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Conjunctivitis


Expert reviewer, Mr Ali Mearza, Consultant Ophthalmic Surgeon
Next review due September 2023

Conjunctivitis is inflammation and swelling of the thin, clear layer that covers the white of your eye and lines your eyelid (the conjunctiva). It can make your eyes look red, feel gritty and be watery or sticky. It’s sometimes called pink eye.

Conjunctivitis is common, especially in children, and usually gets better on its own within a week or so. There are things you can do to ease your symptoms, often with treatments you can get from your pharmacist. You don’t usually need to see your GP for conjunctivitis, but there are some occasions when it’s important to seek medical advice.

Children are playing

Types of conjunctivitis

There are three main types of conjunctivitis. These are:

  • infective conjunctivitis, which may be caused by viruses or bacteria
  • allergic conjunctivitis, for instance as part of hay fever if you’re allergic to pollen
  • irritant (chemical) conjunctivitis, when your eyes come into contact with something which irritates them (for example, chlorine in swimming pools)

Causes of conjunctivitis

Different things can cause the inflammation and swelling in conjunctivitis.

Viral conjunctivitis

Viruses are a common cause of conjunctivitis, especially in adults. The virus that most commonly causes conjunctivitis also causes the common cold. You might get viral conjunctivitis if you have a cold or come into contact with somebody who’s coughing or sneezing. This virus is very contagious.

Bacterial conjunctivitis

Lots of different bacteria can cause conjunctivitis. Most often it’s bacteria from your own skin or respiratory system (nose and throat) that causes it. In children and older people, bacterial conjunctivitis is more common than viral conjunctivitis.

You can also get bacterial conjunctivitis by:

  • coming into contact with somebody who has conjunctivitis
  • wearing contact lenses that are infected
  • touching your eyes with unwashed hands
  • using contaminated eye make-up and facial lotions

Conjunctivitis in babies

Neonatal (newborn) conjunctivitis affects babies in their first month. One of the most common causes is an infection passed on at birth by a mother with chlamydia or less often, gonorrhoea. Neonatal conjunctivitis can cause permanent eye damage if it isn’t treated quickly.

Allergic conjunctivitis

If you’re allergic to plant pollens 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. These are the most common causes of allergic conjunctivitis.

Another type of allergic conjunctivitis is called giant papillary conjunctivitis, which can happen if you use contact lenses or have had eye surgery. For more information, see our FAQ: Are contact lens wearers more likely to get conjunctivitis?

You may have an allergic reaction to eye drops and eye make-up, which can cause inflammation of your eyelids. This form of conjunctivitis is called contact dermatoconjunctivitis.

Irritant conjunctivitis

Sometimes, conjunctivitis is caused by an irritating or toxic substance coming into contact with your eye. These may include chemicals found in:

  • eye medicines with preservatives (if you use them for a long time)
  • swimming pools that contain chlorine
  • air pollution, including smoke and fumes

You may also get conjunctivitis if something rubs or scratches your eye (for example, a foreign body that gets caught under your eyelid).

Symptoms of conjunctivitis

Conjunctivitis can affect one or both of your eyes. Symptoms of conjunctivitis include:

  • redness of the white of your eye
  • a watery or thick and sticky, yellow or green discharge from your eyes; they may be stuck together when you wake in the morning
  • blurry vision caused by discharge around your eye
  • a gritty feeling in your eye that can feel itchy or burn
  • swollen eyelids

If you have allergic conjunctivitis, both of your eyes will feel really itchy. You may have hay fever or asthma symptoms too.

If you have symptoms of conjunctivitis, speak to your pharmacist. They can offer you help and advice about what might help ease your symptoms.

When to see a doctor for conjunctivitis

If conjunctivitis doesn’t get better after two weeks with treatment from your pharmacist or your symptoms get worse, contact your GP.

Contact your GP straightaway or get an urgent appointment with an optician if:

  • you have pain inside your eyes
  • you become sensitive to light
  • you have sudden changes to your vision

These may be signs of a more serious problem with your eyes.

