If it feels like someone threw sand in your eyes, but you haven't been anywhere near a beach or sandbox lately, you may have conjunctivitis. Conjunctivitis is an inflammation of the conjunctiva, the mucous membranes that line the inner surface of the eyelids and the front of the eyeball.
"Conjunctivitis usually involves both eyes and doesn't affect vision," says Jon H. Bosland, M.D., a general ophthalmologist in private practice in Bellevue, Washington. "Symptoms can include routine burning or itching, extreme sensitivity to light, and tearing. The eyes get red and the lids and surface of the eye can become swollen, he continues. There may also be a watery, mucus secretion or, in the case of bacterial infection, a thick discharge coming from the eyes. The discharge may be so thick that you wake up in the morning with a crust over your eyes and the feeling that your eyes are "glued" shut.
The causes of conjunctivitis are as numerous as the types. Infectious types of conjunctivitis, which are highly contagious, can be caused by viruses or by bacteria, such as pneumococcus, streptococcus, and staphylococcus. "The eyes are continually bombarded with germs all of the time. But the blink reflex and the tearing reflex are amazingly effective at fighting off most of these germs," explains Bosland. "And if a particularly aggressive set of germs attacks the eye, the backup defense mechanisms come into play. The blood vessels dilate to bring more bacteria-killing white blood cells to the area, and the eye begins discharging the infection," he continues. These defensive maneuvers by the body result in the symptoms of conjunctivitis.
Noninfectious types of conjunctivitis tend to be caused by foreign bodies getting under the lid, exposure to ultraviolet light, and allergies. Wind, smoke, and other types of air pollution, as well as the chlorine in swimming pools, can irritate the conjunctiva. The chronic condition of "dry eye" can also cause conjunctivitis, according to Bosland.
"Allergic conjunctivitis is most often associated with itching and swelling of the white part of the eye, which can sometimes be so severe that the white part of the eye looks like a balloon sticking out between the lids," says Charles Boylan, M.D., a pediatric ophthalmologist at A Children's Eye Clinic of Seattle. "Young children often get this when they play out in the grass and weeds in the summertime and get pollen on their hands and then into their eyes. In this instance, the eye can swell up in a matter of minutes," says Boylan.
Whatever the cause, conjunctivitis can be painful and irritating. As with most symptoms or conditions involving the eyes, it is important to see a doctor for correct diagnosis and treatment. Although a viral or bacterial conjunctivitis will usually go away on its own, it will go away much quicker with the use of proper antibiotics and anti viral agents, says Carol Ziel, M.D., an ophthalmologist with the Eye Clinic of Wausau in Wisconsin. Bosland adds that if an infectious conjunctivitis lasts longer than two or three weeks, it can start to turn into chronic conjunctivitis. "In this instance, the bacteria get into the outer corners of the eyelid and spill over into the eye, infecting it as well. And these mixed infections involving the eyelid and the eye can go on for quite a long time," he cautions. In addition to seeing a doctor and following his or her advice, you can take some simple steps at home to help relieve discomfort and, if you have infectious conjunctivitis, to keep from spreading the infection around.
Cool the itch of allergic conjunctivitis.
"If there is any itching in relation to the conjunctivitis, cool compresses will really help to reduce it," says Ziel. Simply wet a washcloth with cool water and hold it against the eyes.
Ice the swelling.
Applying an ice pack to the eyes can help bring down any swelling from allergic conjunctivitis. "Try to keep the ice on long enough to reduce the swelling to the point where the eyelid can close down over the cornea," says Boylan. (The cornea is the transparent circular covering in front of the eyeball that helps to focus light entering the eye.) "Otherwise, the cornea could dry out, which is another problem in itself," he adds. "You rarely see this type of conjunctivitis not improve with ice packs and a little bit of time. Often, by the next morning, the swelling is almost completely gone."
Apply heat to fight a bacterial infection.
"Hot compresses can help the infection quite a bit because the heat dilates the blood vessels, bringing fresh blood to the area, and raises the temperature up above what is optimum for the germ to survive," explains Bosland. "The heat also relaxes the muscles around the eye, which can be quite soothing," he continues. Applying a washcloth soaked in hot water (provided it is not hot enough to burn the skin) or using a hot water bottle works very well.
Drop in some relief.
For minor allergic conjunctivitis, over-the-counter eye drops may provide soothing relief. "Any of these eye drops are fine to use provided there is nothing seriously wrong with the eye and provided you use them on a short-term basis only," says Boylan. For safety's sake, and especially if you are also using prescription eye medication, ask your doctor if it's OK to use over-the-counter eye drops.
Conjunctivitis caused by bacteria or viruses is very contagious, so you'll need to keep from sharing towels, washcloths, pillows, and handkerchiefs with others. "The fluid draining from the eyes could get on the towel or pillow and infect someone else," warns Ziel.
Keep your hands off.
"Because conjunctivitis can be quite contagious, it's good to keep the germs off of your hands," says Ziel. If you have infectious conjunctivitis, try not to rub your eyes, and be sure to wash your hands after wiping your eyes or applying eye medication.
Shield your eyes.
Conjunctivitis can make your eyes extremely sensitive to light and other irritants. So do all you can to give them a break. If you're going outdoors, put on a pair of sunglasses to help shield your eyes from wind and sunlight. Put off mowing the lawn or working in the garden until your conjunctivitis has cleared, or at least wear a pair of goggles to keep pollen and dust out of your eyes. Take time off from swimming, or wear a pair of well-fitting swimming goggles. And, when possible, close your eyes to give them a rest.