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Conjunctivitis

>Close Introduction

The white part of your eye and the inner surfaces of your eyelids are covered by a transparent membrane (thin layer of cells) known as the conjunctiva. If the conjunctiva becomes inflamed, you have a condition called conjunctivitis.

There are three types of conjunctivitis: irritant, allergic, and infective. Each type of conjunctivitis is caused by different factors.

Irritant conjunctivitis

Irritant conjunctivitis occurs when an irritant such as chlorine or an eyelash gets into your eyes. This can make your eyes sore, and if you rub them it can irritate them more. Avoiding the irritant and not rubbing your eyes will help. However, if your eyes are very red and painful, you should seek medical help immediately.

Allergic conjunctivitis

Allergic conjunctivitis occurs when your eye comes into contact with an 'allergen'. An allergen is a particular substance that makes your body's immune system react abnormally, causing irritation and inflammation in the affected body part. See useful links for more information on allergic conjunctivitis.

Infective conjunctivitis

Infective conjunctivitis can be caused by a virus, bacteria or, in rare cases, by a sexually transmitted infection such as chlamydia or gonorrhoea. The most common symptoms include reddening and watering of the eyes. You may also notice a sticky coating on your eyelashes, particularly when you first wake in the morning, which can make your eyes feel like they're stuck together. Infective conjunctivitis is a very common condition and is responsible for 35% of all eye-related problems recorded in doctor’s surgeries. It is most common in children and the elderly.

Infective conjunctivitis rarely requires any medical treatment because the infection will normally heal by itself, usually within one or two weeks. For most people, the condition does not cause any complications.

Those most at risk of developing complications from infective conjunctivitis are newborn babies, who are 28 days old or younger. An infection in the eye at a very young age can cause permanent damage. If you have infective conjunctivitis that is caused by a sexually transmitted infection (STI), your condition may last several months, rather than weeks.

>Close Symptoms

The symptoms of infective conjunctivitis will normally begin in one eye. However, after a few days, you will often find that the other eye becomes affected too.

The symptoms of infective conjunctivitis can vary from person to person, but may include those listed below.

  • Reddening of the affected eye(s) - this happens as a result of the irritation and widening of the tiny blood vessels in your conjunctiva (thin layer of skin inside your eyelids). If your eyes are very red and very painful, or if your vision is affected, or if your eyes are extremely sensitive to light (photophobia), you should seek immediate medical assistance.
  • Watering eyes - the conjunctiva contain thousands of cells that produce mucus, and tiny glands that produce tears. Irritation causes the glands to become overactive, so that they water more than usual.
  • Sticky coating on eyelashes - you are more likely to notice this when you first wake in the morning. Your eyelids may feel like they are stuck together because the pus that is produced by the infection forms into sticky clumps on your lashes.
  • Slight soreness.
  • Swollen eyelids.
  • Enlarged lymph node in front of the ear - a lymph node is part of the body's immune system, and helps protect the body from bacteria and infection. You might feel an enlarged lymph node as a raised bump, underneath the skin.

If you are suffering from infective conjunctivitis, you may also have the symptoms of an upper respiratory tract infection. An upper respiratory tract infection is one that affects your throat and airways. Symptoms may include:

  • coughing,
  • fever,
  • headache, and
  • aching limbs.

>Close Causes

Infective conjunctivitis occurs when the conjunctiva (the thin layer of cells covering the white of your eye and the inner surface of your eyelids) becomes inflamed as a result of an infection. There are a variety of factors which can cause an infection to develop in your eye. The three most common causes are:

  • bacteria,
  • viruses, and
  • sexually transmitted infection (STI).

There are no particular signs or symptoms that will allow your doctor  to distinguish between a bacterial infection and a viral infection. Both types of conjunctivitis will normally heal by themselves. If your conjunctivitis is caused by a sexually transmitted infection (STI), such as chalmydia, it will usually result in your conjunctivitis lasting for several months, rather than weeks.

If your condition is persistent, you will have an eye swab to determine the cause of the infection (see 'diagnosis' section). If your infective conjunctivitis is caused by an STI, you will have to undergo screening and treatment for the infection. Newborn babies can develop conjunctivitis if the mother has Chlamydia because the infection is often passed to the baby during birth.

Spreading the infection

You are more likely to develop infective conjunctivitis if you have been in close contact with someone who is already infected. It is therefore very important that you make sure that you wash your hands thoroughly after coming into contact with someone who has the condition.

Diagnosing infective conjunctivitis

In most cases of infective conjunctivitis, your consultant will be able to diagnose the condition from your symptoms and by examination. Red, swollen eyes, which are covered in a sticky discharge, are very common features of infective conjunctivitis.

Some conditions which may cause reddened eyes are outlined below.

  • Acute glaucoma - this is a rare form of glaucoma which causes a build up of pressure in the eye. Symptoms of pain, and loss of vision, can develop very rapidly. Left untreated, acute glaucoma can result in a permanent loss of vision. 
  • Keratitis - this is when your cornea (the clear layer at the front of your eye that allows light to travel through your eye) becomes inflamed, and sometimes ulcerated. In severe cases, this can cause scarring of the cornea, which can lead to a permanent loss of vision.
  • Iritis - this condition causes your iris (the coloured part of your eye, behind the cornea) to become inflamed. If you have iritis, and it is not treated, it can cause the iris to stick to the front surface of the lens, which prevents fluid draining from the pupil. This can cause permanent damage to the eye.

Swab test

If your doctor is unsure about the diagnosis, or needs to determine the cause of your infection, they may have to take a swab from your infected eye. This will be tested in a laboratory to find out the cause of your condition. Your doctor can then provide you with the most appropriate treatment.

While your doctor is awaiting the results of your swabs, you may be prescribed a short course of antibiotics to help keep your symptoms under control. When your doctor finds out the results of the swab, you will then be prescribed the most suitable form of treatment for the cause of your condition.

Newborn babies

If your baby is 28 days old or younger and displays symptoms of infective conjunctivitis, it is important to contact your doctor straight away. Many babies may have what is known as a 'sticky eye'. This usually occurs when the tear (lachrymal) duct cannot drain properly. If it cannot drain, it produces a discharge of pus, which can look similar to infective conjunctivitis. However, this condition is not serious, and does not require urgent treatment.

If your baby also has redness in their eye, it may be a sign that the eye is infected. Your doctor will examine your baby closely to see if this is the case. Any newborn babies with infective conjunctivitis must be referred to an eye specialist (ophthalmologist) straight away, so that their condition can be managed and treated to prevent any damage occurring to the eye. Infective conjunctivitis in newborn babies (neonatal conjunctivitis) can, in rare cases, cause serious complications (see 'complications' section). However, with prompt treatment, most babies will make a full recovery.

>Close What Next

You do not need a GP’s written referral letter to see a Moorfields Private doctor. If you know which doctor you would like to see, please contact their private secretary to make an appointment or receive further information, alternatively, email us at enquiries@moorfields-private.co.uk

 


 

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