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Conjunctivitis

Roger Holden Eye SurgeonThe conjunctiva is the thin membrane that covers the white part of the eye and the inside part of the eyelids. Conjunctivitis simply means this membrane is inflamed. The eyeball therefore looks red and there can be some minor discomfort. The vision is not usually affected though some blurring is to be expected because there is more watering of the eye. Sometimes there is an associated slimy discharge. Conjunctivitis almost never damages the eye. The two main causes are infection and allergy.

Infective
The most common infections are viruses and bacteria. Viral infections tend to start in one eye with the other eye only becoming involved quite a bit later. Bacterial infections tend to spread to both eyes very quickly and often have slimy discharge.

Bacterial infections usually respond well to antibiotic drops or cream. That said given time they will usually resolve without treatment. Viral infections take longer to resolve and do not respond to antibiotics. Eye lubricants can help keep the eye comfortable.  Simple hygiene such as not sharing towels can help prevent spread to other family members.

Allergic

Allergic conjunctivitis is fairly common. Often it is tree or grass pollen that is the cause and therefore tends to be seasonal, worse in the spring and summer. Others are allergic to airborne contaminants and therefore suffer all year round. As a rule there are relatively symptom free periods followed by exacerbations when things get worse. Many of these children have an “allergic tendency” with other associated conditions such as asthma and eczema.

The symptom of itching is the clue that it’s an allergic problem. It usually affects both eyes and there is often a stringy discharge. Antibiotics do not help; indeed in these allergic children they can make things worse.

It’s very difficult to avoid the causes for allergic conjunctivitis so we do not look for them with patch testing. Mild cases can be treated with drops that reduce the inflammation (antihistamines) and others that reduce the frequency of exacerbations (mast cell stabilisers). These can be given as a combined drop (olopatidine is our current one). Antihistamine syrup can also help. More severe cases need stronger drops (steroids) with potentially serious side effects. These children are carefully monitored by the eye clinic.

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