Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Pink eye (conjunctivitis) can be due to infectious or
Infectious pink eye is highly contagious.
Infectious pink eye can be caused by bacteria
Avoiding contact with infected people, disinfection of household surfaces,
and good hygienic practices can help prevent the spread of infectious pink eye.
Noninfectious pink eye can be caused by allergy,
chemical irritation, underlying inflammatory diseases, or trauma.
What is "pink eye"?
Pink eye, or conjunctivitis, is inflammation of the membranes (conjunctiva) covering the whites of the eyes and the membranes on the inner part of the eyelids. These membranes react to a wide range of bacteria, viruses, allergy-provoking agents, irritants, and toxic agents, as well as to underlying diseases within the body. Viral and bacterial forms of conjunctivitis are common in childhood, but they occur in adults as well. Pink eye can occur in people of any age. Overall, however, there are many causes of pink eye. These can be classified as either infectious or noninfectious. Pink eye does not cause any changes in vision.
What infections cause pink eye, what are infectious pink eye symptoms, and how are they treated?
The leading cause of a red, inflamed eye is virus infection. Adenoviruses are the type of virus that is most commonly responsible for the infection. Other viruses that can cause pink eye include herpes simplex virus (HSV), varicella-zoster virus (VZV), poxvirus (molluscum contagiosum, vaccinia), picornavirus (enterovirus 70, Coxsackie A24), and human immunodeficiency virus (HIV).
Viral pink eye symptoms are usually associated with more of a watery discharge that is not green or yellow in color. Viral pink eye is most common in late fall and early spring. Often, viral "cold-like" symptoms, such as sinus congestion and runny nose, are also present. The eyelids may be swollen. Sometimes looking at bright lights is painful.
While viral pink eye may not require an antibiotic, those affected should see a doctor, as occasionally this form of pink eye can be associated with infection of the cornea (the clear portion of the front of the eyeball). This infection must be correctly detected and treated. Viral pink eye is highly contagious and typically remains contagious for 10 to 12 days after the onset of symptoms. The symptoms of viral pink eye can last 1 to 2 weeks. Symptoms are pronounced for the first three to five days after symptoms appear, with slow resolution over the following one to two weeks.
Bacterial pink eye
Staphylococci and Streptococci, are types of bacteria that commonly cause pink eye. Gonococci and chlamydia may also cause bacterial pink eye. Symptoms of pink eye caused by bacteria occur rapidly and can include
a moderate to large amount of discharge, usually thick and yellow or greenish in color,
swelling of the lymph nodes in front of the ears.
The discharge commonly accumulates after sleeping. Affected children may awaken most unhappy that their "eyes are stuck shut," requiring a warm washcloth applied to the eyes to remove the discharge. Bacterial pink eye is treated by repeated warm washcloths applied to the eyes (try applying these to your child's eye one eye at a time during a favorite video) and requires antibiotic eyedrops or ointment prescribed by the doctor.
What does pink eye look like?
Be careful not to use medication prescribed for someone else, or from an old infection, as these may be inappropriate for your current infection or may have been contaminated from other infections by accidentally touching the medicine bottle to infected areas. A safe, effective, and potentially less frightening method of putting drops into the eyes of children involves asking your child to lie down flat, with instructions to merely "close your eyes," and placing the recommended number of drops in the inner corner of the eye, next to the bridge of the nose, and letting them make a little "lake" there. When your child relaxes and opens the eyes, the medicine will flow gently into the infected mucous membranes without the need to "force open" the eyes.
When you feel that you or your child might have bacterial pink eye, it is very important to see your doctor immediately for several reasons. First, if the cause is a bacterial infection, an antibiotic will be needed to help the infection-fighting immune system to kill this infection. Secondly, if you are experiencing other symptoms such as a runny nose, cough, earache, etc., there is a good chance that these symptoms are caused by the same bacteria, and an oral antibiotic may
also be needed to treat this infection along with the antibiotic drops or ointment for the eyes. Oral antibiotics are also required for some types of bacterial pink eye. Finally, your doctor will want to exclude the possibility that the infection has spread to areas where the symptoms may not yet be recognizable.
Chlamydia pink eye
Pink eye due to infection with
chlamydia is an uncommon form of bacterial pink eye in the U.S., but it
is very common in Africa and Middle Eastern countries. Chlamydia can cause pink eye in adults and neonates. It is a cause of pink eye in adolescents and adults that can be sexually transmitted. Chlamydia pink eye is typically treated with erythromycin (E-Mycin, Eryc, Ery-Tab, PCE, Pediazole, Ilosone) or
oral tetracycline (Sumycin), except in children less than
8 years of age, because of possible discoloration of the teeth.