Types of conjunctivitis
Conjunctivitis is categorised into three main types. These are:
- infective (viral and bacterial) conjunctivitis
- allergic conjunctivitis
- irritant (chemical) conjunctivitis
Infective (viral and bacterial) and allergic conjunctivitis are most common. Over a third of people who go to see their GP about a problem with their eye each year in the UK have this type.
Symptoms of conjunctivitis
Conjunctivitis can affect one or both of your eyes. Viral conjunctivitis usually starts in one eye and then spreads to the other.
Symptoms of conjunctivitis include:
- redness of the white of your eye
- white or yellow discharge in your eyes – this may make them stick together in the morning and be difficult to open
- blurry vision caused by discharge around your eye, which clears when you blink
- a gritty feeling in your eye that can feel itchy or burn
- watery eyes
- sensitivity to light
If you have viral conjunctivitis, you may have cold-like symptoms, such as a fever and sore throat.
Some of these symptoms can be caused by problems other than conjunctivitis. But if you have pain in your eye or feel sensitive to light or your sight is affected, contact your GP or optometrist straight away. An optometrist is a registered health professional who examines eyes, tests sight and dispenses glasses and contact lenses. Often the infection will clear up on its own and you can use self-help measures to ease any discomfort. But if your symptoms last longer than two weeks or get worse, contact your GP surgery for advice.
If you think your baby has conjunctivitis, contact your GP straight away, or accident and emergency department at your local hospital if they’re closed.
Diagnosis of conjunctivitis
Your GP or nurse will ask about your symptoms and examine you, and ask you about your medical history too.
They may take a swab of your eye and send it to a laboratory to be tested. This will help to identify what’s causing your conjunctivitis. Your GP may refer you to an ophthalmologist (a doctor who specialises in eye health), although isn’t usually necessary.
Treatment of conjunctivitis
The treatment for conjunctivitis depends on the cause. It usually gets better without any treatment within a week or two.
If you use contact lenses, don’t wear them until your conjunctivitis has completely cleared up. Prepare to wear glasses for a while as it might be for two weeks or more. You can wear contact lenses again 24 hours after you’ve finished any treatment you’ve been given – as long as your symptoms have cleared up. If you wear disposable lenses, use a fresh set.
To help ease the discomfort of conjunctivitis, you may find a cool compress, such as a facecloth soaked in water, soothing on your eyes. Wipe away any discharge from your eyelids and lashes with cotton wool soaked in cooled boiled water or saline too.
If your conjunctivitis is caused by an allergy to pollen, try the following to help stop your symptoms getting worse.
- Try to stay away from what it is that you’re allergic to.
- On days when the pollen count is high, keep windows closed, and wear sunglasses when you’re outside.
If you’re allergic to dust mites it may help to:
- wash your bed linen regularly
- fit a mattress with a cover that doesn’t let dust mites through it
- use synthetic pillows
Lubricant eye drops
You can buy lubricant eye drops over the counter from a pharmacist, which may help to relieve discomfort.
If you have bacterial conjunctivitis, your GP will probably suggest waiting for a week first to see if your conjunctivitis gets better on its own. If it doesn’t, they may prescribe you antibiotic eye drops (or ointment). You can also get a type of antibiotic called chloramphenicol from a pharmacy so you can treat yourself without needing to see your GP.
Antihistamine medicines or eye drops may help if you have allergic conjunctivitis. These should work quickly to give you some relief from your symptoms.
Mast cell stabilisers
Your GP may prescribe a type of medicine called mast cell stabilisers, such as sodium cromoglicate, nedocromil sodium or lodoxamide. These come as eye drops. Some types of mast cell stabilisers are available over the counter from a pharmacy.
Mast cell stabilisers work by stopping allergy cells from releasing substances that cause swelling and inflammation. These are more effective for long-term relief of allergic conjunctivitis but may take a few weeks to start working. You can take antihistamines at the same time as mast cell stabilisers. These will give you immediate relief while you wait for the mast cell stabilisers to work.
Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist or GP for advice.
Causes of conjunctivitis
Viruses are a common cause of conjunctivitis. The virus most often associated with conjunctivitis also causes the common cold (adenovirus). You might get infective conjunctivitis if you have a cold, or come into contact with somebody who’s coughing or sneezing. It’s very contagious.