If you have a baby under a month old and think they may have conjunctivitis, contact your midwife or GP straightaway. Conjunctivitis in a newborn baby can sometimes be serious. If your GP surgery is closed, go to the accident and emergency department at your local hospital. For more information, see our FAQ: My baby has a sticky eye.

Diagnosis of conjunctivitis

If you seek medical attention for conjunctivitis, your GP or nurse will ask about your symptoms and examine you, and ask about your medical history. They may take a swab of your eye and send it to a laboratory to be tested to help identify what’s causing your conjunctivitis. Your GP may refer you to an ophthalmologist (a doctor who specialises in eye health), although this isn’t usually necessary.

Treatment of conjunctivitis

Conjunctivitis usually gets better within a week or two without any treatment, but it can last longer and you may need specialist help. Allergic conjunctivitis will usually get better within a few hours once you’re away from the source of your reaction.

You can ask your pharmacist for advice on what might help ease your symptoms. They’ll advise you about any over-the-counter treatments such as eye drops or antihistamines that might help. The type of treatment you may need will vary depending on what’s causing your conjunctivitis.

Your GP may not be able to prescribe treatments for conjunctivitis unless you’ve already tried treatments from your pharmacy.

Self-help

Try not to scratch or rub your eyes as you may make your symptoms worse.

To help ease the discomfort of conjunctivitis, you may find it helps to put a cool facecloth soaked in water on your eyes to soothe them. Wipe away any discharge from your eyelids and lashes with cotton wool soaked in cooled boiled water. Use a separate piece of cotton wool for each eye.

You can buy lubricant eye drops over the counter from a pharmacist. These may help to relieve discomfort too.

If you use contact lenses, don’t wear them until your conjunctivitis has completely cleared up and wear glasses until it does. If you’re taking a treatment for conjunctivitis, wait a further 24 hours after you’ve finished it to wear contact lenses again. If you wear disposable lenses, use a fresh set.

If you have allergic conjunctivitis, the best thing you can do is try to avoid what you’re allergic to. For instance, if you’re allergic to house dust mites, it might help reduce your symptoms if you change your bedding regularly and use synthetic pillows and acrylic duvets. If your conjunctivitis is caused by an allergy to pollen, there are ways to ease the symptoms of hay fever.

Medicines

You may need to try several combinations of medicines until you find the one that suits you best.

Medicines for viral conjunctivitis

There aren’t any antiviral medicines that work on the viruses that cause conjunctivitis so try the self-help measures while it clears up.

If your eyes are feeling very irritated, lubricating eye drops may help to soothe them. Sometimes, the cornea (the clear part at the front of your eye) is also affected and this, in turn, may affect your vision. If this happens, it’s important to see a specialist who can diagnose this and prescribe you a course of steroid eye drops, which usually helps.

Antibiotics for bacterial conjunctivitis

Conjunctivitis usually gets better on its own, and you won’t need antibiotics. If your conjunctivitis is caused by a virus, which is often the case, antibiotics are no use at all. This is why your GP will probably suggest waiting for a week to see if your conjunctivitis gets better on its own. If it doesn’t, and you have tried over-the-counter medicines, they may suggest you use antibiotic eye drops (or ointment).

You can buy an antibiotic called chloramphenicol from a pharmacy, so you can treat yourself without needing to go through your GP. Your pharmacist will advise whether it’s suitable for you.

If you have an eye infection caused by the bacteria Chlamydia, or wear contact lenses, your GP may prescribe you antibiotic tablets and eye drops. If they think antibiotics are the best option for you, they’ll explain why.

Medicines for allergic conjunctivitis

Antihistamine medicines or eye drops may help if you have allergic conjunctivitis. These should work quickly to give you some relief from your symptoms.

Allergic conjunctivitis can also be treated with a type of medicine called mast cell stabilisers. These come as eye drops. Some types of mast cell stabiliser are available over the counter from a pharmacy.

