Pink Eye (Conjunctivitis)
Pink eye, or conjunctivitis is very common. The conjunctiva is the membrane forming the moist lining of the eyelids. It is more exposed to the exterior environment than any other part of the body and therefore open to more microorganisms than any other membrane in the body. There is also a thin layer of conjunctiva covering the surface of the cornea. If it becomes infected, conjunctivitis is the result.
Pink eye infection generally starts in one eye and easily spreads to the other eye. Red, irritated eyes result that go away in three days to a week. If the symptoms last longer than that you should see your eye doctor. This is important because if the infection enters the cornea (the transparent surface of the eyeball) little cloudy areas can develop that may harm your vision.
About the Conjunctiva
The conjunctiva is the membrane forming the moist lining of the eyelids and covering the surface of the cornea. If the conjunctiva becomes infected, conjunctivitis is the result. This protective layer is more exposed to the exterior environment than any other part of the body, and it is therefore open to more microorganisms than any other membrane.
The conjunctiva is made up of flattened and columnar epithelium cells (skin and lining) and goblet cells (mucin-secreting). It also secretes tears, but less than the tear glands. It contains both nerve cells and microcapillaries that deliver nutrients and remove waste. It is connected to the sclera (the white of the eye) by a thin vascular membrane called the episclera. The kinds of conjunctiva are:
- Tarsal (palpebral) conjunctiva lines the eyelids.
- Fornix conjunctiva forms the junction between tarsal and ocular conjunctiva. This type of conjunctiva is very flexible and permits eyelids and eyeballs to move freely.
- Ocular (bulbar) conjunctiva covers the white part of the eye and is tightly bound to the underlying layer of sclera. This type of conjunctiva moves as the eyeball moves.
Types of Conjunctivitis
Eye doctors refer to conjunctivitis types as follows:
Allergic conjunctivitis, inflammation due to allergies, is caused by the immune system's release of histamine and other biochemicals.
Viral conjunctivitis can occur along with colds or flu and is contagious. Most often, rubbing the eyes with contaminated hands causes it to spread.
Bacterial conjunctivitis generally requires antibiotics for treatment.
- Various organisms can cause conjunctivitis including: contagious herpes keratitis, gonococcal, and chlamydia (not common). The incidence has increased in recent years and may be due, in part, to increased antibiotic-resistant strains.
- Neonatal conjunctivitis (ophthalmia neonatorum) is found in newborn children, passed from the mother's birth canal.
Chemical origins may be due to an acidic or alkaline material getting in the eye.
Related disorders include episcleritis and scleritis.
Some symptoms of conjunctivitis include:
- red, irritated eyes
- morning "glued" eyelids, from night discharges
- sensitivity to light
- feeling of itchiness
- feeling of griminess
Repeated conjunctivitis can be due to chronic dry eyes. Our tears contain natural antibiotics that help neutralize normal bacteria around our eyes. With less tears, come fewer natural antibiotics.
Infections, including infected insect bites and scratches, are a common cause of conjunctivitis.
- Bacteria. Bacteria, such as pneumococcus, staphylococcus, or streptococcus, are the cause of some cases. Bacterial conjunctivitis is more common in children.
- Virus. Pink eye can also be caused by an adenovirus that spreads by many means, including swimming pools, wet towels, or touching your eyes with dirty hands. Viral conjunctivitis is more common in adults.
Insect bites, debris, and rubbing the eyes can contribute to pink eye. Chronic dry eyes may contribute to the cause. The tear film provides protective, lubricating, nutritional, and antimicrobial functions, and plays an important role in visual acuity. A lack of natural tears, therefore, reduces our ability to fight bacterial infection.
Drugs that can cause dry, irritated eyes include antihistamines, acne medicine, antidepressants, Parkinson's medications, sleeping pills, birth control pills, blood pressure medications, pain relievers such as NSAIDS (for example, ibuprofen), and nasal decongestants.
Allergies and sensitivities that manifest in the eyes often cause pink eye. This includes environmental pollution, pollen, and other allergens.
- Vernal keratoconjunctivitis. This condition typically occurs only seasonally, and it is thought to be an allergic disorder. Patients experiencing conjunctivitis only during allergy seasons, often have other family members with allergy-related conditions, such as asthma or hay fever. It is more common in boys than girls, and more common under 20 years old. It occurs most often in hot-climate summers.
- Allergic conjunctivitis. Some people are susceptible to allergic conjunctivitis brought on by the use of drugs.
Topical eye antibiotics are sometimes have the
side effect of causing an allergic reaction of pink or red eye. Oral antibiotics or those given intravenously for
bacterial infections can also cause symptoms in some people.
- Synthetic penicillins (amoxicillin and ampicillin)- one may experience some mild pink eye or red eye, itching and dryness. In rare cases they may cause blood vessel hemorrhages in the conjunctiva and in the retina
- Tetracycline - in addition to pinkness or redness, one might experience light sensitivity and blurred vision
- Sulfonamides - many people are allergic to "sulfa drugs". This can cause blurred vision, light sensitivity and hemorrhages in the eye.
- Note: Whenever taking antibiotics make sure you take probiotics such as acidophilus or bifidus and vitamin C to help ward off some of the side effects of the antibiotics.
After other potential problems have been ruled out, conventional medicine usually prescribes sulfa-based eyedrops. These usually work within three days. If not, broad-spectrum antibiotic eyedrops or ointment is prescribed; these only work with bacterial infections. Use preservative-free allergy or antihistamine eyedrops to help keep the eyes lubricated and reduce itching. Antihistamines or steroids may be prescribed by an eye doctor and should only be used under the doctor’s direction. Whenever taking antibiotics, make sure you take probiotics as well.
Patients who wear contacts and those who have a sexually-transmitted disease must be treated.
Diet & Nutrition
Certain nutrient-providing herbs such as burdock, forsythia, goldenseal and echinacea may help reduce the symptoms of conjunctivitis.
- Yogurt. The acidophilus in yogurt combats the bacterial infection. For that reason, we also suggest acidophilus supplements. Eat 1/2 cup of yogurt with the live cultures three times a day or take an acidophilus supplement (with about six billion live or probiotic organisms) three times a day. Yogurt can also be used in a soothing compress to the eyes. You don't need to put the yogurt directly in your eyes, but instead, use it in a compress.
- Vitamin A. Vitamin A is especially important in promoting health in all skin and membrane tissues, including the conjunctiva of the eyelids. Do not take vitamin A if you are pregnant or have Stargardt's.
- Vitamin B Complex. Conjunctivitis can be triggered by a vitamin B2 (riboflavin) deficiency, but supplementing with the entire B complex can increase the availability of vitamin B2 without inducing deficiencies of the other B vitamins. Riboflavin plays an essential role in maintaining the structure and function of the ocular surface. Riboflavin deficiency induces ocular surface damage.
- Preservative-free eyedrops. To keep the eyes moist, homeopathic eyedrops are available. They can help with natural tear production and for those with dry eyes.
- Use warm compresses daily. Herbs can be included in an infusion, such as burdock, chamomile, chrysanthemum flower, eyebright, echinacea, goldenseal, marigold and red raspberry leaf.
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