Pink eye is a well known common term for conjunctivitis which is the infection or inflammation of the conjunctiva, the transparent membrane that covers the white part of the eye (sclera) and lines the eyelids. In addition to redness and inflammation, conjuctivitis is usually associated with a watery discharge that develops into a crust while sleeping or a mucosy, goopy discharge that makes it difficult for the patient to open their eyes in the morning. The type of discharge will depend on the type of conjunctivitis.

General Symptoms of Pink Eye:

• Redness of the white part of the eyes

• Watery or mucosy discharge

• Itchiness (Allergic)

• Swollen eyelids

• Hazy or blurry vision

• Oversensitivity to light

• Pain

The 3 main types of pink eye are:

• Bacterial

Streptococci and staphylococci are bacteria types that are most responsible for bacterial conjuntivitis. However, chlamydia and gonococci (sexually transmitted diseases) can also cause pink eye. It is accompanied by eye pain or tenderness, scratchiness, swelling, redness, and mucousy discharge. The spread of bacterial pink eye is usually a result of using the personal items of infected people, such as makeup, makeup tools, hand/face towels or pillowcases that have been infected with bacteria or simply by rubbing the eyes with dirty hands. If not treated, it can last for more than 10 days, but if treated, it should resolve in 3-5 days.

• Viral

Viruses such as the adenoviruses and herpes virus are the most common causes of viral conjunctivitis. When a virus is the cause, there is usually a lot of watery discharge and mild redness (pink eyes) and it is sometimes accompanied with nasal congestion, puffy eyelids, runny nose and rarely, pain. It is usually contracted from cough and sneeze droplets from an infected individual or contaminated surfaces such as door knobs. It can take 2 weeks to as long as 2-3 months to resolve depending on the type of virus and the seriousness of the infection. VIRAL CONJUNCTIVITIS IS HIGHLY CONTAGIOUS so the infected person needs to be very hygenic and use separate hand/face towels, pillowcases and other shared items.  They should also stay home from school and work to stop the spread of the pink eye, until they are completely recovered.

• Allergic/Vernal/GPC

Allergic Conjunctivitis is associated with serious itching and a clear, watery discharge is the most commonly seen discharge. It is usually bilateral (inboth eyes) with minimal crusting in the mornings. Pain and decreased visual acuity are not commonly reported in simple allergic conjunctivitis and should prompt the provider to consider another diagnosis. Eyelid edema and chemosis (swelling) are not uncommon and can be quite marked.  Often, allergic pink conjuctivitis is accompanied by sneezing or coughing. Allergens that trigger pink eyes include grass, dust, pollen, mold, and ragweed. Allergic conjunctivitis can be seen as an isolated finding but is often associated with allergic rhinitis, atopic dermatitis, and/or asthma.
    
Vernal Keratoconjunctivitis is an allergic conjunctivitis usually most severe in the spring and is associated with thick mucus discharge, pain, photophobia (light sensitivity), and blurred vision. Patients will also often complain of foreign body sensation. On examination, corneal ulcers and conjunctival infiltrates can sometimes be found.  Allergy based pink eyes are not usually contagious.  However, when patients rub their eyes because of the itching from allergic conjunctivitis, it can turn into a secondary bacterial conjunctivitis because bacteria was introduced into the eyes from rubbing. 

Giant Papillary Conjunctivitis (GPC) is an allergic conjunctivitis often caused by over-wearing contact lenses that are too old and are covered with protein build-up.  The symptoms are consistent with simple allergic conjunctivitis but with the continued abuse of old contact lenses, it will give way to worsening itch and thickening discharge that becomes a thick mucus that clouds the contact lenses. Patients usually report worsening pain and blurry vision with the increased sense of foreign body sensation. The examination findings reveal giant papillae (bumps) covering the conjunctiva lining the eyelids

Prevention

The best way to prevent pink eye is by practicing good hygiene which includes:

• Avoid putting dirty hands in your eyes

• Make it a habit to wash your hands often

• Keep animals away from sheets and pillowcases

• Avoid sharing towels and other personal items

• Do not use dirty items

• Changing your pillow cover regularly

• Avoid sharing makeup items like eyeliners, mascara, etc.

Treatment of Pink Eye

• The treatment of pink eye is dependent on its underlying cause. If it is caused by a virus, it cannot be cured by antibiotics, so you may just have to wait for the virus to run its course which could last from four to seven days to three months. Sometimes anti-viral or steroid medication is indicated to prevent scarring. Viral pink eye can be easily contracted so it is imperative to prevent further spreading.

• Antibiotics are most effective against bacterial pink eye and usually are in the form of eye drops. Depending on the prescription, eye drops will be administered about four to six times daily. It is important that you follow the specific instructions that Dr. Kubota gives you when using your medication even after the disappearance of symptoms.

• For pink eye caused by allergies, the allergy should be treated and allergy eye drops are usually prescribed.  It is also important to avoid allergens as much as possible, but some allergies can be choronic.
   

Whenever the symptoms of pink eye emerge, the best preventive measure is to stay at home until the discharge and redness cease to avoid the spread of the bacteria or virus. You should also visit Dr. Kubota immediately to begin treatment. While mild pink eyes can sometimes go away on its own, some of the more serious forms can cause a scarring and damage to the eyes.