Pinkeye, or conjunctivitis, is an inflammation of the clear outside covering of the white part of the eye and the inside lining of the eyelids (the conjunctiva). Although many things can cause it, viral and bacterial infections are the most common. Pinkeye affects children of all ages at any time of year, and it can spread easily from one person to another or from one eye to the other by contact with the eye discharge.
Conjunctivitis can be viral, bacterial, or allergic. Viruses that commonly cause pinkeye include adenovirus, enterovirus, and influenza virus, the same viruses that cause upper respiratory infections and colds. Herpes simplex virus causes a rare but serious form of pinkeye. Bacteria that commonly cause pinkeye are Streptococcus pneumoniae, Staphylococcus aureus, and Haemophilus influenzae. Gonorrhea and chlamydia can also cause bacterial pinkeye in newborns; these sexually transmitted diseases are passed to the baby through the birth canal. If untreated, serious eye damage can develop. Other causes of pinkeye include allergies (pollen, animal dander, dust mites) and irritants (aerosols, chemicals, smoke). Infants also can develop conjunctivitis as the result of a narrow tear duct that does not let tears flow normally.
Bacterial pinkeye is more common in younger children, particularly during the winter, and viral pinkeye is more common in older children with colds, especially during the fall.
When the conjunctiva becomes red and swollen, discharge from the eye usually indicates an infection. Crustiness develops in the morning when the eyelashes are stuck together. In cases of bacterial infections, the child may also have an ear infection. With viral infections, the child typically has other symptoms such as a head cold, fever, and coughing. Infection often begins in one eye but spreads easily so both eyes usually become affected with itchiness and thin, watery discharge. Any type of conjunctivitis can cause mild pain or discomfort, often described as a feeling of having sand in the eye.
Pinkeye usually goes away without any complications. "Pinkeye is usually a virus that has to run its course," says David L. Rogers, M.D., clinical assistant professor of ophthalmology at The Ohio State University, director of research in the department of ophthalmology at Nationwide Children's Hospital in Columbus, Ohio, and a member of the American Association for Pediatric Ophthalmology and Strabismus (AAPOS).
In rare cases, the infection may spread to the cornea (the clear membrane that covers the colored part of the eye), which causes more pain, extreme light sensitivity, and difficulty seeing normally. For bacterial infections, a doctor will prescribe antibiotic drops or ointment. The treatment will usually last about one week. It is important that you give the medication exactly as prescribed. Any pus should be wiped away with a clean, damp cloth or cotton ball before the medication is put into the eye. Try not to wipe the pus across the entire eye. Pus from the edge of the eyelid can be wiped off gently with cotton swabs. The infected eye should not be covered with a bandage. For blocked tear ducts, a warm compress may also help. For allergic pinkeye, special eyedrops or oral medications may become necessary.
Contact your doctor immediately if you suspect that there is a deeper infection, if your child complains of increasing pain, unclear vision, or increased light sensitivity, if there is swelling, redness, or warmth around the eye, or if your child has fever along with the eye symptoms.
It is hard to prevent your child from developing pinkeye because it often occurs with colds. Pinkeye caused by bacteria is extremely contagious and is easily spread when children rub their eyes, so encourage your child not to do so. Frequent hand washing is also important -- for your child, for you, and for any caregiver. Your child can return to daycare or school the day after treatment starts, provided there is not a great deal of discharge from the eye. For pinkeye caused by bacteria, the chance of passing the infection lowers once the child has been treated with antibiotic drops or ointment for 24 hours.
Regarding bacterial pinkeye caused by sexually transmitted diseases, the use of antibiotic eye ointment for all newborns shortly after birth has lowered the chance of spreading gonorrhea, which can cause blindness. A caesarean delivery is usually recommended if the woman giving birth has active genital herpes at the time of birth.
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