Optometry in Focus: Conjunctivitis (Pink Eye)

Happy Monday, y’all!

With school back in session and cooler weather on its way, I suppose it’s time for a discussion on conjunctivitis, colloquially known as pink eye.

But first, let’s start with a quick ocular anatomy review.


Despite how tempting it would be to just post a picture with fancy labels and the like, I think this section will work the best if you stop what you’re doing for a moment and find a way to look at your eye – a mirror would probably be the easiest.
What do you see?
If you’re like most people, you’ll notice the colored part, or the iris, first.  If you get really close to the mirror or change the lighting, you should be able to see a change in the size of the dark hole in the center of the iris. This is your pupil, which varies in size to adjust the amount of light coming into your eyes.
Above the iris and the pupil is the cornea.  This clear structure is difficult to truly see in the mirror, but if you wear contacts, this is what the contact drapes over.
In addition to the colored portions, you’re surely able to see the white part of the eye, or the sclera, which functions to maintain the shape and structure of your eye, while providing a protective barrier!
What’s missing?
If you look very carefully (or wash your hands and gently touch the white part of your eye), you’ll notice that there’s an easily moveable jelly-like material that covers a majority of your eye (minus the cornea).  And, unsurprisingly, its this structure, the conjunctiva, that is highlighted in the post today!
Ready?  Let’s get to it!


Now that we’ve got the basic anatomy down, the question is: what is conjunctivitis?
For those of you fluent in medical-ese, you’ll know that the suffix “itis” means inflammation.  In this case, the inflammation is of the conjunctiva.
Now, conjunctivitis can come in various forms – predominantly bacterial, viral, and allergic – depending on the offending agent.  In each of these cases, a foreign object is identified by the immune cells circulating in the conjunctiva, which then activates the immune response to remove the unwanted material.  Unfortunately, this process creates inflammation – the symptoms of which are determined by the particle causing the immune response.

Viral Conjunctivitis

Viral conjunctivitis is inflammation of the conjunctiva secondary to an immune response to a viral particle. Common symptoms are:
  • Watering
  • Irritation
  • Mild light sensitivity
  • Pinkish red eye
  • Typically one eye, or one eye before the other
This often occurs in someone with a history of an upper respiratory infection, or exposure to someone with an upper respiratory infection.
Viral conjunctivitis is highly contagious (arguably the most contagious type of conjunctivitis).  For this reason, when people present with viral conjunctivitis should refrain from touching their eyes (it easily spreads between eyes as well), wash hands frequently, clean pillowcases, and use their own hand towels, etc, to prevent the spread of the infection to others in the household.
Unfortunately, especially considering the high transmission rate of viral conjunctivitis, there is no true treatment for this condition (just as there is no treatment for the common cold).  Rather, the focus is on reducing symptoms through cool compresses and artificial tears.  In cases of extreme symptoms, providing there is no corneal involvement, topical steroids may be used.

Bacterial Conjunctivitis

Bacterial conjunctivitis, as could be assumed, is inflammation of the conjunctiva caused by an immune response to bacteria.  Common symptoms are:
  • Deeper (beefy) red eye
  • Irritation
  • Significant discharge
  • Typically one eye, or one eye before the other
Bacterial conjunctivitis is also contagious, however, generally less than viral.  Additionally, this condition is generally easily managed with topical antibiotics.

Allergic Conjunctivitis

This topic is one that I already covered in my post on ocular allergies.  For a quick review, however, allergic conjunctivitis is inflammation of the conjunctiva in response to, well, a number of different particles (of non-viral or non-bacterial origin).  Common symptoms are:
  • Light red eye
  • Itching
  • Mild watering
  • Potential swelling of eye lids
  • Normally both eyes at the same time vs one then the other
Allergic conjunctivitis is NOT contagious, so there is no concern of spreading it at school or between family members. Additionally, allergic conjunctivitis can be treated with over the counter or prescription topical (or occasionally oral) medications.

Parting Advice

Regardless of the type of conjunctivitis, it is important to remember to wear glasses, rather than contacts, during times of ocular inflammation.
Additionally, if you are experiencing symptoms, it’s always wise to talk to your optometrist, even if you think you may know what’s going on.
If you learned something from this post, please share it with a friend or family member!  If you liked it, please subscribe, or like my page on Facebook! And as always, if you have any questions or comments, please contact me – I’d love to hear from you!

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