Ask the experts
My daughter contracted pinkeye at school and I'm really trying to keep the rest of the family from getting it. How can I prevent pinkeye? How does a person get pinkeye?
Chemical and allergic pinkeye are not contagious, but infectious forms of pinkeye are highly contagious and are spread by direct contact with infected people. If someone has infectious pinkeye, avoid touching the eye area and wash the hands frequently, particularly after applying medications to the eye area. Never share towels or handkerchiefs, and throw away tissues after each use. Disinfecting surfaces like countertops, sinks, and doorknobs can also help prevent the spread of infectious pinkeye.
Staphylococci and Streptococci are types of bacteria that commonly cause pinkeye. Gonococci and chlamydia may also cause bacterial pinkeye. Symptoms of pinkeye caused by bacteria occur rapidly and can include
- eye pain or burning,
- a moderate to large amount of oozing or eye 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 with crusty eyelashes most unhappy that their "eyes are stuck shut," requiring a warm washcloth applied to the eyes to remove the discharge. Bacterial conjunctivitis is treated by repeated warm washcloths applied to the eyes (try applying these to a child's eye one eye at a time during a favorite video) and requires antibiotic eyedrops or ointment prescribed by the doctor.
Be careful not to use medication prescribed for someone else, or from an old infection, as these may be inappropriate for the 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 the 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 the 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 someone thinks he (or she) has bacterial conjunctivitis (bacterial pinkeye), it is very important to see a 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. Types of topical ophthalmic (eye drops) antibiotics often used for pinkeye include besifloxacin (Besivance), gatifloxacin (Zymaxid), levofloxacin (Levaquin, Quixin, Iquix), moxifloxacin (Moxeza, Vigamox), tobramycin (Tobrex), ciprofloxacin (Ciloxan), erythromycin (Ilotycin), and others. Secondly, if someone is 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 eye drops or ointment for the eyes. Oral antibiotics are also required for some types of bacterial pinkeye. Finally, a doctor will want to exclude the possibility that the infection has spread to areas where the symptoms may not yet be recognizable.
The leading cause of an inflamed, red eye is viral infection. Adenoviruses are the type of virus that is most commonly responsible for the infection. Other viruses that can cause pinkeye include herpes simplex virus (HSV), varicella-zoster virus (VZV), poxvirus (molluscum contagiosum, vaccinia), picornavirus (enterovirus 70, Coxsackie A24), and human immunodeficiency virus (HIV).
Viral conjunctivitis symptoms are usually associated with more of a watery discharge from the eye that is not green or yellow in color. The discharge may resemble an increase in tears or watery eyes. Viral pinkeye is most common in late fall and early spring. Often, common cold symptoms, such as sinus congestion and runny nose, are also present. The eyelids may be swollen or puffy and the inner eyelids reddened. Sometimes looking at bright lights is painful so that the individual experiences sensitivity to light.
While viral pinkeye may not require an antibiotic, those affected should see a doctor, as occasionally this form of pinkeye 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 conjunctivitis is highly contagious and typically remains contagious for 10 to 12 days after the onset of symptoms. The symptoms of viral pinkeye can last one to two weeks. Symptoms are pronounced for the first three to five days after symptoms appear, with slow resolution over the following one to two weeks.
Boyd, Kierstan. "Conjunctivitis: What Is Pink Eye?" American Academy of Ophthalmology. Mar. 1, 2017.
Yeung, Karen K. "Bacterial Conjunctivitis." Medscape.com. Dec. 4, 2015. <http://emedicine.medscape.com/article/1191730-overview>.