Pink Eye (Conjunctivitis)

What are the symptoms of pink eye?

Pink eye has many common symptoms. And many of the symptoms happen with other eye diseases. The common symptoms include:

• Redness in the white of your eye (sclera) or on your eyelid’s inner surface.
• Eye discharge (usually thicker than normal tear fluid and can be yellowish, greenish or white; it can cause crusting on your eyelashes or eyelids).
• Foreign object sensation (feeling like something’s stuck in your eye, but there’s nothing there).
• Dry eyes or watery eyes (epiphora).
• Itchy or irritated eyes.
• Burning eyes.
• Blurred vision (may come and go).
• Light sensitivity (photophobia).
• Swollen eyelids (blepharitis).
• Eye pain or discomfort (usually mild).

What causes pink eye?

Conjunctivitis has dozens of potential causes, but there’s one simple way to organize them: infectious and noninfectious.

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Infectious causes

“Infectious” means the disease that causes pink eye is contagious and can spread to the unaffected eye or other people. Pink eye’s most common infectious forms spread very easily.

Infectious causes come in four subtypes: viral, bacterial, fungal and parasitic. Viral and bacterial conjunctivitis are extremely common. Fungal and parasitic conjunctivitis are generally uncommon or even rare.

Viral conjunctivitis

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Viruses are the most common cause of acute (short-term) conjunctivitis. The most common virus type that can cause it is the adenovirus family. Adenoviruses cause upper respiratory infections similar to colds or the flu.

Many other viruses can cause pink eye, too. Examples include:

• Common systemic viruses like measles or mumps.
• Viruses that cause forms of eye herpes.
• Molluscum contagiosum.
• Enteroviruses or coxsackieviruses, better known for causing hand, foot and mouth disease (uncommon).
• SARS-CoV-2 virus, the virus that causes COVID-19 (uncommon).

Bacterial conjunctivitis

Bacteria rank second among the most common causes of infectious conjunctivitis. The most common bacterial culprits are:

• Staphylococcus, the same family of bacteria that cause staph infections.
• Streptococcus, the bacteria family that causes strep throat and pneumococcal disease.
• Haemophilus influenzae, a bacteria family best known for causing meningitis in young children.
• Sexually transmitted infections (STIs), like chlamydia, gonorrhea and syphilis. When these conditions pass from birthing parent to child during birth, it can lead to neonatal conjunctivitis, a condition that can cause permanent eye damage and blindness.

Noninfectious causes

These include causes that don’t spread to people from other people, animals, or contaminated objects or surfaces. Examples include:

• Allergens, including molds, pollen or other substances that cause allergies.
• Irritants or toxic substances, including shampoos, cosmetics, contact lenses or contact solution, dirt, smoke and pool chlorine. It can also include certain types of medications, especially medications that treat open-angle glaucoma.
• Eye Injuries that damage the conjunctiva.
• Immune disorders and conjunctival tumors or cancers.

What are the risk factors for conjunctivitis?

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There are many possible risk factors for conjunctivitis, including:

• Hand hygiene. Conjunctivitis can easily spread from your hands to your face. If you aren’t washing or sanitizing your hands frequently, you might be more likely to develop this condition.
• Age. Viral conjunctivitis is common in adults and children, while bacterial conjunctivitis is far more likely in children under age 4. There’s also a higher risk for people in their 20s, but experts aren’t certain why.
• Time of year. Allergic conjunctivitis is much more common in spring and summer. Infectious forms of conjunctivitis are also more common during cold and flu season.
• Medical history. Having seasonal allergies or allergy-related conditions like eczema or atopic dermatitis can make you more likely to develop conjunctivitis.
• Sharing personal items. The contagious forms of conjunctivitis spread easily on certain objects, especially eye-related items like cosmetics and contact lens containers. The contagious forms can also spread easily on cloth, like washcloths, towels and pillowcases.

What are the complications of pink eye?

Pink eye usually isn’t a dangerous condition, and many cases — especially less serious cases — go away on their own as your immune system handles the infection. But some types of pink eye won’t go away and need treatment.

Though they aren’t common, conjunctivitis complications can sometimes cause permanent eye damage and even blindness if they go too long without treatment. Complications like this include:

• Trachoma.
• Uveitis.
• Corneal inflammation (keratitis) and cornea-conjunctiva inflammation (keratoconjunctivitis).
• More severe corneal diseases, especially corneal ulcers and recurrent corneal erosions.

Because of the risk of permanent damage, you shouldn’t ignore pink eye symptoms if they’re still getting worse after more than a few days.

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