Conjunctivitis is an inflammation of the membrane covering the inside of your
eyelids and the outer part of your eyeball. Commonly called "pink eye,"
conjunctivitis is generally not serious but can be highly
contagious. |
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Signs and Symptoms |
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Conjunctivitis causes the following symptoms in one or both
eyes.
- Redness
- Itching
- Tearing
- Discharge (watery or thick)
- Crust that forms overnight
- Sensitivity to light
- Gritty feeling
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What Causes It? |
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Conjunctivitis is most often the result of viruses, like those that cause the
common cold. Conjunctivitis can also be caused by bacterial infections,
allergies, chemicals, irritation from contact lenses, or eye injury. Viral and
bacterial conjunctivitis are very contagious. |
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What to Expect at Your Provider's
Office |
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If both eyes are affected, with itching and a clear discharge, it's likely
that allergies are the cause. Swollen glands usually indicate a virus, and a
thick, crusty discharge is a sign of a bacterial infection.
Your provider may use a lamp for closer examination, or gently swab a stain
across the surface of your eye. He or she may test your vision or measure the
pressure in your eye, to rule out glaucoma. |
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Treatment Options |
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Conjunctivitis is generally not a serious problem and often will go away by
itself. But it is still important to consult your health care provider. Chronic
conjunctivitis, left untreated, can cause permanent eye damage.
Treatment varies according to the cause of inflammation. Bacterial
conjunctivitis is generally treated with antibiotics. Forms of conjunctivitis
caused by viruses do not respond to antibiotics, but antihistamines and
anti-inflammatory medications may help relieve your symptoms. Cool compresses
may help to reduce itching and swelling. |
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Drug Therapies |
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- Viral conjunctivitis: Cool compresses three times daily for 1 to 3
weeks; may also use antihistamines to relieve inflammation. Trifluridine 1%
drops, every 2 hours. Oral and/or topical acyclovir may also be
needed.
- Allergic conjunctivitis: Avoid contact with allergen. Treat with cool
compresses, over-the-counter or topical antihistamines, NSAIDs (particularly
ketorolac), and possibly mild corticosteroids.
- Bacterial conjunctivitis: trimethoprim sulfate and polymixin B
sulfate drops, 1 drop 3 times daily for one week, or polymixin B-bacitracin
ointment. Fluoroquinolones as second-line therapy. Tobramycin (0.3%) or
gentamicin as drops, or 10% sodium sulfacetamide as drops, every four
hours.
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Complementary and Alternative
Therapies |
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Alternative therapies can help relieve your symptoms. If you have a mild case
of conjunctivitis, begin with compresses. For a moderate infection, use an
eyewash as well. |
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Nutrition |
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Doses listed are for adults. Decrease by one-half to two-thirds for children,
at the recommendation of a health care provider. Vitamin A (10,000 IU per day),
vitamin C (250 to 500 mg two times per day), and zinc (30 to 50 mg per day)
strengthen your immune system and help you heal faster. |
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Herbs |
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Herbs may be used as dried extracts (capsules, powders, teas), glycerites
(glycerine extracts), or tinctures (alcohol extracts). Compresses and eye washes
are external treatments. A compress is made with a clean cloth, gauze pads, or
cotton balls soaked in a solution and then applied over the eyes. Eye washes may
be administered with an eye cup or a sterile dropper.
Compress: Use five drops of tincture in ¼ cup water or steep 1 tsp. herb in 1
cup hot water for 5 to 10 minutes and strain. Soak cloth or gauze in solution
and apply to the eyes for 10 minutes, three to four times a day.
- Eyebright (Euphrasia officinalis): helps fight infection and
dry up excess fluid, specific for eyes
- Chamomile (Matricaria recutita): helps fight
infection
- Fennel seed (Foeniculum vulgare): helps fight
infection
- Marigold (Calendula officinalis): soothes
irritation
- Plantain (Plantago lanceolata, P. major): astringent and
soothing. The fresh leaves are the most effective plant part.
- Flaxseed (Linum usitat issimum): as a soothing poultice made
with 1 oz. of bruised flaxseed steeped for 15 minutes in 4 oz. of water, wrapped
in cheesecloth, then applied directly to the affected eye.
- Grated fresh potato has astringent (drying and disinfecting)
properties. Wrap in cheesecloth and apply.
Use above herbs singly or in combination: Mix equal parts together then steep
1 tsp. herb in 1 cup of hot water to make a tea. Cool before administering to
the eye.
Eyewash: goldenseal (Hydrastis canadensis) and boric acid: 10 drops of
goldenseal tincture with 1 tsp. of boric acid in 1 cup of
water. |
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Homeopathy |
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Although very few studies have examined the effectiveness of specific
homeopathic therapies, professional homeopaths may consider the following
remedies for the treatment of conjunctivitis based on their knowledge and
experience. Before prescribing a remedy, homeopaths take into account a person's
constitutional type. A constitutional type is defined as a person's physical,
emotional, and psychological makeup. An experienced homeopath assesses all of
these factors when determining the most appropriate treatment for each
individual.
