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Conjunctivitis is a common eye condition that affects children and adults alike. This condition is defined by an inflammation of the protective membrane that lines your eyelids and the whites of your eye (conjunctiva). Conjunctivitis can be caused by one of three reasons; by a bacterial infection, a viral infection, or as a reaction to irritants or allergens that have come into contact with the eye. Regardless of the cause of conjunctivitis, when the small blood vessels in the conjunctiva become inflamed, they become more visible and the whites of the eyes appear red and bloodshot. Other typical symptoms of conjunctivitis include grittiness, discharge, watery eyes and soreness, which may vary depending on specific cause. (whether a virus, bacterium or allergen). The treatment required depends on the type of conjunctivitis, which can be determined based on the patient history, signs, symptoms and an examination of the eye by a healthcare provider.

Viral Conjunctivitis

Viral conjunctivitis is often associated with the common cold, viral and respiratory infections such as measles and the flu. Due to the fact that airborne viruses can be easily spread through sneezing or coughing, viral conjunctivitis is highly contagious. Typically this type of conjunctivitis presents with redness, sensitivity to light, irritation and a watery discharge which starts in one eye and usually spreads to the other eye shortly after. For confirmation, clinical diagnosis (or either viral cultures or immunodiagnostic testing) is required.


Unlike bacterial infections, viral conjunctivitis cannot be treated with antibiotics, eye drops or ointments. Since viral conjunctivitis clears with time, treatment is usually focused on supportive therapies, such as eye drops and a cool compress to relieve the symptoms. Just like the common cold, viral conjunctivitis has to run its course and will usually start to go away on its own after a week or so, but may take up to three weeks for all symptoms to completely disappear. While drops usually will not shorten the infection, for more severe cases, topical steroid drops may occasionally be prescribed to reduce discomfort from inflammation. Additionally vasoconstrictors to whiten the eyes and decongestants to reduce the swelling on the surface of the eye may be prescribed to help reduce the symptoms.

Bacterial Conjunctivitis

Similar to viral conjunctivitis, bacterial conjunctivitis is highly contagious and is caused by an infection of the eye with bacteria such as Staphylococcus aureus, Streptococcus pneumonia, or Haemophilus. Patients are often instructed in proper hygiene and hand washing, as bacterial conjunctivitis can be spread through direct or indirect contact with eye secretions/fluid from an infected person. Based on the appearance of the discharge, bacterial conjunctivitis can be differentiated from viral conjunctivitis as having a more yellow/green and thicker discharge. Another indicator of bacterial conjunctivitis is if the condition occurs at the same time as an ear infection.


To help shorten the length of infection, reduce complications and reduce the spread to others the most effective treatment for bacterial conjunctivitis includes antibiotic eye drops. However, even without antibiotic treatment, the symptoms should ease after a few days and the infection will usually run its course over a period of 7 to 8 days.

Reactive Conjunctivitis

Although all people who have allergies are at higher risk, allergic or reactive conjunctivitis is not contagious. This flare-up in the eyes is caused by an allergic reaction to small irritants such as animal dander, dust mites, feathers and airborne allergens such as pollen or mould spores or by a reaction to chemical substances such as plant sap, sawdust from treated timber or household chemicals. After exposure, the allergen causes a rapid release of inflammatory mediators including histamine and others, resulting in the immediate conjunctivitis symptoms. Typical symptoms of allergic conjunctivitis include watery eyes and a burning, itchy sensation in both of the eyes, accompanied by a runny nose, stuffiness and light sensitivity.


Treatment for allergic conjunctivitis first starts with finding the cause(s) of the symptoms and avoid these if possible. Often this can be difficult to avoid, in which case anti-allergy medicine or drops are usually recommended. Additionally to reduce the allergic response to the irritants, antihistamine tablets, such as loratadine and mild steroid eye drops may be required.

How to prevent the spread of conjunctivitis?

Viral and bacterial conjunctivitis can be easily spread from person to person, through hand-to-eye contact by hands or objects that are contaminated with the infectious bacteria or virus. For this reason, it is important to practice good hygiene to control the spread of conjunctivitis, by following the steps:

  • Don’t touch your eyes with your hands
  • Wash your hands often, especially if you have come into contact with someone who has conjunctivitis or after using any type of medicine in the eyes such as drops or topical antibiotics
  • Use a clean towel and washcloth daily. If you have conjunctivitis, any washcloths or medication applicators that are not disposed of should be washed immediately after use.
  • If you have conjunctivitis, ensure to dispose of eye cosmetics, such as mascara
  • If you are a disposable contact lens wearer then dispose of your lenses and case and wear glasses until the conjunctivitis settles
  • Don’t share towels or washcloths with others
  • Wash your pillowcases, bed sheets, towels often using hot water
  • Don’t share personal eye care items (including eyeglasses, sunglasses, eye cosmetics, contact lenses and lens containers) with others
  • Do not sample the eye makeup testers in stores
  • If you have conjunctivitis, avoid swimming in pools as not only will this cause further irritation to your eye but will also pose a serious risk for the spread of conjunctivitis.

Conjunctivitis is a term that may sound scary, but this common eye problem can be easily treated and the symptoms will usually fade after a few days, leaving your vision and the appearance of your eyes back to their normal state. Furthermore, by following a few simple precautions, the spread of conjunctivitis can be avoided.

While most cases will recover on its own, if you have any concerns/questions or if you develop a fever, ear pain or tiny bumps on your eyes we recommend you contact your healthcare provider or book an appointment with one of our ophthalmologists here at Auckland Eye.

Conjunctivitis Monday, 6 Aug 2018

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