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Conjunctivitis is defined as the infection or inflammation of the conjunctiva (the transparent membrane that lines the eyelid and part of the eyeball). Conjunctivitis is also called as ‘pink eye’ because the inflammation causes small blood vessels in the conjunctiva to become more prominent, and thus cast pink or red color to the whites.  Conjunctivitis affects people at all ages.1 Conjunctivitis is caused due to various kinds of bacteria, virus or fungi. Certain environmental factors are also responsible in causing conjunctivitis. Conjunctivitis can be classified as infectious or noninfectious. Infectious conjunctivitis is further classified based on the type of the infecting organism (bacteria, virus or fungi).

Signs and Symptoms of conjunctivitis

The symptoms are usually mild but if untreated it may lead to serious complications. Some of the signs and symptoms are enumerated below.2

  • Redness
  • Swelling
  • Discharge from the eyes, which may be watery (yellow or green in color) and form crusts around the eyelashes. Itchy eyes with pus-like discharge, if the infection is due to a virus. A pus-like discharge which turns crusty during the night is due bacterial infection
  • Intolerance to light
  • Excess tears from the eyes
  • Burning sensation and discomfort of the eyes
  • Vision problems

Causes of conjunctivitis

Bacteria, fungi or viruses can cause conjunctivitis. At times, allergic agents, irritants (chemicals or foreign bodies in the eye), overexposure to sunlight and toxic agents are also implicated as the causative agents. The causative agent and the age of the patient determine the course of therapy.

Causes of conjunctivitis include the following:

  • Adenovirus causes viral conjunctivitis.
  • Bacteria like Staphylococcus epidermidis, Streptococcus pyogenes, Neisseria meningitidis and Moraxella lacunata cause mucopurulent conjunctivitis.
  • Neisseria gonorrhoeae causes hyperpurulent conjunctivitis.
  • Vernal conjunctivitis is due to an allergic reaction. It often occurs in people with a strong family history of allergies and is the most common during the spring and summer.
  • Conjunctivitis is often associated with wearing of contact lens and is called giant papillary conjunctivitis.
  • Airborne irritants liquid or powder relatively causes toxic conjunctivitis.
  • Environmental conditions like dust, smoke, pollen or grass can also cause conjunctivitis.
  • Rare causes of conjunctivitis include exposure to sunlamps, problems with the tear ducts etc.

Diagnosis of conjunctivitis

Diagnosis of conjunctivitis is based on past medical and personal history, presenting signs and symptoms and other diagnostic tests. The diagnostic tests for conjunctivitis include eye examination and microbiological analysis. Microbiological analysis is done by culturing sample of eye secretions from the conjunctiva and the results aid in identifying the nature of the infective agents. Microbial culture is very useful for the physician to start with the treatment.3

Treatment of conjunctivitis

The course of the treatment is dependent on the cause.

Antibiotic eye drops or ointment is recommended for bacterial infections and entire course of the medications should be completed to prevent the recurrence of infection.

Ocular decongestants, antiinflammatory and antiallergic medicines may be prescribed for conjunctivitis caused due to an allergy or inflammation.4

Topical corticosteroids may be useful if there is a considerable level of inflammation.5

Apart from these, artificial tears may help in reducing the discomfort of the eye due to photophobia and cold compresses can be used to reduce the swelling and discomfort of the eyelids.

Prevention of conjunctivitis

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Conjunctivitis can be highly contagious, if good hygiene is not maintained. Hygienic practices are surely helpful in preventing the spread of conjunctivitis. Some of the following points are very useful in prevention of conjunctivitis.6

  • Using a clean cloth or tissue to remove the watery discharge from the eyes and ensure proper disposal of it.
  • Frequent washing of hands with antiseptic soap and drying thoroughly to avoid, spread of the infection, especially before and after touching the face or eye of the infected person.
  • Environmental substances, which are known to cause to conjunctivitis should be avoided.
  • Contact lens equipment, solutions or containers should not be shared.
  • Protective sunglass is advocated when exposed to unusual light conditions.
  • Avoid close contact with people affected with conjunctivitis.
  • Usage of the prescribed medicines should be known and followed.
  • Clean towel, handkerchiefs and pillows should be used. Change the pillow-cases frequently.
  • Stop using cosmetics, especially mascara.
  • Clothes should be washed daily.
  • Avoid sharing personal things with others.


1.Alessandrini EA. The case of the red eye. Pediatr Ann. 2000; 29(2): 112–116.

2.Frank N (ed.). Ophthalmology: Principles and Concepts. 8th edn. St. Louis: Mosby-Year Books Inc., 1996.

3.Ivan SR, Dawson CR. Conjunctiva. In: Vaughan DG, Asbury T, Riordan-Eva P (eds). General Ophthalmology, 14th edn. Norwalk, CT: Appleton and Lange, 1995.

4.Friedlaender MH. The current and future therapy of allergic conjunctivitis. Curr Opin Ophthalmol. 1998; 9(4): 54–58.

5.Kane KY, Meadows S, Ellis MR. Clinical inquiries. When should acute nonvenereal conjunctivitis be treated with topical antibiotics? J Fam Pract. 2002 Apr; 51(4): 312.

6.Wirbelauer C. Management of the red eye for the primary care physician. Am J Med. 2006; 119(4): 302–306.

Written by: healthplus24.com team

Date last updated: January 19, 2015

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