Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Conjunctivitis, known as "pink eye," is an inflammation
of the thin,
transparent membrane covering the inner eyelid and the white part of the
eye
known as the conjunctiva. Symptoms of this condition can include:
redness of the eyes,
eye pain,
blurred vision,
sensitivity to light,
burning or itching of
the eye,
a scratchy feeling in the eye and,
a discharge that may be watery or may
contain pus.
Conjunctivitis may begin in one eye but often spreads to involve
both eyes.
The term pink eye is most commonly used to refer to the infectious (viral or
bacterial) type of conjunctivitis,
but conjunctivitis may also result from allergic reactions or from chemical
irritants such as air pollution, smoke, or noxious fumes. Rarely, underlying
chronic medical conditions including systemic lupus erythematosus or rheumatoid arthritis can cause a persistent
conjunctivitis. The infectious form of conjunctivitis is very common in children
and is highly contagious.
Children and adults who develop infectious pink eye
should see a doctor to determine whether antibiotic treatment is necessary. Most
cases of infectious pink eye are caused by viruses and will not respond to
antibiotic treatment. In these instances, the discharge from the eye is clear
and watery and symptoms of a cold may be present. Viral pink eye infections usually last
from about seven to 10 days.
Pink eye, or conjunctivitis, is redness and inflammation of the membranes (conjunctiva) covering the whites of the eyes and the membranes on the inner part of the eyelids. These membranes react to a wide range of bacteria, viruses, allergy-provoking agents, irritants, and toxic agents, as well as to underlying diseases within the body. Viral and bacterial forms of conjunctivitis are common in childhood, but they occur in adults as well. Pink eye can occur in people of any age. Overall, however, there are many causes of pink eye. These can be classified as either infectious or noninfectious. Pink eye does not cause any changes in vision.
What infections cause pink eye, what are infectious pink eye symptoms, and how are they treated?
Viral pink eye
The leading cause of a red, inflamed eye is virus infection. Adenoviruses are the type of virus that are most commonly responsible for the infection. Viral pink eye symptoms are usually associated with more of a watery discharge that is not green or yellow in color. Viral pink eye is most common in late fall and early spring. Often, viral "cold-like" symptoms, such as sinus congestion and runny nose, are also present. The eyelids may be swollen. Sometimes looking at bright lights is painful.
While viral pink eye may not require an antibiotic, those affected should see a doctor, as occasionally this form of pink eye can be associated with infection of the cornea (the clear portion of the front of the eyeball). This infection must be correctly detected and treated. Viral pink eye is highly contagious. The symptoms of viral pink eye can last
one to two weeks. Symptoms are pronounced for the first three to five days after symptoms appear, with slow resolution over the following one to two weeks.
Bacterial pink eye
Staphylococci and Streptococci, among others, are types of bacteria that commonly cause pink eye. Symptoms of pink eye caused by bacteria occur rapidly and can include
a moderate to large amount of discharge, usually thick and yellow or greenish in color,
swelling of the lymph nodes in front of the ears.
The discharge commonly accumulates after sleeping. Affected children may awaken most unhappy that their "eyes are stuck shut," requiring a warm washcloth applied to the eyes to remove the discharge. Bacterial pink eye is treated by repeated warm washcloths applied to the eyes (try applying these to your child's eye one eye at a time during a favorite video) and requires antibiotic eyedrops or ointment prescribed by the doctor.
What does pink eye look like?
Be careful not to use medication prescribed for someone else, or from an old infection, as these may be inappropriate for your current infection or may have been contaminated from other infections by accidentally touching the medicine bottle to infected areas. A safe, effective, and potentially less frightening method of putting drops into the eyes involves asking your child to lie down flat, with instructions to merely "close your eyes," and placing the recommended number of drops in the inner corner of the eye, next to the bridge of the nose, and letting them make a little "lake" there. When your child relaxes and opens the eyes, the medicine will flow gently into the infected mucous membranes without the need to "force open" the eyes.
When you feel that you or your child might have bacterial pink eye, it is very important to see your doctor immediately for several reasons. First, if the cause is a bacterial infection, an antibiotic will be needed to help the infection-fighting immune system to kill this infection. Secondly, if you are experiencing other symptoms such as a runny nose, cough, earache, etc., there is a good chance that these symptoms are caused by the same bacteria, and an oral antibiotic may
also be needed to treat this infection along with the antibiotic drops or ointment for the eyes. Finally, your doctor will want to exclude the possibility that the infection has spread to areas where the symptoms may not yet be recognizable.
Chlamydia pink eye
Pink eye due to infection with
chlamydia is an uncommon form of bacterial pink eye in the U.S., but it
is very common in Africa and Middle Eastern countries. Chlamydia can cause pink eye in adults and neonates. It is a cause of pink eye in adolescents and adults that can be sexually transmitted. Chlamydia pink eye is typically treated with erythromycin (E-Mycin, Eryc, Ery-Tab, PCE, Pediazole, Ilosone) or
oral tetracycline (Sumycin), except in children less than
8 years of age, because of possible discoloration of the teeth.
Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints, as well as other organs in the body. Because it can affect multiple other organs of the body, rheumatoid arthritis is referred to as a systemic illness and is sometimes called rheumatoid disease.
Crohn's disease is a chronic inflammatory disease,
primarily involving the small and large intestine, but which can
affect other parts of the digestive system as well. Abdominal pain, diarrhea, vomiting, fever, and weight loss are
common symptoms.
