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Red Eye

more about Red Eye

Viral conjunctivitis, Bacterial Conjunctivitis, Pink Eye, and Infectious Conjunctivitis

  • The conjunctiva is the membrane that lines the eyelids and the Sclera (white of the eye). Infection or irritation of the conjunctiva and the inflammation (redness, irritation, swelling) that results is termed Conjunctivitis.

  • Eyes are red or pink.
  • Eyelids stick together especially in the morning.
  • Eyes Itch
  • Excess tearing.
  • White-yellow or cream color thick sticky discharge (usually in bacterial infections).
  • Watery discharge (Allergic or Viral).
  • Pain may be present.
  • Bacterial symptoms often in one eye.
  • Virus infections and allergies often affect both eyes.
  • Bleeding or hemorrhage can be seen as tiny blood vessels rupture (Viral or chemical).
  • Viruses such as Herpes can cause tiny Ulcers (shallow open sores).
  • Swelling of conjunctiva can occur.
  • Sensitivity to light.

  • Virus infections:

    1. Adenoviruses
    2. Herpes Simplex
    3. Coxsackie's virus
    4. Measles virus
  • Bacteria:
    1. Staphylococcus aureus
    2. Streptococcus pneumoniae
    3. H. Influenza
    4. Neisseria and others
    5. Trachoma -- Chlamydia
    6. Tuberculosis
    7. Syphilis
  • Parasites or Fungi
  • Allergic reactions:
    1. Hay Fever pollen dust
    2. Contact lenses
    3. Auto-immune (body's defenses attack the conjunctiva)
    4. Sjogren's Syndrome
    5. Wegener's Granulomatosis
    6. Chemicals
    7. Smog
    8. Spray perfumes or deodorants
    9. Industrial pollutants
    10. Smoke
    11. Facial creams
    12. Ultraviolet light

  • History
    1. Symptoms
    2. Do others in family have similar symptoms?
    3. Illnesses
    4. Job
    5. Medication
    6. Chemical exposure
    7. Family history
    8. Allergies
    9. Travels
  • Direct examination of the eye with an Ophthalmoscope, an instrument with a light that allows the doctor to check the inside of the eye.
  • Vision exam -- using an eye chart
  • Eye discharge may be collected and sent for a culture
  • Cultures that identify the type of infection and bacteria usually take about 48 - 72 hours to grow.
  • Viral cultures take longer
  • The doctor can stain the crusty eye discharge with a special dye and look at it under a microscope (Gram stain or Giemsa stain), but this is a rare treatment these days.
  • Special stains and slides can be prepared from the discharge to look for specific infections such as the Papanicolaou test for Herpes Simplex.
  • Staining the eye with Fluorescein dye will show cuts and ulcers under an ultraviolet lamp.
  • Blood tests can also be done for specific causes

  • See causes.
  • During delivery if mother has Neisseria gonorrhea or Chlamydia the baby's eyes are infected.
  • Trauma.
  • Schools or institutions where others have conjunctivitis.
  • Poor hygiene and frequent touching eyes.

  • If ulcers or damage has occurred, the patient is referred to an eye specialist (Ophthalmologist)
  • Warm (NOT HOT) water can be used to wash the debris.  Cold water may help with irritants, chemicals and Allergic Conjunctivitis.
  • Remove contacts
  • Bacterial infections include:
    1. Antibiotic eye drops or ointments that are given for 5-7 days
    2. Gentamicin, Tobramycin and Erythromycin ophthalmic preparations are often put in every 4 hours.
    3. Antibiotic pills are rarely necessary, but Doxycycline, taken orally for 3 weeks, is effective against Chlamydia.
    4. Viral infections without ulcerations are usually resolved without treatment
    5. Antiviral eye drops and pills such as Acyclovir are effective therapies for Herpes
  • Allergic reactions:
    1. Allergy medicines
    2. Avoid the causative agent
    3. Oral and antihistamine eye drops

  • Contact your doctor for an eye exam. If the chemicals have gotten into your eye, wash them immediately with cold water and get to the emergency room.  Do not delay treatment!

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