Page 106 - July-Sept 2024 Edition

he Eye asked me for an article on conjunctivitis so I said Aye Aye, the Eye on the eye.
TApparently it’s been going round. Technically conjunctivitis is an “-itis of the conjunctiva”
so describes any inflammation: chemical, allergic, traumatic, autoimmune, or infectious. But
most people think “pink eye”: a common epidemic in schools that we can’t avoid, but hope
as adults we’re immune to it from our own grubby childhoods. So let’s talk about infectious
conjunctivitis. But quick warning: some causes of red eyes are serious.
Even in the middle of an epidemic of adenovirus pink eye, an alert doctor will see an occasional
auto immune uveitis or other rare potentially blinding disease. Sometimes treatment is so urgent that
making an appointment tomorrow isn’t an option. Most epidemics of conjunctivitis are viral. Usually an
adenovirus but who cares: any virus from Covid to measles can cause a red eye. A good GP will have
a quick look, shine a torch, check the pupil, make sure the inside of the lower eye lid is redder than the
surface of the eye and put in some fluoresceine eye drops to check for ulcer. Herpes is one virus you
don’t want to miss. Pain is important. If it’s more painful then you think it ought to be, go right away.
A regular viral pink eye starts suddenly usually in one eye, and then just as it’s getting better starts
in the other eye. On what side does conjunctivitis always start? Answer at the bottom of the page. If
conjunctivitis is part of a general viral upper respiratory infection it will start in both eyes along with other
signs of a common cold: running nose, cough, sore throat, maybe a bit of a fever. Typically the eyes feel
a bit sore, gritty, or itchy. Of course they look pink and usually look a lot worse than they feel. There may
be slight tears, or a lot of discharge. There may be pus and even bloody oozing. The conjunctiva can
get swollen, even close the eye. As a general rule severe swelling with the whole surface lumpy is more
common in allergic conjunctivitis, and swollen with pus is more likely to be bacterial. Pain and blurred
vision could be a sign of more severe disease.
Can it be prevented? We advise everyone with pink eye to wash their hands like lady Macbeth and stay
away from other children. Doctors and nurses wash hands after touching any red infected eye. But to
be honest the reason we see epidemics is because it’s so contagious. Realistically if you’re not immune
from prior exposure you’re going to get it, never mind how careful you are. My 5 year old granddaughter
woke up with it this weekend and took a day off school: spent half her time over here playing with our
new puppy. We found two thirds of her class had it too, but no adults. Try and avoid rubbing your eyes:
all that discharge is a great culture medium for bacteria and you can easily get a staph or strep infection
on top of the initial epidemic virus.
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