Recommended reading: Conjunctivitis: Do antibiotics help?
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A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M.; 2013.
A.D.A.M. Medical Encyclopedia.
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 proteins and antibodies that kill bacteria.
There are many causes of conjunctivitis. Viruses are the most common cause. Viral conjuctivitis is referred to as "pink eye." Pink eye can spread easily among children.
Other causes include:
- Allergies (allergic conjunctivitis)
- Bacteria
- Certain diseases
- Chemical exposure
- Fungi
- Parasites (rarely)
- Use of contact lenses (especially extended-wear lenses)
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.
Symptoms
- Crusts that form on the eyelid overnight
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 you avoid your allergy triggers. 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 eyedrops 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
- 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.
- 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.
- Yanoff M, Cameron D. Diseases of the visual system. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 431.
Review Date: 8/14/2012.
Reviewed by: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
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Effects of antihistamines on eczema
Eczema is a common chronic disease. Itch is the most important symptom, and eczema is often accompanied by dry skin. Skin lesions include rash, redness, swelling of the skin, crusts, oozing, and sometimes also bleeding as a consequence of persistent scratching. Although the disease can resolve during childhood, it might also recur in or persist into adult life. The cause of eczema is considered to be a combination of genetic and environmental factors. Moisturisers, topical corticosteroids, and topical immunomodulators are the mainstay during treatment of eczema, while more severe cases might need UV light therapy or systemic immunosuppressants. Itch is very difficult to treat and leads to scratching, which leads to more inflammation of the skin, and often people with eczema end up in a vicious circle of itching and scratching. The role of histamine in itching associated with eczema is not fully elucidated, but oral H1 antihistamines have been used for many years in the treatment of eczema. These might have been used largely for their sedative action, with highly sedative antihistamines, e.g. chlorpheniramine and hydroxyzine. However, oral H1 antihistamines are widely used in the treatment of allergic disorders, such as urticaria, allergic rhinitis, and allergic conjunctivitis, but their efficacy in alleviating itch and eczema remains unclear. This systematic review sought evidence for the effects and safety of the use of oral antihistamines for eczema, to guide their use in clinical practice.
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