Conjunctivitis

Conjunctivitis is an inflammation of the membrane covering the inside of your eyelids and the outer part of your eyeball. Commonly called "pink eye," conjunctivitis is generally not serious but can be highly contagious.

Signs and Symptoms

Conjunctivitis causes the following symptoms in one or both eyes.

• Redness
• Itching
• Tearing
• Discharge (watery or thick)
• Crust that forms overnight
• Sensitivity to light
• Gritty feeling

What Causes It?

Conjunctivitis is most often the result of viruses, like those that cause the common cold. Conjunctivitis can also be caused by bacterial infections, allergies, chemicals, irritation from contact lenses, or eye injury. Viral and bacterial conjunctivitis are very contagious.

What to Expect at Your Provider's Office

If both eyes are affected, with itching and a clear discharge, it's likely that allergies are the cause. Swollen glands usually indicate a virus, and a thick, crusty discharge is a sign of a bacterial infection.

Your provider may use a lamp for closer examination, or gently swab a stain across the surface of your eye. He or she may test your vision or measure the pressure in your eye, to rule out glaucoma.

Treatment Options

Conjunctivitis is generally not a serious problem and often will go away by itself. But it is still important to consult your health care provider. Chronic conjunctivitis, left untreated, can cause permanent eye damage.

Treatment varies according to the cause of inflammation. Bacterial conjunctivitis is generally treated with antibiotics. Forms of conjunctivitis caused by viruses do not respond to antibiotics, but antihistamines and anti-inflammatory medications may help relieve your symptoms. Cool compresses may help to reduce itching and swelling.

Drug Therapies

• Viral conjunctivitis: Cool compresses three times daily for 1 to 3 weeks; may also use antihistamines to relieve inflammation. Trifluridine 1% drops, every 2 hours. Oral and/or topical acyclovir may also be needed.
• Allergic conjunctivitis: Avoid contact with allergen. Treat with cool compresses, over-the-counter or topical antihistamines, NSAIDs (particularly ketorolac), and possibly mild corticosteroids.
• Bacterial conjunctivitis: trimethoprim sulfate and polymixin B sulfate drops, 1 drop 3 times daily for one week, or polymixin B-bacitracin ointment. Fluoroquinolones as second-line therapy. Tobramycin (0.3%) or gentamicin as drops, or 10% sodium sulfacetamide as drops, every four hours.

Complementary and Alternative Therapies

Alternative therapies can help relieve your symptoms. If you have a mild case of conjunctivitis, begin with compresses. For a moderate infection, use an eyewash as well.

Nutrition
Doses listed are for adults. Decrease by one-half to two-thirds for children, at the recommendation of a health care provider. Vitamin A (10,000 IU per day), vitamin C (250 to 500 mg two times per day), and zinc (30 to 50 mg per day) strengthen your immune system and help you heal faster.

Herbs
Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Compresses and eye washes are external treatments. A compress is made with a clean cloth, gauze pads, or cotton balls soaked in a solution and then applied over the eyes. Eye washes may be administered with an eye cup or a sterile dropper.

Compress: Use five drops of tincture in ¼ cup water or steep 1 tsp. herb in 1 cup hot water for 5 to 10 minutes and strain. Soak cloth or gauze in solution and apply to the eyes for 10 minutes, three to four times a day.

• Eyebright (Euphrasia officinalis): helps fight infection and dry up excess fluid, specific for eyes
• Chamomile (Matricaria recutita): helps fight infection
• Fennel seed (Foeniculum vulgare): helps fight infection
• Marigold (Calendula officinalis): soothes irritation
• Plantain (Plantago lanceolata, P. major): astringent and soothing. The fresh leaves are the most effective plant part.
• Flaxseed (Linum usitat issimum): as a soothing poultice made with 1 oz. of bruised flaxseed steeped for 15 minutes in 4 oz. of water, wrapped in cheesecloth, then applied directly to the affected eye.
• Grated fresh potato has astringent (drying and disinfecting) properties. Wrap in cheesecloth and apply.

Use above herbs singly or in combination: Mix equal parts together then steep 1 tsp. herb in 1 cup of hot water to make a tea. Cool before administering to the eye.

Eyewash: goldenseal (Hydrastis canadensis) and boric acid: 10 drops of goldenseal tincture with 1 tsp. of boric acid in 1 cup of water.

Homeopathy
Although very few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of conjunctivitis based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type. A constitutional type is defined as a person's physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual.

• Euphrasia — for conjunctivitis with large volumes of watery tears that burn the face and may in time become a thick discharge; despite the production of watery tears, the individual complains of a dry, gritty sensation in the eyes
• Argentum nitricum — for red, swollen eyes with pus-like discharge and splintering pains
• Pulsatilla — for conjunctivitis with yellow-green discharge and itchy eyes that may accompany or immediately follow a cold; the eyelids tend to stick together and symptoms generally improve with cold compresses; this remedy is most appropriate for individuals who tend to be irritable and have mood swings
• Belladonna — for the first stages of conjunctivitis including the sudden onset of burning, bloodshot eyes, swollen eyelids, and hypersensitivity to light; the eyes are generally hot and throbbing to the touch
• Sulphur — for burning, pain, and redness of the eyes accompanied by a yellow discharge with foul odor; the eyes are often crusted together and the individual is usually very hot and thirsty
• Apis mellifica — for red, burning eyes and excessive swelling that feel better with cold applications

Acupuncture
Treatment may be administered for pain relief and relieving congestion.

Following Up

Viral and bacterial conjunctivitis are both very contagious. Family members should use separate towels. Wash your hands often. Children should generally be kept home from school and day care.

Be sure to follow your health care provider's advice about using any medications, particularly if you have been given antibiotics or corticosteroids. If you wear contact lenses, keep them clean to avoid further irritation and future infections. Do not wear them until your eyes have healed.

People with allergy-related conjunctivitis sometimes develop a severe form with a stringy discharge, swollen eyelids, scaly skin, and significant discomfort. This needs aggressive treatment to prevent scarring of the cornea.

Special Considerations

In most U.S. hospitals, medication such as silver nitrate is routinely administered to the eyes of newborns to prevent conjunctivitis from developing from bacteria in the birth canal

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