Conjunctivitis ("Pink Eye")
McKenzie Pediatrics (November 2000)
What Is "Pink Eye"?
The term "pink eye" means many things to many people, but it is not a medical term. The correct word for this condition is Conjunctivitis, an inflammation of the conjunctiva, the transparent covering of the eyeball and the inner eyelids. It is very common, and there are several different types, each with many causes.
What Are Causes of Red or Pink Eye?
Most red or pink eyes are caused by infections. Other possible causes include allergies, corneal abrasions, foreign bodies, and crying!
What Is Viral Conjunctivitis?
Most conjunctivitis in school-aged children are caused by viruses. They almost always resolve without treatment, usually within 7 days or less, without permanent damage. The most common viruses to cause conjunctivitis are Adenoviruses, of which there are many different types. Often, though not always, the child will also have an ongoing Upper Respiratory Infection ("Cold"). The symptoms of viral conjunctivitis might include:
- Eye Discomfort (though not pain)
- Watery Eyes
- Sensation of a Foreign Object in Eye
- One or Both Eyes Red or Pink
- Either No Discharge, or Whitish-Yellow
- Occasional Light-sensitivity
The child's vision and pupils should not be affected by viral conjunctivitis. Treatment is supportive (see later section). The infection is contagious, but mostly to direct contact of any discharge. Since most viral conjunctivitis has associated "cold" symptoms, the child has likely already been contagious through their nasal secretions!
What Is Bacterial Conjunctivitis?
This is the most common type of conjunctivitis in pre-school aged children. It rarely causes permanent damage. The bacteria that most often cause conjunctivitis are Haemophilus influenza non-typeable, and streptococcus pneumoniae, the same bacteria that are the most common causes of ear and sinus infections. The symptoms of bacterial conjunctivitis include:
- Eye Discomfort (though rarely pain)
- Usually Less watery Than Viral
- Matting of Eyelids Upon Awakening
- One (1/4th) or Both (3/4th) Eyes Affected
- Yellow-Green or Green Discharge
- Eyes Possibly Draining Even While Awake
Again, the child's vision and pupils should not be affected. Treatment is with a topical antibiotic, or just an oral antibiotic if there is also an ear or sinus infection. Topical antibiotic ointments are best in infants, especially since most purulent eye discharge in infants is caused from an infected tear duct, rather than a cause of conjunctivitis!