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What is conjunctivitis and how to treat it

Posted on 21 January 2017

How to treat conjunctivitis and what is it?

You wake up and your eyes are red and stuck together. You know you have conjunctivitis, otherwise known as pinkeye, but what is it really. What is conjunctivitis?
Contact lens rubbing eye

The conjunctiva is a thin membrane that extends over the surface of the eye (excluding the cornea or clear window at the front of your eye) and it also extends to the inside of your eyelids. The purpose of the conjunctiva is to supply blood, oxygen and nutrients to the ocular tissues, stop any foreign bodies from entering behind your eye, and help lubricate the eyeball surface. The conjunctiva contains many minute blood vessels which become dilated when the conjunctiva becomes inflamed, resulting in the typical red eye appearance of conjunctivitis.
Treatment for conjunctivitis depends on the type of conjunctivitis you have and what has caused it. There are many different causes and types of conjunctivitis however these can primarily be broken into viral, bacterial, allergic, chemical, dryness and irritated conjunctivitis. 
Firstly, if you think you have developed conjunctivitis, is essential to cease all contact lens wear until it has resolved. It would be prudent to replace the contact lens case and lenses once your eyes are back to normal.

Bacterial Conjunctivitis
this is the most common type of conjunctivitis found in children. It is associated with a thick, ropy, coloured discharge which is worse upon waking. Sometimes the discharge makes the eyes difficult to open in the morning and must be cleared from the eyelashes. The eyes are very red however this is not associated with pain or discomfort. It is generally in both eyes however one eye may be affected a day or two before the other. Bacterial conjunctivitis is self-limiting and treatment is not essential. However to make you more comfortable and to lessen the chance of infecting the rest of the family there are some simple remedies you can undertake. Upon waking bath eyes with salty water. You can either purchase over-the-counter saline, or wait until boiled water cools then add a tablespoon of salt. Use a cotton ball dipped in this solution to irrigate your eyes. An antibiotic drop or ointment such as Chlorsig can also be applied four times daily for about five days.

Viral Conjunctivitis
there are several subtypes of viral conjunctivitis and it takes about a week between when you are exposed to the virus to when you start developing symptoms. Symptoms include red eyes with a thin watery discharge. It is not uncommon for the eyelids to be quite puffy. The conjunctivitis will appear in one eye followed one or two days later by symptoms in the other eye. Sometimes it is associated with a cold or flu and there is a discomfort under the jawbone or in front of the ears. Although you may be sensitive to glare and light, there is no pain associated with the conjunctivitis. Generally viral conjunctivitis is caused by the same virus that causes a cold or upper respiratory tract infection. Common viral conjunctivitis can be treated by using copious amounts of ocular lubricant eyedrops and regular saline rinses. In severe cases a mild steroid or anti-inflammatory drop will have to be prescribed. Occasionally viral conjunctivitis can be secondary to the same virus that causes cold sores, in which case a 10 day course of ocular anti-viral ointment such as Zovirax Ophthalmic will need to be prescribed by your eye care practitioner. Bilateral conjunctivitis which persists for many weeks can sometimes be secondary to a STD and oral medication will be needed to resolve the infection.

Allergic Conjunctivitis
Allergic conjunctivitis can either be perennial or seasonal. Seasonal allergic conjunctivitis tends to appear at the change of seasons particularly in spring and autumn. Perennial allergic conjunctivitis has symptoms all year-round. Symptoms include both eyes being puffy, red and very itchy. Sometimes the skin on the eyelids can be red and thickened. Allergic conjunctivitis is often associated with asthma, hayfever or sinusitis. The first line of treatment consists of removing the allergen or source of the conjunctivitis, if it is known. Vacuum and mop the house rather than dusting or sweeping. Change and wash the bedsheets more regularly and change the pillow regularly. The symptoms can be treated with copious chilled preservative-free ocular lubricants such as Refresh or TheraTears, as well as an antihistamine eyedrop such as Zaditen twice daily.

Giant Papillary Conjunctivitis
Giant papillary conjunctivitis, otherwise known as GPC is secondary to an irritation from contact lens to the conjunctiva on the inside of your top eyelid. The top eyelid walks about 3 km a day over your eyeball and is continually rubbing over the contact lens. Occasionally this can set up an irritation and the response of the conjunctiva is to thicken and secrete mucus. Treatment consists of reducing the hours of contact lens wear, refitting contact lenses in a different material or design, refitting with gas permeable contact lenses, antihistamine eyedrops such as Zaditen and a mild steroid eyedrop such as FML. GPC is easy to treat but difficult to control as it quite often recurs.

Dry Eye Conjunctivitis
Conjunctivitis from dry eye is also called keratoconjunctivitis sicca. It can be exacerbated by contact lens wear, medication, environmental factors, age, smoking, alcohol and some autoimmune conditions. Symptoms include chronically burning, gravelly, scratchy, sandy eyes and it always occurs in both eyes. Occasionally symptoms are worse upon waking because of sleeping with the eyes open slightly, however generally the symptoms from conjunctivitis related to dryness increase as the day progresses. Treatment consists of trying to improve the activity of the tear glands which can be achieved by regularly performing lid scrubs in the shower with a product such as  Sterilid. You should then apply a heated wheat pack to your eyes for several minutes to soften the oils in the blocked tear glands. The symptoms of dry eye conjunctivitis can be improved by instilling an ocular lubricant such as Refresh during the day, and Genteal gel at night-time. It has been found that taking 2 to 3000 mg daily of Omega-3 tablets will improve the symptoms of dry eye. You may need to be refitted with a contact lens specifically designed to reduce dry eye symptoms such as a daily wear contact such as Dailies Total One. More information on eye drops for contact lens use can be found here

Listed above are only a few types of conjunctivitis. While not an exhaustive list, it will give you an idea as to what type of conjunctivitis you may be suffering from. Remember: cease all contact lens wear until the conjunctivitis has resolved.