You can get bacterial conjunctivitis by:
- coming into contact with somebody who has conjunctivitis
- having recently had an upper respiratory infection, such as a common cold
- wearing contact lenses that are infected
- touching your eyes with unwashed hands
- using contaminated eye make-up and facial lotions
Conjunctivitis in babies
Neonatal conjunctivitis affects newborn babies (within the first month of their life). One of the most common causes is an infection passed on by the baby’s mother if she has chlamydia or gonorrhoea when giving birth. This can happen even if the mother has no symptoms of infection. Neonatal conjunctivitis can cause permanent eye damage if it isn’t treated quickly. See the FAQ ‘What’s the difference between a sticky eye and conjunctivitis in babies?’ for more information.
If you’re allergic to plant pollens that are released at the same time each year, you may get seasonal allergic conjunctivitis. All year round (perennial) allergic conjunctivitis can be caused by house dust mites and animal fur.
Another type of allergic conjunctivitis is called giant papillary conjunctivitis. This can happen if you use contact lenses and are allergic to them, or if you have had eye surgery. See the FAQ ‘Why are contact lens wearers more prone to getting conjunctivitis?’ for more information.
Using eye drops and eye make-up can cause inflammation of your eyelids. This form of conjunctivitis is called contact dermatoconjunctivitis.
Irritant (chemical) conjunctivitis
Chemical conjunctivitis can be caused by a number of things, including:
- irritant chemicals
- eye medicines (if you use them for a long time)
- chlorine in swimming pools
- air pollution
- contact lens cleaning solutions
Prevention of conjunctivitis
Infective conjunctivitis is contagious so you might feel you want to take time off work, or your children from school. There are no rules to say you should keep your child away from school. Although if there’s an outbreak of infective conjunctivitis, your child’s school may advise otherwise. You’ll be less likely to pass on bacterial conjunctivitis a day or two after you start any antibiotics. Viral conjunctivitis is usually contagious until your eye is no longer red and you aren’t producing tears so much.
Here are some tips on how you can prevent spreading conjunctivitis.
- Wash your hands regularly and try not to touch your eyes.
- Use clean towels and pillows and don’t share them with anybody.
- Change your pillow cases regularly.
- Don’t go swimming until you’re better.
- Don’t share make-up with anybody else.
To prevent getting conjunctivitis from somebody else, follow all the hygiene tips above and:
- clean your contact lenses correctly
- replace your eye make-up products regularly
If you get allergic conjunctivitis, try to avoid anything you know you’re allergic to (wherever possible).
FAQ: What’s the difference between a sticky eye and conjunctivitis in babies?
A sticky eye in babies due to a blocked tear duct is common and often clears up without any treatment within a year. Neonatal conjunctivitis is more serious and can be a sign of a severe infection. It’s important to contact your GP as soon as possible if you think your baby has conjunctivitis soon after birth.
Sometimes newborn babies are born with a blocked tear duct – usually because their tear drainage system hasn’t fully developed. Your baby may have more watery eyes than normal and their eyes can become crusty. This is commonly known as sticky eye and the medical term is congenital nasolacrimal duct obstruction. This usually clears without any treatment within a year as the tear drainage system opens up and fully develops.
The symptoms of conjunctivitis can include watery eyes, just like with a sticky eye. This means it can sometimes be difficult to tell the difference between the two. But with conjunctivitis, your baby may also have:
- puffy, red and tender eyelids
- watery, bloody or thick pus coming from their eyes
- red eyes
Your baby can get neonatal conjunctivitis if you pass an infection on to them when you give birth. The two most serious infections are chlamydia and gonorrhoea, which can develop into a severe eye infection and could eventually lead to blindness. Neonatal conjunctivitis is treated with antibacterial eye drops.
FAQ: Why are contact lens wearers more prone to getting conjunctivitis?
If you wear contact lenses that you don’t dispose of each day, they can become infected with bacteria – particularly if you don’t disinfect them well. The infection can then spread to your eye, and even re-infect your eye once an infection has been treated. The chemicals and preservatives in contact lenses and their cleaning solutions can also cause your eyes to become irritated and itchy too. This can cause a type of conjunctivitis called giant papillary conjunctivitis.
Other causes of giant papillary conjunctivitis are an allergic reaction to a contact lens or debris on a contact lens. This can sometimes scrape your eyelid and trigger the condition.
Symptoms of giant papillary conjunctivitis include:
- itchy and burning eyes
- your eyes producing a lot of mucus
- blurred vision, caused by mucus sticking to your contact lens
You may notice your contact lens move when you blink too.
If you have any of these symptoms, it’s important to get them checked by your GP or an optometrist. This is a health professional who examines eyes, tests sight and dispenses glasses and contact lenses.
You’ll need to stop wearing your contact lenses if you have giant papillary conjunctivitis. And you might need to change the products you use to care for your lenses too. Sometimes you may need to switch to different contact lenses altogether, perhaps one that you can replace more regularly.
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