Are your eyes red too? This could be due to conjunctivitis!

Are your eyes suddenly red, maybe itchy, or have a discharge coming out of your eyes? Or are both eyes so swollen that you can't open them in the morning? Although it's a minor inconvenience, this is something that many people experience and is a bit annoying. We usually call it "eye disease". This is what we're going to talk about today. To be precise, this is medically called `(Conjunctivitis)`. There's nothing to be afraid of, we'll talk about this in detail, in a way that you can understand.

What is this eye disease (conjunctivitis)?

Simply put, the white part around our eyes (we call this `(Sclera)`), and on the inside of the eyeball there is a very thin, membrane-like thing. This is what we call `(Conjunctiva)`. It's like a transparent screen on a window. When this membrane called `(Conjunctiva)` becomes swollen or inflamed, eye diseases occur.

This is actually very common. Because there are many reasons for this to happen, and those reasons are also very common in our environment. For some people, this gets better in a few days, at most in less than four weeks. We call it `(Acute conjunctivitis)` (short-term eye disease). But sometimes it can last for more than four weeks. Then it becomes `(Chronic conjunctivitis)` (long-term eye disease). It can happen in just one eye or in both eyes at the same time.

How common is eye disease?

Imagine, some people have `(Seasonal allergies)`. That is, allergies caused by things like pollen and dust at certain times of the year. Doctors say that the eye disease caused by such allergies, that is `(Allergic conjunctivitis), develops in between 15 and 40 people out of every hundred . That means it is that common.

Other types of eye diseases (those caused by viruses and bacteria) are more common in certain age groups and at certain times of the year. Just as we get more colds and flu during the cold season and when school starts, this is also the case.

How do you see when your eyes are sick?

As the name suggests, when an eye infection occurs, the white part of the eye (the sclera) may appear pink or red. This is the first thing most people notice. The eyelids may also be swollen and may even look a little droopy. It is also common to have a discharge, or a discharge, from the eye. This discharge may cause your eyes to be sticky when you wake up in the morning.

What are the symptoms of eye disease?

There are several common symptoms of eye disease. However, some of these symptoms can also be seen in other eye diseases. Therefore, it is best to see a doctor to find out for sure.

Here are the most common symptoms:

• Redness in the white part of the eye (`(Sclera)`) or inside the eyeball.
• A mucus-like fluid drains from the eyes. This is thicker than normal tears and may be yellow, green, or white in color. This can cause the eyelids and eyelids to be crusty in the morning.
• A feeling like something small, like a speck of dust, is stuck in the eye (but nothing is really there).
• Dry eyes or sometimes excessive tearing (Epiphora).
• Itchy eyes or a burning sensation inside the eyes.
• Burning sensation in the eyes.
• Slightly blurred vision (this can come and go, it's not always there).
• Sensitivity to light, that is, difficulty looking at light (Photophobia).
• Blepharitis.
• Eye pain or discomfort (this is usually mild, severe pain is rare).

What are the causes of eye disease?

There are many causes of eye diseases, but we can simply divide them into two categories: infectious causes and non-infectious causes.

Infectious causes

"Contagious" means that the pathogen (either a virus or bacteria) causing this eye disease can be transmitted to your other eye, or from you to someone else. Eye diseases that are contagious in this way are very easily spread, especially among children.

There are several main types of these infectious causes:

• Those caused by viruses
• Those caused by bacteria
• Those caused by fungi (this is a little less common)
• Caused by parasites (this is also very rare)

Let's now look at the two most common infectious causes.

Due to viruses (Viral conjunctivitis)

The main cause of short-term `(Acute conjunctivitis)` is a virus. Among these, the `(Adenovirus)` group of viruses is the most common. This `(Adenovirus)` is a type of virus that causes upper respiratory infections like the common cold and flu. So, when you have a cold, you may also get an eye infection.

Many other viruses can cause eye infections. For example:

• With common viral diseases like measles and mumps.
• Viruses that cause herpes in the eyes.
• With the skin disease `(Molluscum contagiosum)`.
• Hand, foot and mouth disease is caused by Enteroviruses or Coxsackieviruses (these are less common).
• The `(SARS-CoV-2)` virus that causes `(COVID-19)` (this is also uncommon, but possible).

