Often I see students with reddened
eyes at school, and the first question the teachers and parents ask is, “Is it
contagious?” Here’s some information about conjunctivitis:
Conjunctivitis, commonly known as pinkeye, is an
inflammation of the conjunctiva, the outermost layer of the eye, a normally
clear thin membrane that covers the white part of the eye and lines the inner
surface of the eyelids. The three most common causes of conjunctivitis
are: infectious, allergic, and irritant.
Infectious conjunctivitis is usually
caused by either bacteria or viruses.
The viral type is often associated with a cold or sore throat. Ear
infections may accompany bacterial conjunctivitis because similar bacteria can
cause both infections. Bacterial conjunctivitis occurs more frequently in
younger children and viral conjunctivitis is more common in older children and
adults. Parasites and fungal infections are rare causes of conjunctivitis.
Outbreaks of infectious conjunctivitis
are seasonal in nature. They tend to occur most frequently in the winter, when
children are indoors more often and in close contact with each other; outbreaks
decrease during warm weather, when close contact decreases.
Allergic conjunctivitis occurs more
frequently among those with allergic conditions. It may be seen only at certain
times of the year, if caused by allergens such as grass or ragweed pollen.
Other allergy-causing substances like animal dander, dust mites, or cosmetics
can cause year-round symptoms of conjunctivitis. Allergic conjunctivitis
typically affects both eyes at the same time.
Irritant conjunctivitis can be caused
by chemicals, such as those in chlorine and soaps, air pollutants such as smoke
and fumes, wearing contact lenses, dry eye, or related to the use of
medications.
What Are the Signs and Symptoms?
The different types of conjunctivitis can present differently. In
addition, symptoms may vary from person to person.
Viral conjunctivitis
¨
Watery discharge
¨
Irritation
¨
Red eye
¨
Usually begins with one eye, but
spreads easily to the other eye
¨
Recent upper respiratory tract
infection
Allergic
conjunctivitis
¨
Usually affects both eyes
¨
Itching, discomfort
¨
Tearing, reddened eyes
¨
Swollen eyelids
¨
Exposure to allergen
Bacterial
conjunctivitis
¨
Thick discharge may cause the lids to
stick together
¨
Swelling of the conjunctiva
¨
Redness
¨
Tearing
¨
Irritation and/or a gritty or burning
feeling
¨
Mild eyelid swelling
¨
Usually begins with one eye, but
spreads easily to the other eye
Severe eye pain or blurred vision that fails to clear with a blink
are not typical features of conjunctivitis. Anyone
with these complaints should be seen by an ophthalmologist.
Is It Contagious?
All types of infectious conjunctivitis are contagious and can
spread by touching the eyes. A child can first become infected from direct
contact with someone who has the infection or something that person has
touched, such as a used tissue. The infectious organisms can also spread
through coughing and sneezing. In addition, certain viruses spread in the
summertime when children swim in contaminated water or share contaminated
towels.
Allergic and irritant conjunctivitis
are not contagious.
Treatment
Conjunctivitis
requires medical attention. The appropriate treatment depends on the
cause of the problem. Although infectious conjunctivitis usually is not
serious, in rare cases it can cause permanent damage so be sure to follow the
doctor’s directions.
For
the allergic type, allergen
avoidance, cool or warm compresses and artificial tears may relieve discomfort
in mild cases. In more severe cases, non-steroidal anti-inflammatory
medications and antihistamines may be prescribed. Some patients with
persistent allergic conjunctivitis may also require topical steroid drops.
Bacterial
conjunctivitis is usually treated with antibiotic eye drops or ointments
that cover a broad range of bacteria.
Like the common cold, there is no cure
for viral conjunctivitis; however,
the symptoms can be relieved with cool or warm compresses and artificial tears
(if needed). For severe cases, topical steroid drops may be prescribed to
reduce the discomfort from inflammation.
Often, infectious conjunctivitis will go away by itself without
medical treatment, but doctors usually recommend treatment because it speeds up
the healing process and decreases the likelihood that the infection will
spread.
Frequent proper hand washing with soap and warm water can
reduce the spread of this highly contagious infection. Additional measures include avoiding touching the face, not sharing towels or
washcloths, and avoiding shaking hands.
When Should I Call My Child's Doctor?
If you think your child has conjunctivitis, it’s important to
contact your child's doctor to determine what is causing the conjunctivitis and
the best form of treatment.
If the conjunctivitis does not improve after 2 to 3 days of
treatment, or after a week when left untreated, call the doctor again. Other
serious eye conditions can mimic infectious conjunctivitis, so schedule a visit
to an ophthalmologist if your child complains of severe pain, changes in
eyesight, or sensitivity to light.
If you notice increasing swelling, redness, and tenderness in the
eyelid and skin around the eye, especially if your child also has a fever, it
may mean the infection has spread to the tissues around the eye, which would
require antibiotic treatment and close follow-up.
Thank you,
Sharon Kahn RN
Sprague School Nurse
781-263-1965
