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HomeHealthTreatment of conjunctivitis - viral, bacterial, allergic

Treatment of conjunctivitis - viral, bacterial, allergic

Redness, irritation in the eyes are symptoms that most people have experienced at some point. Not all tearing is automatically conjunctivitis. It could be temporary eye irritation from dust, sun, or it could be dry eye due to prolonged work on a screen. 

What is conjunctivitis?

In conjunctivitis, inflammation or infection of the conjunctiva develops. This is the thin, transparent tissue that lines the inside of the eyelid and covers the white part of the eye. It is considered one of the most common diseases in ophthalmology, affecting people of all ages. Fortunately, the condition is successfully treated, and there are effective conjunctivitis drops and other remedies.

Types of conjunctivitis can be described according to the underlying cause. It is usually divided into infectious and non-infectious.

Viral conjunctivitis - symptoms and treatment

It is most often caused by adenoviruses. Symptoms are watery discharge, redness and irritation, watery eyes, sensitivity to light. Often there is edema, swelling of the eyelids. You can orientate yourself if you have had any respiratory infection. This conjunctivitis is highly contagious and can be spread to other people through direct or indirect contact with infected eye secretions. For example, if you wipe your eyes without washing your hands properly, you touch objects that then get on other people. 

Bacterial conjunctivitis - symptoms and treatment

This conjunctivitis is usually caused by bacteria such as Staphylococcus aureus, Streptococcus pneumoniae and Haemophilus influenzae. Symptoms are purulent or pus-like discharge, redness, swelling, and sometimes pain. It is also highly contagious, spreading through contact with infected surfaces or secretions.

Allergic conjunctivitis - symptoms and treatment

It is triggered by allergens such as pollen, dust mites or pet dander. Symptoms are itching, redness, watering and swelling of the eyes. Often accompanied by other allergic symptoms such as a runny nose. Unlike infectious conjunctivitis, this conjunctivitis is not contagious.

Other types of conjunctivitis – chemical, neonatal, giant papillary

The cause is contact with irritants such as chlorine in swimming pools, smoke or fumes. Those affected usually complain of redness, watery eyes and discomfort immediately after exposure. It is also not a contagious disease. 

There are some other types of conjunctivitis. Giant papillary conjunctivitis, for example, is associated with prolonged use of contact lenses or the presence of a foreign body in the eye. Symptoms are itching, discharge of mucus and feeling of a foreign body in the eye. Apparently not infected either. 

Neonatal conjunctivitis is another lesser known conjunctivitis. It can be caused by bacterial infections, such as those from the birth canal. Symptoms are redness, swelling and discharge in newborns. The bacterial form is contagious and requires immediate medical attention.

Treatment according to the type of conjunctivitis

First, a diagnosis must be made and the cause of conjunctivitis determined. This is done with an ophthalmologist's examination and laboratory tests.

Viral conjunctivitis is often self-limiting. It mainly treats the symptoms. There are effective drops for viral conjunctivitis - artificial tears. Cold compresses are also recommended.

Antibiotic eye drops or ointments work most effectively with bacterial conjunctivitis. When the cause is an allergy, antihistamines, decongestants (anti-edema agents) or anti-inflammatory eye drops are prescribed.

For conjunctivitis associated with chemical irritants, you should immediately flush the eye with water or saline. In more serious cases, seek medical attention.

Can you have the flu with conjunctivitis? 

Yes, it is possible to have the flu and conjunctivitis at the same time. However, keep in mind that not every viral illness is the flu, even if it's severe, it's the flu. Classic flu hits the body harder and can weaken the immune system. This facilitates secondary infections, including viral conjunctivitis.

There are a number of other viruses that can cause conjunctivitis. Here are some of the more common ones:

  • Adenoviruses
  • Herpes simplex virus (HSV)
  • Varicella-zoster virus
  • Enteroviruses
  • Measles virus
  • Rubella virus
  • Coronavirus (COVID-19), although less common.

Why some people develop conjunctivitis from viruses and others do not

An interesting question is why some people are more likely to develop conjunctivitis and others not, despite being exposed to the same viruses. There are several reasons for this. Individual differences in the strength and response of the immune system are one explanation. Also, some people may have already had contact with the same virus and have partial immunity. If you work for hours on a computer or suffer from any hormonal imbalance (thyroid, etc.), this can lead to increased dry eyes. Thus, viruses more easily overcome the protective tear barrier in the eye.

Genetic variations can affect how the body responds to viral infections. Certain genes can make some people more susceptible to developing conjunctivitis when infected with specific viruses. Human leukocyte antigen (HLA) types can affect immune responses, making some people more susceptible to eye inflammation.

People who wear contact lenses are at a higher risk of developing conjunctivitis, especially if they do not follow proper lens hygiene practices. Environmental factors such as pollution, smoke or allergens also have a negative effect.

Newborns, young children and the elderly have weaker immune systems, making them more susceptible to infections, including conjunctivitis. Hormonal fluctuations, such as those during puberty or pregnancy, can affect immune function and susceptibility to infection.

How long does conjunctivitis last?

The duration of conjunctivitis depends on the underlying cause. Viral usually lasts from 7 to 14 days, but in some cases it can stay up to three weeks. Symptoms such as redness, watery discharge and irritation usually begin to improve within a week. However, the eye may remain slightly red for a longer period of time.

Viral conjunctivitis is highly contagious during the first few days when symptoms are most severe. It remains infected while the eyes are red and watery.

With appropriate antibiotic treatment, bacterial conjunctivitis often improves significantly within 2 to 3 days, but may last up to a week or more without treatment. Symptoms such as purulent discharge, redness, and swelling begin to disappear within a few days of starting antibiotic drops or ointment. Bacterial conjunctivitis is contagious until the eyes stop producing discharge and the person has been on antibiotics for at least 24 to 48 hours.

Allergic conjunctivitis usually lasts as long as a person is exposed to the allergen. 

How to deal with swelling in conjunctivitis?

Edema or swelling of the eyelids is a common symptom of conjunctivitis. What can you do? Applying cold compresses can significantly reduce swelling and provide immediate relief. Use a clean cloth or a cold, damp cloth. It can be infused with chamomile tea, green or black tea, or even plain water. Place on closed eyelids for 10-15 minutes several times a day. Cold helps constrict blood vessels, reducing inflammation and swelling.

In allergic conjunctivitis, antihistamines can be effective in reducing both swelling and other allergy symptoms.

Pills such as loratadine or cetirizine can help reduce common allergic reactions. These are names of drug molecules, the preparations themselves are sold in pharmacies under different trade names.

Antihistamine eye drops such as ketotifen can directly address eye symptoms, including swelling. Nonsteroidal anti-inflammatory drugs or corticosteroid eye drops (prescribed only by a doctor) can help reduce inflammation and swelling.

Drink plenty of water to help flush out toxins and reduce inflammation. Include foods rich in omega-3 fatty acids such as fish, flax seeds and walnuts. They help reduce inflammation. Elevating your head while sleeping on a higher pillow helps reduce puffiness around the eyes.

Author Iliana Angelova

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