ProvidersJ. Daniel Bobbitt, MD Lucy Y. DesPortes, MD Adrian J. Elfersy, MD Robert A. Flores, MD Sumit K. Gupta, MD Wei Huang, MD, PhD Scott L. Jaben, MD James G. Kaufmann, MD Casey Mathys, MD ***COMING AUGUST 14, 2017*** N. Ron Melton, OD Joshua A. Rheinbolt, MD Rachel P. Sabo, MD Robert M. Saltzmann, MD Nehali V. Saraiya, MD Craig S. Self, MD Vipul C. Shah, MD Donald H. Stewart III, MD F. Scott Sutherland, MD David N. Ugland, MD Brent B. Warren, MD
- Chronically red eye
- Watery eyes
- Eye swelling
- Eye pain
Conjunctivitis is the term used by doctors to describe inflammation of the conjunctiva. In ordinary terms, conjunctivitis is simply the most common cause of red or "pink" eye.
The white of the eye (sclera) is covered by a thin, filmy membrane called the conjunctiva, which produces mucous to coat and lubricate the surface of the eye. It normally has fine blood vessels within it, which can be seen on close inspection. When the conjunctiva becomes irritated or inflamed, the blood vessels that supply it enlarge and become much more prominent, and the eye turns red. A discharge of water, mucous, or pus may be present as the body fights the infection or inflammation.
Many different source of eye irritation can cause conjunctivitis.
- Infections (bacteria, viruses)
- Environmental irritants
Because the conjunctiva is a simple tissue it responds to all these stimuli in one way: it turns red.
Infectious causes of conjunctivitis include bacteria and viruses. Bacterial infections, such as staphylococcus, or streptococcus, cause a red eye which is associated with considerable amounts of pus. If the amount of discharge from the eye is great, an acute infection is likely, and prompt consultation with an ophthalmologist is advisable.
On the other hand, some bacterial infections are more chronic and may produce little or no discharge except for some mild crusting of the eyelashes in the morning.
Viruses are also common causes of conjunctivitis. Some viruses produce the familiar red eyes, sore throat, and runny nose of a common cold. Others may infect only one eye. Viral conjunctivitis usually produces a watery discharge and lasts from one to two weeks.
Infectious conjunctivitis, whether bacterial or viral, can be quite contagious, so contact with the patient's tears through used handkerchiefs and towels should be avoided. Handwashing after contact with the patient helps to prevent spread of the infection.
Allergies tend to cause a type of conjunctivitis that produces a discharge. Some kinds of allergies, like hay fever, make the eyes very itchy, while others may merely produce a chronic redness. Finally, environmental irritants such as smoke or fumes may cause conjunctivitis. Any type of conjunctivitis is aggravated by dryness of the eyes.
There are several eye diseases that also produce a red eye and which can lead to blindness unless recognized and treated. It is important to avoid confusing them with conjunctivitis, so a medical evaluation of a red eye by an ophthalmologist is always a good idea. This is especially important if pain, blurred vision, or severe light sensitivity are present, since these symptoms are not typically found in simple conjunctivitis. Pain, blurred vision, or severe light sensitivity may signal the presence of glaucoma, an ulcer of the eye, or an inflammation of the inside of the eye.
Eye disease can occur at any age. Many eye diseases do not cause symptoms until the disease has done damage. Since most blindness is preventable if diagnosed and treated early, regular medical examinations by an eye doctor are very important.
Blepharitis, or chronic inflammation of the eyelids, is a very common condition. Symptoms typically include irritation, itchiness, and occasionally redness. Blepharitis can begin in early childhood, producing "granulated eyelids," or it may develop in later adulthood. Blepharitis is not contagious; however, it can be chronic. Blepharitis may appear in several forms, such as seborrheic or ulcerative. Both types of blepharitis occur in individuals of all ages, particularly those with abnormally oily skin of the scalp and face or seborrhea, or in acne rosacea - a skin condition.
Seborrheic blepharitis is a dandruff-like scaling of the skin on the lid margins that results in soreness, redness, and crustiness. It is most often associated with dandruff of the scalp and overactivity of the skin oil glands.
Ulcerative blepharitis is usually a more severe condition caused by bacteria. Skin bacteria resides on the surface of everyone's skin, but in certain individuals they thrive on the eyelids at the base of the eyelashes, causing blepharitis. This blepharitis is characterized by matted, hard crusts about the eyelashes, which upon removal leave small ulcers that may bleed or ooze. The white part of the eye may turn red. In severe cases, the cornea (the clear front window of the eye) may become inflamed.
In both types of blepharitis there may be a loss of eyelashes (madrosis), whitening of lashes (polisis), and distortion of the margins of the eyelids, which can cause chronic tearing. Dry eye syndrome often accompanies blepharitis and both conditions will require treatment.
While blepharitis is uncomfortable and often chronic, it is treatable. Strict lid hygiene performed nightly is necessary as described in the following steps.
- Warm compresses: place a clean washcloth under hot - but not too hot - tap water, rinse out and fold the washcloth up so it hold the heat. Hold the washcloth over both eyes, rewarming as needed, for 5 to 10 minutes. Remember, if the washcloth cools, rewarm it so heat can be applied for 5 to 10 minutes.
- Lid massage: while applying the clean warm washcloth, gently massage the eyelids to open any associated clogged oil glands.
- Lid scrub: place a small amount of lid scrub cleanser on a washcloth or gauze pad, or use a pre-soaked pad. Close your eyes and scrub along the eyelid margins for 5 to 10 seconds or long enough to work up a lather. Rinse with Water.
- It is important to do the above in the correct order to obtain the best results. Perform this treatment as prescribed or as symptoms reoccur. It is recommended this be done preferably twice a day initially for 2 to 4 weeks (at which time most patients see an improvement), and then nightly when instructed. You must be diligent and thorough regarding treatment. You may be instructed to apply antibiotic ointment to the lid margin or use an antibiotic drop after the lid scrub.
- Treatment of oily scalp and skin with anti-dandruff shampoos may also be helpful.
Blepharitis is a chronic problem that can usually be controlled with lid hygiene. In more severe cases and/or in the acute phases, various topical antibiotics, ointments/drops, and even cortisone preparations may be necessary to alleviate the condition. While cortisone can hasten relief of symptoms, long-term use can cause side effects. Rarely, some people may develop glaucoma, cataracts, or viral infections from cortisone, so limit the use of steroid drops or ointments according to your doctor's instruction.
Avoid rubbing your eyes or exposing them to irritants like chemical fumes, cigarette smoke, and smog. Avoid harsh cleaners and colored tissues, which can further aggravate the sensitive lid area.
Remember, if your eyes are red, sore, or scaly, you may have blepharitis. If your eyes burn or feel scratchy you may have associated dry eyes and require frequent artificial tears.
If you have experienced any of the symptoms of blepharitis, we recommend you have a thorough eye examination.