Conjunctivitis

Conjunctivitis is a common condition that causes redness and inflammation of the thin layer of tissue that covers the front of the eye (the conjunctiva).

People often refer to conjunctivitis as red eye.

Other symptoms of conjunctivitis include itchiness and watering of the eyes, and sometimes a sticky coating on the eyelashes (if it's caused by an allergy). Read more about the symptoms of conjunctivitis.

Conjunctivitis can affect one eye at first, but usually affects both eyes after a few hours.

What causes conjunctivitis?

The conjunctiva can become inflamed as a result of:

• a bacterial or viral infection – this is known as infective conjunctivitis
• an allergic reaction to a substance such as pollen or dust mites – this is known as allergic conjunctivitis
• the eye coming into contact with things that can irritate the conjunctiva, such as shampoo or chlorinated water, or a loose eyelash rubbing against the eye – this is known as irritant conjunctivitis

Treating conjunctivitis

Treatment isn't usually needed for conjunctivitis, because the symptoms often clear up within a couple of weeks. If treatment is needed, the type of treatment will depend on the cause. In severe cases, antibiotic eye drops can be used to clear the infection.

Irritant conjunctivitis will clear up as soon as whatever is causing it is removed.

Allergic conjunctivitis can usually be treated with anti-allergy medications such as antihistamines. If possible, you should avoid the substance that triggered the allergy.

It's best not to wear contact lenses until the symptoms have cleared up. Any sticky or crusty coating on the eyelids or lashes can be cleansed with cotton wool and water.

Washing your hands regularly and not sharing pillows or towels will help prevent it spreading.

See your GP immediately if you have:

• eye pain
• sensitivity to light (photophobia)
• disturbed vision
• intense redness in one eye or both eyes
• a newborn baby with conjunctivitis 

Complications

Conjunctivitis can be a frustrating condition – particularly allergic conjunctivitis – but in most cases it doesn't pose a serious threat to health.

Complications of conjunctivitis are rare, but when they do occur they can be serious and include:

• a severe case of allergic conjunctivitis can lead to scarring in the eye
• in cases of infective conjunctivitis, the infection can spread to other areas of the body, triggering more serious secondary infections, such as meningitis

Read more about the complications of conjunctivitis.

Neonatal conjunctivitis

Neonatal conjunctivitis is a type of conjunctivitis that affects newborn babies less than 28 days old.

Most cases of neonatal conjunctivitis aren't particularly serious. A small number of cases occur if a baby is born to a mother who has a sexually transmitted infection (STI), such as chlamydia or gonorrhoea.

These infections don't necessarily cause symptoms in the mother, so many of them are unaware they're infected. With STIs, there's a possibility of serious complications if the infection is left untreated. Contact your GP if you notice any redness in your baby’s eyes.

Infective conjunctivitis

Most cases of infective conjunctivitis don't need medical treatment and clear up in one to two weeks.

Self care

There are several ways you can treat infective conjunctivitis at home. The advice below should help ease your symptoms.

• Remove your contact lenses – if you wear contact lenses, take them out until all the symptoms of the infection have gone; don't re-use old lenses after the infection has gone because they could be a potential source of re-infection; always use new lenses, solutions and cases after an infection.
• Use lubricant eye drops – these are available over the counter at pharmacies or they may be prescribed for you; they may help ease any soreness and stickiness in your eyes; always follow the manufacturer’s instructions.
• Gently clean away sticky discharge from your eyelids and lashes using cotton wool soaked in water.
• Wash your hands regularly – this is particularly important after touching your eyes and will stop the infection spreading to others.

Antibiotics

Antibiotics aren't usually prescribed for infective conjunctivitis because it usually clears up by itself and there's a very low risk of complications for untreated conjunctivitis.

However, if the infection is particularly severe or it has lasted for more than two weeks, you may be prescribed antibiotics. Some schools or playgroups may insist that a child is treated with antibiotics before they can return, although this is rare.

Chloramphenicol and fusidic acid are the two main types of antibiotics that may be prescribed.

Chloramphenicol - Purchase from local pharmacy or access free through the Common Ailments Service

Chloramphenicol is usually the first choice of antibiotic and comes in the form of eye drops. It's available without a prescription from pharmacies to treat bacterial conjunctivitis.

Chloramphenicol needs to be used carefully to get the best results, so make sure you follow the advice of your pharmacist about how and when to use it, or check the patient information leaflet that comes with the medication so you know how to use it properly.

If eye drops aren't suitable for you, you may be prescribed the antibiotic as an eye ointment instead.

Further information available at

 http://www.nhs.uk/Conditions/Conjunctivitis-infective/Pages/Treatment.aspx