunctiva is a clear membrane that covers the white part of the eye.

What causes it?

Lots of things can make the eyes look pink or red. It can be from infection, allergies (like to dust, pollen, animal dander, medications), chemicals (such as if you accidentally get soap in your eye), excess or improper contact lens use, trauma, or from getting something stuck in your eye.

Technically any of the above causes of conjunctivitis could be considered "pink eye" but I would say that most people use the phrase "pink eye" to refer to a viral infection of the eye.

causes of conjunctivitis; allergies; bacteria; virus; contact lens; Eye Dogtor Julie; @carmel.md

Some common causes of conjunctivitis include infection (e.g. bacteria, virus), allergies (e.g. pollen, animal dander), improper contact lens use, and trauma/foreign bodies in the eye.

Is it contagious?

There are many causes of conjunctivitis as listed in the section above. If it's from an infection, then yes, it can be contagious.

How do you treat it?

For infections:

  • If the conjunctivitis is caused by a bacteria, we often start antibiotic drops or ointment up to 4 times a day for 7-10 days to see if this helps. 
  • Viral eye infections, on the other hand, do not respond to antibiotics. For the majority of viral infections, we need to let the infection run its course (which unfortunately can mean 2-3 weeks of symptoms). We recommend strict hand hygiene and frequent cleaning of bedsheets, pillow covers, and clothing to prevent reinfection. Note, different types of viruses can make the appearance of the eyes look worse than others, and we may need to start eyedrops like steroids depending on what is seen on the eye exam.
  • Your child should not be going to school while actively infected as this may put other children (and their families) at risk for catching the same eye infection!

For allergies: 

  • We usually start treatment with allergy eye drops and oral anti-histamines if a child has systemic symptoms as well.
  • For older kids who are using contact lenses, sorry, these have to stay out of the eyes while we treat the allergic conjunctivitis. Often contact lenses can make the allergy reaction in the eyes worse and slow down recovery.

For trauma, contact lens-related redness, or concern for a chemical exposure/ foreign body in the eye: 

  • Treatment will depend on what is seen on the eye exam. Bottom line - you should definitely have your child evaluated by a medical professional as soon as possible if the eye(s) are red in the setting of an eye injury. I've previously written about what to do if your child sustains an eye injury here.  

How can I prevent my child from getting it?

  • Keep everyone's hands clean! Wash your hands and your child's hands frequently to prevent infection.
  • Do your best to prevent your child from touching his/her eyes or face. 
  • If someone at home has had a cold recently, wash the bedsheets, pillow cases, and clothing to avoid spread of infection. Some of the viruses that cause colds can also cause conjunctivitis.
  • If your child has bad seasonal allergies or has had a previous flare up of allergic conjunctivitis, start anti-allergy medications and eyedrops just prior to the start of allergy season to prevent flare ups. Avoid the allergen if at all possible. 
  • If you have an older child who wears contact lenses, please remind him/her of the importance of hand washing, proper handling/cleaning of the lenses, and disposing the lenses on schedule. 
  • You and your child should be wearing the proper eye protection while doing house work and during sports activities to prevent eye injury.

What if my baby has a lot of tearing on top of the redness and discharge? Is this all from pink eye?

It could be, but it could also be from a blocked tear duct or a condition called glaucoma where the eye pressures are really high. If your child's tearing is constant, please have this checked out.

What are the long terms effects on my child's vision if s/he has had conjunctivitis?

Most eye infections will clear without any issues. A neglected infection could lead to permanent scarring and other eye problems if not treated. Chronic allergies in the eyes that are not well-controlled and trauma can also lead to scarring. This could affect vision in the long-term depending on the severity of the scarring.