Conjunctivitis

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What is it about ?

Conjunctivitis is inflammation of the conjunctiva.

The conjunctiva is the mucous membrane that lines the white of the eye and the inside of the eyelids. This mucous membrane contains small blood vessels. If irritation occurs, they swell and make the eye redden.

Inflammation can be caused by

  • an infection (by a bacteria, virus or fungus),
  • an allergic reaction (to pollen, dog or cat hair or dander, eye drops, lens fluid, cosmetic products, etc.),
  • a physico-chemical reaction (to drugs for local treatment of the eye, to chlorine, due to welding, etc.),
  • dry eye (dry eye).

What is its frequency?

About 13 in 1,000 people see their GP each year for a red eye. Conjunctivitis is the most common cause of a red eye.

How to recognize it?

The most important symptom is a completely red eye, accompanied by tingling as if there is sand in the eye. Often a watery or purulent discharge causes the eyelid to stick in the morning. The pus usually indicates an infection. Rather, the itching suggests an allergic reaction. Very rarely, light intolerance (photophobia) occurs. Sight (visual acuity) is normal, although the flow may cause occasional image distortion.

How is the diagnosis made?

The doctor will start by inspecting your eye for redness. He is also looking for a possible foreign body in the eye. In the event of a strongly purulent discharge, the doctor may take a sample with a cotton swab and send it to the laboratory for further examinations. He may also check whether your eyesight is correct (measurement of visual acuity). Sometimes it will deposit a dye (fluorescein) on your eye to see if the cornea is damaged.

If you have a purulent discharge and an upper respiratory infection at the same time, there is a good chance that the cause is infectious. In adults, the fact that one eye (or both) gets stuck in the morning more than likely indicates bacterial conjunctivitis.

If there are allergy symptoms at the same time (runny nose, prolonged cough, atopic eczema) or if you have hay fever, it is most likely allergic conjunctivitis.

If you have one or more of the following symptoms, the general practitioner will refer you to an ophthalmologist for additional examinations: severe pain, hypersensitivity to light (photophobia), sensitivity to pressure, change in visual acuity, opaque cornea, speckled or ulcerated, small or deformed pupil.

What can you do ?

Gently remove any spillage with a cotton ball or clean compress that you have wet with tap water. Always start from the outside of the corner of the eye inward. Do not wear contact lenses if your eyes are irritated.

The cold can bring some relief. Dampen a clean washcloth with cold water and apply it to your eyes for a few minutes.

Do not use makeup on infected eyes. This can slow down healing.

If you know what you are allergic to, try to avoid contact with these substances.

  • In pollen season, it is best to keep the windows closed (also at night).
  • If you are allergic to dust mites, try to keep the room as little dust as possible and keep the air dry.
  • If you are hypersensitive to animal dander, it is best to stay as far away from them as possible. Do not allow pets into the room. If you are only allergic to your own pet (rabbit, guinea pig, cat or dog), you should consider parting with it. Remember that after your pet is gone, dander can stay in your home for another 6 months, even if you vacuum properly.

If you get any chemical in your eyes, immediately rinse your eyes with lukewarm tap water. Rinse them for at least 10 minutes.

  • You can submerge your head in a container of lukewarm water. Open your eyelids wide and move your head from side to side.
  • You can keep your head under the tap and look in the trickle of water, even if it’s difficult.
  • You can also fill an empty, clean bottle with lukewarm water and pour it into your eye.

What can your doctor do?

It is possible to treat a purulent conjunctiva with a local antibiotic. To do this, use a gel of fucidic acid, or an ointment or drops (eye drops) based on tobramycin, 4 to 6 times a day. The easiest way to administer the ointment is to put a small amount of it in the lower edge of the eyelid. Treatment should be continued until you have no symptoms for at least 2 days.

Spontaneous healing is very common with purulent conjunctivitis, so the doctor may issue you with a delayed prescription. In this case, he will ask you to start the antibiotic treatment only if the symptoms last more than 3 to 4 days of rinsing with water.

If the antibiotic eye drops do not bring results after a week, stop them and return to the general practitioner for a new examination. Sometimes eye drops don’t work because of a viral infection, resistant bacteria, or your eyes are dry or the first diagnosis was wrong.

Acute conjunctivitis associated with viral respiratory tract infection can be treated with artificial tears.

For allergic conjunctivitis, treatment can be used to prevent or treat the symptoms.

  • To prevent symptoms, sodium cromoglycate drops (eye drops) are offered. They start at the start of the pollen season. These drops sometimes make the eyes dry; occasionally, you may also feel like you have a grain of sand in your eye. This is why artificial tears are added to the treatment.
  • To relieve symptoms, one can use anti-allergic eye drops. If you suffer from hay fever, a cortisone nasal spray may be prescribed to decrease eye symptoms.

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