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Conjunctivitis: Infections
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Although most eye inflammations result in a pink discoloration of the eye (because of dilated blood vessels in the conjunctiva), doctors usually use the term pinkeye for conjunctivitis caused by infection with a bacteria or virus. One of the most severe forms of pinkeye is the result of infection with several particular strains of adenovirus. This infection, epidemic keratoconjunctivitis, is extremely contagious and often results in large outbreaks within a community or school. The infection is spread through contact with infected secretions. Such contact may take place person-to-person or through contaminated objects, including doctors' instruments.
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Inclusion conjunctivitis is caused by an infection with chlamydia trachomatis. The symptoms include moderate drainage from the eyes, redness of the eyes, swelling of the conjunctiva, and some swelling of the eyelids. This type of conjunctivitis usually starts 5 to 12 days after birth. Treatment usually will include oral antibiotics.
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Although there is no cure for viral conjunctivitis, symptomatic relief may be achieved with cool compresses and artificial tears. For the worst cases, topical corticosteroid drops may be prescribed to reduce the discomfort from inflammation. However prolonged usage of corticosteroid drops increases the risk of side effects. Antibiotic drops may ... be used for treatment of complementary infections. Patients are often advised to avoid touching their eyes or sharing towels and washcloths. Viral conjunctivitis usually resolves within 3 weeks.
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After the first week of life, other bacteria may be the cause of conjunctivitis in the newborn. The eyes may be red and swollen with some drainage. Treatment depends on the type of bacteria that have caused the infection. Treatment usually will include antibiotic drops or ointments to the eye, warm compresses to the eye, and proper hygiene when touching the infected eyes.
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Laboratory tests are indicated in neonates and adults with suspected inclusion conjunctivitis. At least 50 percent of affected adults have concurrent, possibly asymptomatic chlamydial urethritis or cervicitis.15-17 Coinfection with pathogens that cause other sexually transmitted diseases (e.g., syphilis and gonorrhea) is not uncommon. Therefore, once a diagnosis has been established, a genital work-up of the patient and his or her sexual contacts is indicated before antibiotic treatment is initiated. Treatment consists of a two- to three-week course of oral tetracycline, doxycycline, minocycline (Minocin) or erythromycin. A single 1-g dose of azithromycin (Zithromax) is recommended for adults with lower genital tract infection, but a longer course may be necessary in patients with chlamydial conjunctivitis.4,12
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Some environmental conditions that cause conjunctivitis include wind, smoke, dust, pollen, and grass. As with infections, these factors can cause redness in the eye, swelling of the eyelid, and discharge from one or both eyes. Chemicals in contact lens solutions can sometimes produce similar reactions. Less common causes of conjunctivitis include exposure to sun lamps and problems with the tear ducts, the structures that produce tears for the eyes.
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