Bacterial conjunctivitis

Bacteria are the second most common cause of infectious eye diseases. This is often accompanied by a thick, yellow or green discharge from the eye .

The types of bacteria that most often cause this are:

• `(Staphylococcus)` - These are the bacteria that cause skin infections (`(Staph infections)`).
• Streptococcus - A group of bacteria that causes diseases such as strep throat and pneumonia.
• Haemophilus influenzae - A group of bacteria known to cause meningitis in young children.
• Sexually transmitted infections (STIs) - These include diseases like Chlamydia, Gonorrhea, and Syphilis. If these are passed from mother to baby during birth, they can cause a serious condition called Neonatal conjunctivitis. This can permanently damage the eyes of the newborn and even cause blindness. Therefore, it is very important to be aware of this during pregnancy.

Noninfectious causes

These are the reasons why it is not spread from person to person, from animals, or from dirty objects.

• Allergens : These include mold, pollen, dust, animal dander, and other allergens. These can cause red, itchy eyes.
• Irritants or toxic substances : Shampoos, soaps, cosmetics, contact lenses or contact solutions, dust in the eyes, cigarette smoke, chlorine in swimming pools, etc. Some medications, especially those used to treat open-angle glaucoma, can also cause it.
• Eye injuries : Even a minor injury that damages the `(conjunctiva)` can cause this.
• Immune system diseases and tumors or cancers of the `(Conjunctiva)` (these are very rare).

What are the risk factors that contribute to this development?

There are many risk factors that can affect the development of eye diseases. Let's see what they are.

• Hand hygiene: This is the most important thing. Eye infections can easily spread from our hands to our face and eyes. If you don't wash your hands regularly or use sanitizer, you are more likely to get them. Imagine, what happens if you use public transportation and rub your eyes without washing your hands?
• Age: Viral eye infections are common in both adults and children. However, bacterial eye infections are more common in children under the age of 4. Younger people (in their twenties) are also at higher risk, but the exact reason for this is not clear.
• Time of year: Eye infections caused by allergies are more common in the spring and summer, when flowers are blooming and dust is more common. Infectious eye infections are also more common during cold and flu seasons.
• Medical history: If you have seasonal allergies, or allergy-related conditions like eczema or atopic dermatitis, you are more likely to develop eye disease.
• Sharing personal items: Contagious eye infections can spread easily from certain items, especially eye makeup (mascara, eyeliner), contact lens cases, etc. They can also be spread through shared items, such as towels, pillowcases, etc. You can also get infected by rubbing your face with a friend's towel.

Can eye disease cause complications?

Eye infections are usually not dangerous. In most cases, especially in mild cases, our immune system will control the infection and get better on its own.

But some eye diseases don't get better on their own and need to be treated. Although uncommon, sometimes complications from eye diseases, if not treated properly, can permanently damage the eyes and even cause blindness.

Possible complications include:

• `(Trachoma)` (This is rare in Sri Lanka, but is a major cause of blindness in some parts of the world)
• `(Uveitis)` (inflammation of another part of the inside of the eye)
• Keratitis and Keratoconjunctivitis.
• More severe corneal diseases, especially corneal ulcers and recurrent corneal erosions.

So, if you have symptoms of an eye condition that get worse after a few days, don't ignore it. Definitely see a doctor.

How does a doctor diagnose eye disease?

Most eye diseases are not diagnosed by ophthalmologists. 80 percent of cases are diagnosed by family doctors (primary care providers) and pediatricians. Urgent care and emergency room doctors often diagnose them. The doctor will ask you about your symptoms and examine your eyes.

Sometimes, especially if a bacterial infection is suspected, doctors may recommend a swab test. This involves taking a small amount of fluid from your eye with a soft-tipped swab, similar to a cotton swab, and sending it to a lab for testing. The results will help your doctor decide what treatment is right for you.

The doctor may also recommend that you see an ophthalmologist to monitor your eye over the next few days or weeks, change your treatment if necessary, and see how your eye heals.

What are the treatments for eye disease? Can it be cured?

The good news is that eye disease can be treated, no matter what the cause. Some treatments are specific (that is, they are tailored to the cause), while others help with many types of eye disease, as well as common symptoms.