Systemic lupus erythematosus is a condition characterized by chronic inflammation of body tissues caused by autoimmune disease. Lupus can cause disease of the skin, heart, lungs, kidneys, joints, and nervous
system. When only the skin is involved, the condition is called discoid lupus.
When internal organs are involved, the condition is called systemic lupus
erythematosus (SLE).
Ulcerative colitis is a chronic inflammation of the colon. Symptoms include abdominal pain, diarrhea, and rectal bleeding. Ulcerative colitis is closely related to Crohn's disease, and together they are referred to as inflammatory bowel disease. Treatment depends upon the type of ulcerative colitis diagnosed.
Itching can be a common problem. Itches can be localized or generalized. There are many causes of itching to include: infection (jock itch, vaginal itch), disease (hyperthyroidism, liver or kidney), reactions to drugs, and skin infestations (pubic or body lice). Treatment for itching varies depending on the cause of the itch.
Coxsackie viruses may be divided into two groups. Type A causes hand, foot, and mouth disease and conjunctivitis, while type B causes pleurodynia. Both types sometimes cause meningitis, myocarditis, and pericarditis. There is no specific treatment for this disease.
An allergy refers to a misguided reaction by our immune system in response to bodily contact with certain foreign substances. When these allergens come in contact with the body, it causes the immune system to develop an allergic reaction in people who are allergic to it. It is estimated that 50 million North Americans are affected by allergic conditions. The parts of the body that are prone to react to allergies include the eyes, nose, lungs, skin, and stomach. Common allergic disorders include hay fever, asthma, allergic eyes, allergic eczema, hives, and allergic shock.
The inflammatory bowel diseases (IBD) are Crohn's disease (CD) and ulcerative colitis (UC). The intestinal complications of Crohn's disease and ulcerative colitis differ because of the characteristically dissimilar behaviors of the intestinal inflammation in these two diseases.
A subconjunctival hemorrhage is bleeding under the eye's conjunctiva. There is usually no obvious cause for a subconjunctival hemorrhage, but it may be caused by sneezing, vomiting, infections on the outside of the eye, coughing, and clotting disorders. Symptoms and signs include blood in the white of the eye and a sense of fullness under the lid. No treatment is needed.
Eye allergy (or allergic eye disease) are typically associated with hay fever and atopic dermatitis. Medications and cosmetics may cause eye allergies. Allergic eye conditions include allergic conjunctivitis, conjunctivitis with atopic dermatitis, vernal keratoconjunctivitis, and giant papillary conjunctivitis. Dry eye, tear-duct obstruction, and conjunctivitis due to infection are frequently confused with eye allergies. Eye allergies may be treated with topical antihistamines, decongestants, topical mast-cell stabilizers, topical antiinflammatory drugs, systemic medications, and allergy shots.
Kawasaki disease is a rare children's disease characterized by a fever that lasts more than five days and at least four of the following five symptoms are present: rash, swollen neck lymph gland, red tongue, swelling or redness of the hands or feet, and conjunctivitis. High doses of aspirin are used to treat Kawasaki disease. Cortisone and antiinflammatory drugs may also be used during treatment.
Many common eye disorders resolve without treatment and some may be managed with over-the-counter (OTC) products. It's important to visit a physician or ophthalmologist is the problem involves the eyeball itself or the condition hasn't improved after 72 hours of use of an eye-care OTC product.
Blepharitis is inflammation of the eyelids. Acne rosacea, Staphylococcal bacteria, allergies, sensitivities to makeup or contact lens solutions, head lice, or other conditions may cause blepharitis. Symptoms and signs include itchy eyelids, burning sensation in the eyes, crusting of the eyelids, light sensitivity, red, swollen eyelids, loss of eyelashes, and dandruff of the lashes and eyebrows. Proper eyelid hygiene and a regular cleaning routine controls blepharitis.
Rocky Mountain spotted fever (RMSF) is an infectious disease that's transmitted by the bite of a tick infected with the Rickettsia rickettsii bacterial organism. Initial symptoms of RMSF include fever, nausea, vomiting, muscle pain and severe headache. Later symptoms include rash, abdominal pain, joint pain, and diarrhea. Treatment usually involves a tetracycline antibiotic.
Trachoma is an infectious disease caused by the Chlamydia trachomatis bacteria. Symptoms and signs include redness and irritation of the eyes with tearing. Trachoma is diagnosed by examining the eyes and eyelids. Treatment involves a single dose of azithromycin (Zithromax) or the use of topical tetracycline (Achromycin) ointment. Infected individuals should be counseled about sanitation and taught simple cleanliness.
Occupational asthma is a type of asthma caused by exposure to a substance in the workplace. Symptoms and signs include wheezing, chest tightness, and shortness of breath. The usual treatment for occupational asthma involves removal from exposure and the use of bronchodilators and inhaled anti-inflammatory medicines.
Blepharitis is the medical term for inflammation of the eyelids. The word
"blepharitis" is derived from the Greek word blepharos, which means "eyelid," and
the Greek suffix itis, which is typically used to denote an inflammation in
English. Inflammation is a general term used to describe the process by which
white blood cells and chemicals produced in the body protect us from foreign
substances, injury, or infection. The normal body response of inflammation
involves varying degrees of swelling, redness, pain, warmth, and change in
function. Blepharitis is an inflammation of the eyelids, causing red, irritated,
itchy eyelids, and the formation of dandruff-like scales on the eyelashes. It is
a very common eye disorder with a wide variety of causes. It affects people of
all ages. Although it may be uncomfortable, annoying, or unattractive, blepharitis is not contagious and generally does not cause any permanent damage
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