Conjunctivities: Is it contagious? From Sprague School Nurse, Sharon Kahn RN

          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

          sharon_kahn@wellesley.k12.ma.us

          781-263-1965