Most eye conditions are treated with medication. Most of these, regardless of the type of eye condition, treat the symptoms (such as itching, redness, swelling). These medications usually include corticosteroids (which reduce inflammation) and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil® or Motrin®). These can be given as eye drops or as pills.

Here are the specific treatments given depending on the cause:

• Bacterial conjunctivitis: This is treated with antibiotics. These may be in the form of eye drops, ointments, or even pills.
• Viral conjunctivitis: Most of the time, common viral conjunctivitis does not require any special treatment and will clear up on its own in a few days. However, if the cause is a virus such as Herpes simplex, Varicella-zoster, or a sexually transmitted infection (STI), you may need to take antiviral medications. These viral infections can cause permanent eye damage and even vision loss.
• Fungal/parasitic conjunctivitis: These are very rare. The main treatment for this is antifungal and antiparasitic medications.
• Immune-related conjunctivitis: These medications work by limiting the damage your immune system does to the tissues of your eyes.
• Allergic conjunctivitis: If the eye disease is caused by an allergy , the doctor will first recommend over-the-counter (OTC) or prescription medications such as antihistamines (which control allergies) and decongestants (which reduce swelling).
• Irritant-related conjunctivitis: If the eye infection is caused by an irritant (such as shampoo, smoke), the first thing to do is to rinse the eyes thoroughly with lukewarm water for about five minutes. If it is a strong acid or alkali (such as drain cleaner), rinse the eyes in the same way and seek immediate emergency medical attention. Eye injuries caused by strong toxic substances are medical emergencies!

The most important thing is that antibiotics only treat bacterial infections. They do not help with eye infections caused by viruses or allergies. Also, if your doctor prescribes antibiotics, take them exactly as prescribed, for the full course, and until they are finished. Do not stop taking them just because you feel better, or the infection may get worse.

Non-drug treatments

In addition to medication, there are other simple treatments that your doctor or ophthalmologist may recommend. These vary, but some of the most common are:

• You can buy eye drops from the pharmacy that moisten the eyes. These are also called artificial tears. These provide relief from dry eyes and discomfort.
• Warm or cool compresses. Soak a clean cloth in warm water (not too hot, just lukewarm) and place it over your eyes. This will help reduce pain and discomfort. A cool compress is best for allergies.
• If the eyelash seems stuck, you can remove it by gently wiping it with a damp cloth.

Depending on your condition, your doctor may recommend other treatments. It's a good idea to ask your doctor about this, as they can provide information tailored to your specific condition.

What happens if you get an eye infection? How long will it last?

The outlook for eye disease is generally good, especially if treated appropriately. Mild cases often resolve on their own without treatment, within a few days.

If you feel that your eye condition is not improving with treatment, or if your symptoms are getting worse after two or three days, talk to your doctor. He or she may be able to change your treatment to help you.

The duration of eye disease can vary depending on the type you have:

• If you have an allergic eye condition , it can last as long as you are around the allergen.
• Bacterial infections can last between 7 and 10 days (with treatment, they will subside significantly in 2-3 days).
• Viral infections usually last about a week to two weeks, but in rare cases they can last longer.

If you suspect you have an eye infection, and it gets worse after a few days, it's best to see your family doctor or an emergency room.

When can I (or my child) go back to work or school?

This is a question that many parents have. You or your child can usually return to daycare, school, or work as soon as their symptoms are gone . This can happen within 24 hours of starting antibiotic treatment for a bacterial infection, or within two to seven days for a viral infection (until symptoms subside).

"Asymptomatic" means not having these things:

• There is no yellow/green discharge.
• There are no wrinkles on the eyelashes or in the corners of the eyes.
• There is no pink/red color in the eyes.

However, it's best to check with your doctor to see when it's safe to go back. If your eye infection is caused by an allergy or something else that's not contagious, you don't need to stay home, as it's not contagious to others.

Can eye disease be prevented?