Mast cell stabilisers 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 some relief while you wait for the mast cell stabilisers to work.

If your inflammation is severe and the treatments above aren’t working, a specialist may prescribe you a short course of steroid eye drops.

Always read the patient information that comes with your medicine and, if you have any questions about your medicines, ask your pharmacist or doctor.

Prevention of conjunctivitis

Infective conjunctivitis is contagious, so you might decide to take time off work. You don't necessarily need to keep your child at home if they have conjunctivitis, unless they’re feeling very unwell. Check with their school or nursery if you aren’t sure. You might be told they shouldn’t attend as they may have their own rules.

If you have infective conjunctivitis, wherever possible, it’s best to try to avoid close contact with others for a week or two. This is especially important if you’re a healthcare worker, or work with children. Here are some other 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.
  • Don’t share make-up with anybody else.

If you wear contact lenses, it’s very important to follow all the instructions your optician gives you about cleaning and caring for them. For more information, see our FAQ on contact lenses and conjunctivitis below.

Frequently asked questions

  • Probably not – but you should contact your midwife or GP so that they can check your baby’s eyes. Your baby may just have a blocked tear duct, which gets better without treatment. But they may have an infection, which can be more serious. If your baby is under a month old and has pus coming out of their eye, they need to be seen urgently. If your GP surgery is closed, go to the accident and emergency department at your local hospital.

    Sometimes newborn babies are born with a blocked tear duct, usually because their tear drainage system hasn’t fully developed. Their eyes may keep getting watery, sticky or crusty, which is often called sticky eye. Your baby’s eyes shouldn’t look red or pink and it won’t make your baby feel unwell. The main treatment is to keep your baby’s eyes clean. Blocked tear ducts usually clear without any treatment within a year.

    Sticky eyes may also be a symptom of conjunctivitis. Neonatal (newborn) conjunctivitis is usually due to a bacterial infection, which can be passed on during birth. It’s usually a mild illness but sometimes it can cause serious eye problems if not quickly treated with antibiotics.

    The symptoms of conjunctivitis can include watery eyes, just like with a sticky eye, so it can be difficult to tell the difference. But with conjunctivitis, your baby may also have:

    • puffy, red and tender eyelids
    • a discharge coming from their eyes, which may look like mucus or may be thick and pus-like
    • red eyes

    If your baby has sticky eyes, contact your midwife or GP so they can make sure your baby gets any treatment they need.

  • Yes, if you wear contact lenses and don’t keep the lenses or lens cases clean, you may be more likely to get bacterial conjunctivitis. The chemicals and preservatives in contact lenses and their cleaning solutions can cause your eyes to become irritated and itchy too.

    There’s also a particular kind of conjunctivitis, which is linked to wearing contact lenses, called giant papillary conjunctivitis. Doctors don’t fully understand what causes it but it seems to be a type of allergic reaction to your contact lenses. It may also be partly caused by your contact lenses irritating the surface of your eye. If you develop it, you may need to change the type of lenses you wear or the solutions you use to clean them, or possibly stop wearing them at all.

    If you wear contact lenses, you can help prevent conjunctivitis by:

    • replacing your lenses often
    • not wearing your lenses for long periods of time
    • not sleeping in your lenses
    • cleaning your lenses properly
    • wearing lenses which fit properly
    • not exposing your contact lenses to water (for example, when swimming or showering)

    It’s important to follow all the advice your optician gives you when you get your contact lenses.

    If you get symptoms of conjunctivitis, take your lenses out. You’ll usually need to stop wearing them until your symptoms clear up. It’s also best to get your eyes checked by your optician right away, especially if your eye is painful or red.



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Related information

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  • Reviewed by Rachael Mayfield-Blake, Freelance Health Editor, September 2020
    Expert reviewer, Mr Ali Mearza, Consultant Ophthalmic Surgeon
    Next review due September 2023

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