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Conjunctivitis


Expert reviewer, Professor Simon Taylor, Consultant Ophthalmic Surgeon
Next review due May 2021

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. It usually gets better on its own within a week or so. There are things you can do to ease your symptoms, often with the help of 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.

Image showing front and side views of the different parts of the eye

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)

Symptoms of conjunctivitis

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

  • redness of the white of your eye
  • a discharge in your eyes, which may be watery or thick and sticky, even pus-like; this may make your eyes 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 may burn

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

If you have viral conjunctivitis, you may have cold-like symptoms such as a fever and sore throat.

If you have symptoms of conjunctivitis as described above, speak to your pharmacist. They can offer you help and advice about what might help ease your symptoms. For information about symptoms which mean you should seek medical help, see our section: When should I contact my doctor for conjunctivitis? below.

When should I contact my doctor for conjunctivitis?

If you have symptoms of conjunctivitis and they don’t get better after two weeks with treatment from your pharmacist or they get worse, contact your GP.

Contact your GP straight away 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, which don’t clear when you blink

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

If your baby is under a month old, and you think they may have conjunctivitis, contact your midwife or GP straight away. 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 on this, see our FAQ, ‘My baby has a sticky eye’ below.

Diagnosis of conjunctivitis

If you seek medical attention for symptoms of conjunctivitis, your GP or nurse will ask about your symptoms and examine you. They may ask you about your medical history too. In some circumstances, 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 this isn’t usually necessary.

Treatment of conjunctivitis

Conjunctivitis usually gets better within a week or two without any treatment.

You can ask your pharmacist for advice on what might help ease your symptoms. They’ll be able to advise you about any over-the-counter treatments such as eye drops or antihistamines which 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.

If you have infective conjunctivitis, it can be contagious. For more information on how to stop spreading conjunctivitis to others, see our section on prevention below.

Self-help

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. 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.

If you use contact lenses, don’t wear them until your conjunctivitis has completely cleared up. Be prepared 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.

If you have allergic conjunctivitis, the best thing you can do is try to avoid what you’re allergic to. For instance, regular changes of bedding and using a mattress cover might help reduce symptoms if you’re allergic to house dust mites. If your conjunctivitis is caused by an allergy to pollen, take a look at our health blog on how 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.

Antibiotics for bacterial conjunctivitis

Conjunctivitis usually gets better on its own, and antibiotics aren’t needed. 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, 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 see your GP.

However, in some special cases (for example, if you have an eye infection caused by the bacteria Chlamydia), you’ll need antibiotic tablets and eye drops.

For more information, see our FAQ on antibiotics and conjunctivitis below.

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. Examples include sodium cromoglicate, nedocromil or lodoxamide. 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 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 about your medicines, ask your pharmacist.

Causes of conjunctivitis

Conjunctivitis is inflammation of the thin membrane that lines your eyelid and covers the front of your eye. There are many different things that can cause this inflammation.

Viral conjunctivitis

Viruses are a common cause of conjunctivitis, especially in adults. The virus which 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

There are many different bacteria that can cause conjunctivitis. Bacterial conjunctivitis is most commonly caused by bacteria from your own skin or respiratory system (nose and throat). In children and older people, bacterial conjunctivitis is more common than viral conjunctivitis.

You can get also 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 within the first month of their life. One of the most common causes is an infection passed on at birth by the baby’s mother if she has chlamydia or gonorrhoea. Neonatal conjunctivitis can cause permanent eye damage if it isn’t treated quickly. For more information, see our FAQ on conjunctivitis and sticky eyes in babies below.

Allergic conjunctivitis

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. These are the most common causes of allergic conjunctivitis.

Another type of allergic conjunctivitis is called giant papillary conjunctivitis. This can happen if you use contact lenses or if you’ve had eye surgery. For more information, see our FAQ on contact lenses and conjunctivitis below.

Using eye drops and eye make-up 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 the eye. These may include irritating chemicals such as those 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).

Preventing the spread of conjunctivitis

Infective conjunctivitis may be contagious, so you might decide to take time off work, or keep your children home from school or nursery. There’s usually no need to keep your child at home if they have conjunctivitis, but the school or nursery may have its own rules.

If you have infective conjunctivitis, it’s best to try to avoid close contact with others for a week or two. This is especially important if they are healthcare workers 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.

Following these tips will also help you avoid getting conjunctivitis from somebody 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

  • Antibiotics can only work on bacterial conjunctivitis. If you have viral or allergic conjunctivitis, they’ll have no effect at all. And even bacterial conjunctivitis often clears up on its own without treatment, usually within a week or two. So, most people with conjunctivitis don’t need antibiotics.

    However, if you have bacterial conjunctivitis, using antibiotic eye drops or ointments may mean that your symptoms get better a little sooner.

    If you choose to use antibiotics, you can buy antibiotic eye drops or ointment for conjunctivitis over the counter at your local pharmacy. Your pharmacist can give you advice on whether or not it is suitable for you.

    In some circumstances, your GP may prescribe you antibiotic eye drops or ointment. This is most likely if your symptoms don’t go away with treatment from your pharmacy or are severe or if you wear contact lenses. If your GP thinks antibiotics are the best option for you, they’ll explain why.

  • 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.

    Sometimes newborn babies are born with a blocked tear duct – usually because their tear drainage system hasn’t fully developed. If your baby has this, their eyes may keep getting watery, sticky or crusty. This 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 – infection of the thin layer lining the eyelids and covering the front of the eye. Neonatal (newborn) conjunctivitis is usually due to a bacterial infection, which you may have passed on to your baby when you gave birth. In most cases, it’s a mild illness but sometimes neonatal conjunctivitis 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. 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
    • a discharge coming from their eyes, which may be like mucus or may be thick and pus-like
    • red eyes

    So, if your baby has sticky eyes, contact your midwife or GP. They’ll then be able to make sure your baby gets any treatment they need.

    If your baby is under a month old, and has pus discharging from 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.

  • Yes. If you wear contact lenses, you may be more likely to get bacterial conjunctivitis if your lenses or lens cases aren’t kept clean. 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. It seems to be a type of allergic reaction to your contact lenses. But 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 the clean them.

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

    • replacing your lenses often
    • avoiding 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, you should take your lenses out. You’ll probably need to stop wearing your lenses until your symptoms stop. For more information about this, see our section on symptoms of conjunctivitis above. If you have any symptoms, especially if your eye is painful or red, it’s best to get your eyes checked by your optician right away.


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Related information

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  • Reviewed by Dr Kristina Routh, Freelance Health Editor, May 2018
    Expert reviewer, Professor Simon Taylor, Consultant Ophthalmic Surgeon
    Next review due May 2021



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