Yes, some eye diseases (especially contagious ones) can be prevented, and many others can be reduced in risk. Here are some of the most important things you can do to prevent or reduce your risk of developing eye diseases:

• Wash your hands frequently or use hand sanitizer. This is the number one thing. If your hands look or feel dirty, wash them thoroughly with soap and water for at least 20 seconds. Or, use an alcohol-based hand sanitizer (at least 60% alcohol).
• Avoid touching your eyes, nose, and mouth as much as possible. We unknowingly transfer germs from our hands to our eyes.
• Eye protection. Wear safety glasses when working in dusty areas or with chemicals.
• Never, ever share anything that touches your eyes with others. Things like face towels, handkerchiefs, eye makeup, contact lenses, etc. Infectious diseases can spread before symptoms appear.
• If you are putting `(Eye drops)` in your eyes, make sure the bottle is not dirty. Wash your hands before handling the bottle. When putting `(Drops)` in, be careful not to let the tip of the bottle touch your eye. When you are finished putting in `(Drops)`, put the bottle aside, wash your hands, and then close the bottle.

Do I need to see a doctor for eye problems?

Eye problems don't always require a visit to the doctor. Most of the time, minor cases caused by viruses will clear up on their own in a few days. You can usually treat the symptoms (like a sore throat) at home. But if you have any concerns, don't hesitate to call your doctor.

But in these cases, you should definitely see a doctor:

• If you wear contact lenses and have symptoms of eye disease, stop wearing them immediately and see an eye specialist. Contact lenses can sometimes cause serious infections.
• If you have severe pain in your eyes.
• If sensitivity to light (`(Photophobia)`) is severely increased.
• If you have blurred vision or decreased vision .
• If your eye feels tight, as if something is stuck in it.
• If there is excessive discharge of mucus or pus from the eyes.
• If the symptoms continue to worsen over several days.
• If you have a weakened immune system (e.g., HIV infected, undergoing cancer treatment).

Can eye disease recur?

Yes, eye disease can recur.

• Especially if you have allergic conjunctivitis , your eyes can react and get the disease again every time you are exposed to something that causes you an allergy.
• If you get an eye infection caused by bacteria or a virus, you can unknowingly reinfect yourself. Or you can infect your family members, who can then infect you again.

To prevent this, you need to do these things:

• Wash bed sheets, pillowcases, towels, and handkerchiefs thoroughly in hot water and detergent. Change them frequently, especially during illness.
• Avoid wearing eye makeup completely until the infection is gone.
• Remove old eye makeup, makeup application tools (brushes, sponges), and any makeup used before the infection started, as they may contain germs.
• If possible, wear glasses instead of contact lenses until your condition improves. Clean your glasses regularly.
• If you wear contact lenses, remove the lenses and lens case you were wearing when you got sick. Use new ones. Use only sterile contact lens solution. Wash your hands thoroughly before putting in and taking out your lenses.
• Do not use the same bottle of eye drops that was used for the infected eye on the other eye that is not infected. Doing so can spread the disease to the healthy eye.

What questions should you ask the doctor?

When you go to see the doctor, you might want to ask questions like these:

• What is causing my eye infection? (Virus, bacteria, allergy?)
• What can I do at home to reduce symptoms?
• How should I use the medication (eye drops, ointment) that was prescribed to me? How many times a day and for how long?
• If this is a contagious disease, how can I prevent the eye disease from spreading to others (at home, at work)?
• Should I contact you again if I develop any new symptoms, or if my existing symptoms get worse?
• Are there any requirements that need to be met for my child before he or she can be sent back to school/kindergarten?

It's hard to believe that you've had an eye infection. If a child you care for has it – especially if it's your first time caring for a child – it's easy to feel worried and scared. But remember, eye infections are usually minor conditions that can often be treated very well. If you have any concerns, worries or doubts, never hesitate to talk to your doctor (or the doctor treating your child) for advice.

Finally, a few things to remember

Okay, so now you have a better understanding of eye disease (`(Conjunctivitis)`). Keep these points in mind:

• Eye disease is common, but it is important to manage it properly and try to prevent it.
• Cleanliness is the most important thing! Wash your hands often and avoid touching your eyes as much as possible.
• If it is contagious, take care not to infect others. Do not share towels, pillowcases, or eye makeup.
• If symptoms do not improve within a few days, if they worsen, or if you have severe symptoms (severe pain, blurred vision, excessive sweating), be sure to see a doctor.
• While this is often a simple thing, it can sometimes be a sign of a serious condition, so it's always best to seek medical advice if in doubt.

Wishing you and your family good health!

` Eye disease, Conjunctivitis, Red eyes, Itchy eyes, Discharge from eyes, Eye infection, Eye health