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Recommended reading: Conjunctivitis: Do antibiotics make a difference?

In more than half of all people who have conjunctivitis that is caused by bacteria, the infection goes away without treatment within two to five days. Antibiotic eye drops or ointment can speed up recovery, though. Adverse effects are rare.

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A.D.A.M. Medical Encyclopedia. Atlanta (GA): A.D.A.M.; 2011.

A.D.A.M. Medical Encyclopedia.

Conjunctivitis

Inflammation - conjunctiva; Pink eye

Last reviewed: August 3, 2010.

Conjunctivitis is swelling (inflammation) or infection of the membrane lining the eyelids (conjunctiva).

Causes, incidence, and risk factors

The conjunctiva is exposed to bacteria and other irritants. Tears help protect the conjunctiva by washing away bacteria. Tears also contain enzymes and antibodies that kill bacteria.

There are many causes of conjunctivitis. Viruses are the most common cause. Other causes include:

  • Allergies (allergic conjunctivitis)

  • Bacteria

  • Certain diseases

  • Chemical exposure

  • Chlamydia

  • Fungi

  • Parasites (rarely)

  • Use of contact lenses (especially extended-wear lenses)

"Pink eye" refers to a viral infection of the conjunctiva. These infections are especially contagious among children.

Newborns can be infected by bacteria in the birth canal. This condition is called ophthalmia neonatorum, and it must be treated immediately to preserve eyesight.

See also:

Signs and tests

  • Examination of the eyes

  • Swab of conjunctiva for analysis

Treatment

Treatment of conjunctivitis depends on the cause.

Allergic conjunctivitis may respond to allergy treatment. It may disappear on its own when the allergen that caused it is removed. Cool compresses may help soothe allergic conjunctivitis.

Antibiotic medication, usually eye drops, is effective for bacterial conjunctivitis. Viral conjunctivitis will disappear on its own. Many doctors give a mild antibiotic eyedrop for pink eye to prevent bacterial conjunctivitis.

You can soothe the discomfort of viral or bacterial conjunctivitis by applying warm compresses (clean cloths soaked in warm water) to your closed eyes.

Expectations (prognosis)

The outcome is usually good with treatment.

Complications

Reinfection within a household or school may occur if you don't follow preventive measures.

Calling your health care provider

Call for an appointment with your health care provider if your symptoms last longer than 3 or 4 days.

Prevention

Good hygiene can help prevent the spread of conjunctivitis:

  • Change pillowcases frequently.

  • Do not share eye cosmetics.

  • Do not share towels or handkerchiefs.

  • Handle and clean contact lenses properly.

  • Keep hands away from the eye.

  • Replace eye cosmetics regularly.

  • Wash your hands often.

References

  1. Wright JL, Wightman JM. Red and painful eye. In: Marx JA, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 32.
  2. Rubenstein JB, Virasch V. Conjunctivitis: Infectious and noninfectious. In: Yanoff M, Duker JS, eds. Ophthalmology. 3rd ed. St. Louis, Mo: Mosby Elsevier; 2008:chap 4.6.

Review Date: 8/3/2010.

Reviewed by: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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What works?

  • Antibiotics versus placebo for acute bacterial conjunctivitis Antibiotics versus placebo for acute bacterial conjunctivitis
    Acute bacterial conjunctivitis is an infective condition in which the eyes become red and inflamed. The condition is not normally serious and usually recedes spontaneously within about a week. People with acute conjunctivitis are often given antibiotics, usually as eye drops or ointment, to speed recovery. The benefits of antibiotics to the sufferer of conjunctivitis have been questioned. The review of trials found that the signs of conjunctivitis went away more quickly in people taking antibiotics, but the benefits are marginal as in most cases the infection is self‐limiting.
See all (12)...

Figures

  • Eye.

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Drugs of interest

  • Olopatadine Ophthalmic
    Ophthlamic olopatadine is used to treat the symptoms of allergic pink eye. Olopatadine is in a class of medications called antihistamines. It works by blocking histamine, a substance in the body that causes allergic symptoms.
  • Besifloxacin Ophthalmic
    Besifloxacin ophthalmic is used to treat bacterial conjunctivitis (pinkeye; infection of the membrane that covers the outside of the eyeballs and the inside of the eyelids). Besifloxacin is in a class of medications called fluoroquinolones. It works by killing the bacteria that cause infection.
  • Gatifloxacin Ophthalmic
    Gatifloxacin ophthalmic solution is used to treat bacterial conjunctivitis (pinkeye; infection of the membrane that covers the outside of the eyeballs and the inside of the eyelids). Gatifloxacin is in a class of antibiotics called fluoroquinolones. It works by killing the bacteria that cause infection.
  • Epinastine Ophthalmic
    Ophthalmic epinastine is used to prevent itching of the eyes caused by allergic conjunctivitis (a condition in which the eyes become itchy, swollen, red, and teary when they are exposed to certain substances in the air). Epinastine is in a class of medications called antihistamines. It works by preventing the release of natural substances which cause allergic reactions in the eyes.
  • Azelastine Ophthalmic
    Ophthlamic azelastine is used to relieve the itching of allergic pink eye. Azelastine is in a class of medications called antihistamines. It works by blocking histamine, a substance in the body that causes allergic symptoms.
See all...

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