The Eyes Ought Not Have It

We humans anticipate that certain things will happen at specific times of the year. Flowers are supposed to bloom in spring and summer; snow is supposed to fall in winter. Unfortunately, certain physical conditions follow a similar timeline. We might get athlete’s foot in the summer from walking unshod on the lawn, and might catch a cold in winter, usually from being cooped up in a stuffy building surrounded by contagious people. There’s no theory for the foot fungus, but the absence, or at least the dearth, of endogenous vitamin D and its salutary relationship to colds and flu can be blamed on the lack of enough sunshine to make it. Vitamin D, that is. It isn’t that the sun fails to show up for work every day; it’s that its angle is too shallow to hit the skin just right. Then there are those things that attack us by surprise, like pink eye, a.k.a.conjunctivitis.  Just because you hear about it in kids doesn’t mean adults are immune.

Conjunctivitis can strike any of us; there’s more than one kind. Symptoms can vary from one type and from one person to another.  It’s an inflammatory condition of the conjunctiva, which is the outermost layer of the eye and the inner lining of the eyelid. Bacterial or viral infections are the most common causes, but allergies and chemical reactions can sneak in, as well.  Redness is a giveaway, and tearing and itching in one or both eyes are common. Blurred vision, sensitivity to light, feeling of grittiness and discharge are other signs. Despite that conjunctivitis caused by infection is highly contagious, it doesn’t cause serious health problems if caught early. There’s no doubt that symptoms can be distressing, but complete recovery without after-effects can be expected.

Viral conjunctivitis, the most common, can be diagnosed from signs and symptoms…and from patient history, which should be an element of any medical diagnosis. If discharge from the eye is watery rather than thick, and if it accompanies a cold, it’s probably viral. Lab tests aren’t usually necessary unless there’s a glaring reason. This is something that kids catch from each other, and it doesn’t take much to travel—a shared tissue, swimming in contaminated pool water, sharing a contaminated towel, using the same eye makeup and touching. Thank goodness this is self-limiting (Jackson, 1993).

The bacterial type of conjunctivitis is similarly diagnosed, with the exception of describing discharge as thick instead of watery, possibly in the presence of an ear infection.  The physician might order a lab test to determine which bacterium is the culprit so the treatment plan can be more direct if one is deemed necessary. Some bacterial forms can be more severe than others, requiring drops or ointments. In any case, medications will hasten recovery regardless of bacterium strain. Adults are less likely than children to contract this form of conjunctivitis, the discharge of which can be so sticky that the eyelids glue shut.

Allergic conjunctivitis often is seasonal, particularly when pollen counts are elevated. Itching can be intense and is common in people who have other signs of allergic disease. Besides pollen, dust mites, animal dander, medications, cosmetics and other provoking substances, such as house and garden chemicals, can evoke misery. In this form, the entire eyelid can become swollen. We learned recently that overuse of contact lenses, prolonged exposure to UV from the sun, and vitamin deficiency can relate to allergic pink eye (Sankaridurg, 1999) (Lin, 2013) (Chan, 2007) (Malm, 2007) (Engel, 2009).

The doctor might request an allergen-specific immunoglobin-E (IgE) test to determine allergy to specific substances, but this is usually reserved for those with coexisting skin disease. Allergy shots and antihistamine eye drops can help with allergic conjunctivitis. Over-the-counter drops might do the trick, as well. Medications to address viral and bacterial modes are available. Cool compresses applied to the eyes can ease mild symptoms.

As with any health condition, the ounce of prevention is worth more than the pound of cure. Hygiene is cheap and effective, but relies on the common sense that kids haven’t yet developed, not that all adults have it. Rubbing one’s eyes after coughing into one’s hands can take a respiratory infection to higher places. Genital infections can likewise be transmitted to eyes. Viral conjunctivitis can spread through a community or institution, such as a school, like wildfire. In schools, especially in elementary grades, strict hygiene standards demand enforcement. We have to teach our kids the whys and whens of hand washing. Allergic conjunctivitis is virtually impossible to prevent without moving away from the offending environment or job unless it’s possible to identify the allergen and to remove it. You might not want to remove all the oak trees on your property, and the family’s attachments to the cat might preclude its ouster. But whatever you decide, it would be just your luck to move to Arizona and develop a reaction to clean air and sand.