Is Pinkeye Caused by Feces?

  • Medical Author:
    Melissa Conrad Stöppler, MD

    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.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    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.

Ask the experts

I am in sixth grade and I have pinkeye. My mom said it might be from not washing germs off my hands after I go to the bathroom. Is pinkeye really caused by feces?

Doctor's response

Bacteria or viruses in feces can be a couple of many possible causes of pinkeye. Pinkeye, or conjunctivitis, is inflammation of the membranes (conjunctiva) covering the white parts 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. Pinkeye can occur in people of any age. Overall, however, there are many causes of pinkeye. These can be classified as either infectious or noninfectious.

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,
  • swelling,
  • itching,
  • redness,
  • 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.

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REFERENCES:

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>.

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Reviewed on 10/8/2018