Pink eye: Bacterial and viral conjunctivitis treatment
Treatment for pink eye (conjunctivitis) can vary widely, depending on what causes the eye condition.
Antibiotics usually are the mainstay of treatment for bacterial forms of conjunctivitis, while relief of symptoms often is the best approach for viral types of pink eye that must simply run their course.
Warm compresses placed on closed eyelids may help soothe your eyes if you have viral or bacterial conjunctivitis. Because these two conjunctivitis types are contagious, you also should practice good hygiene such as frequent hand washing to keep from infecting your other eye or people who share your environment.
If your eyes are itchy, scratchy and irritated most of the time, you may need eye drops or pills to treat eye allergies associated with this form of non-contagious pink eye.
Antibiotic treatments for bacterial conjunctivitis
Usually, a broad-spectrum antibiotic treatment in the form of eye ointments or drops is used to treat pink eye infections caused by bacteria. In certain cases where an underlying infection elsewhere in the body may be causing conjunctivitis symptoms, you may be prescribed antibiotics to swallow in tablet form.
Standard antibiotic treatments often will work for ordinary bacterial infections related to staphylococcus (staph) or streptococcus (strep) infections, which are the usual causes of bacterial conjunctivitis in adults.
In children, Haemophilus influenza bacteria — unrelated to common flu, which is viral — also may cause pink eye.
A typical antibiotic treatment often will work for these types of bacterial infections without the need to swab the eye and send off a sample (culture) for evaluation. If the initial treatment doesn't work, then a culture may be needed so that treatment can be changed to a more specialized type of antibiotic.
Your eye doctor might prescribe an eye cleanser to keep your eyes clean or to prevent a bacterial infection from starting. Artificial tears are another common prescription for pink eye, to relieve dryness and discomfort.
Treatments for pink eye caused by sexually transmitted diseases (STDs)
If the discharge from the eye is severe, gonococcal (gonorrhea) conjunctivitis may be an underlying cause, particularly in newborn babies who, while being born, contact mothers who have been infected with a sexually transmitted disease.
Ideally, a mother-to-be should be tested before her baby is born to make sure any pre-existing infection can be cleared up with antibiotics to avoid the possibility of transmitting it to the baby.
If gonococcal conjunctivitis is confirmed in a newborn infant, then antibiotic treatment must be given intravenously (through veins) or through muscles, as well as in the form of topical eye drops or ointments.
Any newborn baby with pink eye must be evaluated for gonococcal and chlamydial conjunctivitis (STDs). However, staphylococcus, streptococcus and other infectious agents should be considered as well, so appropriate treatment can begin.
Again, not all instances of conjunctivitis that occur right after or within a few weeks of birth (ophthalmia neonatorum) are caused by sexually transmitted disease. A baby's eyes can become infected from exposure to other types of bacteria during the birth process. Also, babies who are only a few weeks old can be exposed to pink eye from other bacterial sources after they go home.
Measures such as applying silver nitrate and antibiotic ointments to the eyes of newborn infants within an hour of birth can greatly reduce the rate of gonococcal conjunctivitis. But this will not stop chlamydia-based conjunctivitis, which must be treated with antibiotics after diagnosis.
Antibiotic treatment for conjunctivitis related to chlamydia or gonorrhea also may be needed for sexually active adults exposed to secretions containing these infectious agents.
Viral conjunctivitis treatments
Because many forms of conjunctivitis are viral, for which there is no curative treatment, it's important to pinpoint exact symptoms to determine the underlying cause of pink eye before treatment (if any) is considered.
Antibiotics are effective for bacterial conjunctivitis, but they don't work on pink eye caused by viruses.
Usually, a person with viral conjunctivitis has redness in one or both eyes along with watery or a small amount of mucus discharge. Generally, vision is good.
If you or your child first had an upper respiratory infection such as a common cold, then resulting pink eye may be due to an adenovirus that commonly invades moist, membrane-like tissue lining nasal passages and eyes.
This is why viral conjunctivitis spreads easily when infected children sharing close quarters with family members or classmates start sneezing and coughing. It is often the cause of pink eye epidemics.
Virus-based illnesses such as measles and mumps, while not nearly as common as they once were, also can lead to viral forms of pink eye.
If you have viral conjunctivitis, usually the condition itself can't be treated. But you may need certain types of eye drops to help your eyes feel better.
Examples of eye drops that can help ease discomfort and symptoms of viral pink eye include:
- Antihistamines, which can relieve eye itchiness and irritation.
- Vasoconstrictors, which shrink blood vessels in the eye to reduce redness.
Your eye doctor also may look for other signs to confirm viral infection, such as small bumps (follicles) on the eye or eyelids and an enlarged lymph node located in front of the ear. In some cases of viral conjunctivitis, your body's immune responses and eye inflammation may cause deposits to form near the eye's surface to create problems such as hazy vision.
Sometime steroids are prescribed to control these symptoms and speed recovery. But it is quite possible that once the steroids are discontinued, the disease may continue to run its course. Furthermore, long-term steroid use may be associated with development of cataracts or glaucoma.
Some symptoms may take several months and even a year or longer to disappear. However, most ordinary cases of viral conjunctivitis will run their course without treatment within several days or weeks.
Relief from allergic conjunctivitis
Itchy eyes are nearly always a sign of allergic conjunctivitis. A stringy but scant mucous discharge and red eyes also may be present.
Other common allergic symptoms are a stuffy, runny nose (rhinitis), "scratchy" throat and dry, hacking cough. Vision is rarely affected.
Treatment of allergic conjunctivitis is designed to control symptoms, which may be chronic in some cases.
Depending on the degree of symptoms, many people get relief from over-the-counter vasoconstrictor and antihistamine eye drop combinations for relief of red eyes and itchiness.
If this approach is ineffective or symptoms are more severe, a mild steroid eye drop medication may be used temporarily. Eventually, an eye drop medication known as a mast-cell stabilizer may be substituted. Mast cells release histamine and other causes of eye inflammation and ultimately are responsible for itching.
People whose allergic conjunctivitis symptoms can be controlled only with steroids and who require ongoing treatment must be monitored for potential increases in eye pressure and cataract development that are potential side effects of steroids.
Giant papillary conjunctivitis remedies
Soft contact lens wearers represent the great majority of people afflicted with giant papillary conjunctivitis (GPC).
Symptoms include tearing, significant mucus production and itching of the involved eye. Often, both eyes are involved. A bumpy surface on the underside of the upper eyelid indicates presence of giant papillae.
Remedies for GPC include:
- Removing the foreign body, such as a contact lens, that has caused the abnormal immune response and leaving it out for at least a month or longer.
- After the condition resolves, wearing soft contact lenses only for limited time periods or switching to gas permeable contact lenses to decrease the risk that GPC might recur.
- Using strict contact lens hygiene (such as using appropriate contact lens solutions and changing lenses frequently to help reduce the chance of GPC.
Finally, rinsing the eye's surface with a sterile salt water (saline) solution several times daily may give additional relief. For those with particularly severe GPC, a short course of corticosteroid eye drops may be prescribed.
People interested in continuing to wear contact lenses and who already have had GPC might consider using mast-cell stabilizing agents in eye drops to help suppress the release of histamine and other mediators of inflammation in the eye caused by the body's immune response.