- Euphrasia -- for conjunctivitis with large volumes of watery
tears that burn the face and may in time become a thick discharge; despite the
production of watery tears, the individual complains of a dry, gritty sensation
in the eyes
- Argentum nitricum -- for red, swollen eyes with pus-like
discharge and splintering pains
- Pulsatilla -- for conjunctivitis with yellow-green discharge
and itchy eyes that may accompany or immediately follow a cold; the eyelids tend
to stick together and symptoms generally improve with cold compresses; this
remedy is most appropriate for individuals who tend to be irritable and have
mood swings
- Belladonna -- for the first stages of conjunctivitis including
the sudden onset of burning, bloodshot eyes, swollen eyelids, and
hypersensitivity to light; the eyes are generally hot and throbbing to the touch
- Sulphur -- for burning, pain, and redness of the eyes
accompanied by a yellow discharge with foul odor; the eyes are often crusted
together and the individual is usually very hot and thirsty
- Apis mellifica -- for red, burning eyes and excessive swelling
that feel better with cold applications
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Acupuncture |
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Treatment may be administered for pain relief and relieving
congestion. |
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Following Up |
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Viral and bacterial conjunctivitis are both very contagious. Family members
should use separate towels. Wash your hands often. Children should generally be
kept home from school and day care.
Be sure to follow your health care provider's advice about using any
medications, particularly if you have been given antibiotics or corticosteroids.
If you wear contact lenses, keep them clean to avoid further irritation and
future infections. Do not wear them until your eyes have healed.
People with allergy-related conjunctivitis sometimes develop a severe form
with a stringy discharge, swollen eyelids, scaly skin, and significant
discomfort. This needs aggressive treatment to prevent scarring of the
cornea. |
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Special Considerations |
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In most U.S. hospitals, medication such as silver nitrate is routinely
administered to the eyes of newborns to prevent conjunctivitis from developing
from bacteria in the birth canal. |
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Supporting Research |
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Abelson MB, Casey R. How to manage atopic keratoconjunctivitis. Rev
Ophthalmol. May 1996.
Abelson MB, McGarr P. How to diagnose and treat inclusion conjunctivitis.
Rev Ophthalmol. March 1997.
Abelson MB, Richard KP. What we know and don't know about GPC. Rev
Ophthalmol. August 1994.
Abelson MB, Welch D. How to treat bacterial conjunctivitis. Rev
Ophthalmol. December 1994.
Acute conjunctivitis. Acupuncture.com. Accessed at
http://www.acupuncture.com/Clinical/Conjunct.htm
on January 29, 1999.
Carr AC, Frei B. Toward a new recommended dietary allowance for vitamin C
based on antioxidant and health effects in humans. Am J Clin Nutr.
1999;69(6):1086-1107.
Clinical imperatives of ocular infection. Primary Care Optometry News.
Roundtable. March 1996.
Cummings S, Ullman D. Everybody's Guide to Homeopathic Medicines.
3rd ed. New York, NY: Penguin Putnam; 1997: 90-91.
Friedlaender MH. Update on allergic conjunctivitis. Rev Ophthalmol.
March 1997.
Homeopathic drops for allergy: ready or not? Primary Care Optometry News.
May 1996.
Infectious Diseases and Immunization Committee. Canadian Pediatric Society.
Recommendations for the prevention of neonatal ophthalmia. Can Med Assoc J.
1983; 129:554-555.
JAMA Patient Page. How much vitamin C do you need? JAMA.
1999;281(15):1460.
Johnston CS. Recommendations for vitamin C intake. JAMA.
1999;282(22):2118-2119.
Jonas WB, Jacobs J. Healing with Homeopathy: The Doctors' Guide. New
York, NY: Warner Books; 1996: 180-181.
Levine M, Rumsey SC, Daruwala R, Park JB, Wang Y. Criteria and
recommendations for vitamin C intake. JAMA. 1999;281(15):1415-1453.
Morrison R. Desktop Guide to Keynotes and Confirmatory Symptoms.
Albany, Calif: Hahnemann Clinic Publishing; 1993:5, 28.
Pascucci S, Shovlin J. How to beat giant papillary conjunctivitis. Rev
Ophthalmol. June 1994.
Rapoza PA, Francesconi CM. How to diagnose chronic red eye. Rev
Ophthalmol. October 1997.
Ullman D. Homeopathic Medicine for Children and Infants. New York, NY:
Penguin Putnam; 1992: 67. |
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Review Date:
August 1999 |
Reviewed By:
Participants in the review process include:
Richard A. Lippin, MD, President,
The Lippin Group, Southampton, PA; Sherif H. Osman, MD, President, Medical Staff
Harford Memorial Hospital, Falston General Hospital, Bel Air, MD; Paul Rogers,
MD, Facility Medical Director, Bright Oaks Pediatrics, Bel Air MD; Tom Wolfe,
P.AHG, Smile Herb Shop, College Park, MD.
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