What is "pink eye"?

Pink eye or conjunctivitis refers to a redness or irritation of the membranes on the inner part of the eyelids and the membranes (conjuctiva) covering the whites of the eyes. These membranes react to a wide range of bacteria, viruses, allergy- provoking agents, irritants, and toxic agents, as well as to underlying diseases within the body. Viral and bacterial forms of conjunctivitis are common in childhood. Overall however, there are many causes of pink eye. These can be classified as either infectious or noninfectious.

What infections cause pink eye and how are they treated?

Viral Pink Eye

The leading cause of a red eye is virus infection. Viral pink eye is usually associated with more of a watery discharge, not green or yellow in color, and is frequently associated with viral "cold-like" symptoms. The eyelids may be swollen. Sometimes looking at bright lights is painful. While viral pink eye, may not require an antibiotic, the doctor should see the child, as occasionally this form of pink eye can be associated with infection of the cornea, (the clear portion of the front of the eyeball). This infection must be correctly detected and treated. Viral pink eye is highly contagious.

Bacterial Pink Eye

The bacteria that most commonly cause infectious pink eye are staphylococci, pneumococci, and streptococci. Symptoms include eye pain, swelling, redness, and a moderate to large amount of discharge, usually yellow or greenish in color. The discharge commonly accumulates after the child sleeps. They awaken most unhappy that their "eyes are stuck shut," requiring a warm wash cloth applied to the eyes to remove the discharge and lots of reassurance that their "eyes still work!" This bacterial pink eye responds to repeated warm wash cloths applied to the eyes (try applying these one eye at a time during a favorite video!) and antibiotic eye drops or ointment prescribed by your doctor. Be careful not to use medication prescribed for someone else, or from an old infection, as these may be inappropriate for your child's current infection or may have been contaminated from other infections by accidentally touching the medicine bottle to infected areas. A safe, effective, and "less-scary-for-your- child" method of putting drops into the eyes involves asking your child to lie down flat, suggesting she merely "close your eyes" and placing the recommended number of drops in the inner corner of the eye, next to the bridge of the nose, and letting them make a little "lake" there. When your child relaxes and opens the eyes, the medicine will flow gently into the infected mucous membranes without the need to "force open" the eyes.

Chlamydia is a form a bacterial that is an uncommon form of pink eye in the U.S., but is very common in Africa and the Middle Eastern countries. It can cause pink eye in adults and neonates. It is a cause of pink eye in adolescents and adults that can be sexually transmitted. Chlamydia pink eye is typically treated with tetracycline (except in children less than eight years old, because of possible teeth discoloration) or erythromycin.

Allergic Pink Eye

Allergic pink eye is usually accompanied by intense itching, tearing, and swelling of the eye membranes. Frequent causes include seasonal pollens, animal dander, and dust. It is frequently seasonal, and goes along with other typical "allergy" symptoms such as sneezing, itchy nose, or scratchy throat. Cold moist wash clothes applied to the eyes and over-the-counter decongestant eye drops give welcome relief. Your doctor can prescribe stronger medications if these remedies are not adequate.

Chemical pink eye can result when any irritating substance enters the eyes. Common offending irritants are household cleaners, sprays o

f any kind, smoke, smog, and industrial pollutants. Prompt, thorough washing of the eyes with very large amounts of water is very important. Your doctor or your local poison control center should be contacted at once, even if you think the irritant or chemical is "safe", as some of the most common household products like bleach and furniture polish can be the most damaging!

Persistent conjunctivitis can be a sign of an uncommon underlying illness in the body. Most often these are rheumatic diseases, such as rheumatoid arthritis and systemic lupus erythematosus. Conjunctivitis is also seen in Kawasaki's disease (a rare disease associated with fever in infants and young children) and certain inflammatory bowel diseases such as ulcerative colitis and Crohn disease.

Subconjuctival Hemorrhage

Bright redness of the whites of the eyes can also occur when the tiny blood vessels covering the whites of the eyes rupture from trauma or changes in pressure within the head (for example, after forceful laughing or vomiting, when diving under water, or even bending upside down). This condition is called subconjunctival hemorrhage, and, while it can appear impressive, it is generally harmless.

Remember, your children's eyes are one of their most precious senses. Don't hesitate to contact the doctor if you ever have any question about you or your family members' health!

Pink Eye At A Glance

Pink eye (conjunctivitis) can be infectious or noninfectious.
Infectious pink eye is contagious.
Infectious pink eye can be caused by bacteria or viruses.
Noninfectious pink eye can be caused by allergy, chemical irritation, underlying inflammatory diseases, or trauma.