Eye infections must be properly diagnosed for treatment to be effective, but minor cases can be avoided if you take basic precautions, says Barbara Rowlands

It’s one thing arriving at work red-eyed after a party or a long-haul flight, quite another when all you’ve done is watch television and go to bed early. But eye infections – most of which come under the umbrella term, ‘conjunctivitis’ – are more common than you might think and though they aren’t serious, they’re uncomfortable and annoying.

Conjunctivitis is an inflammation of the conjunctiva, the mucous membrane that covers the whites of the eyes. It often starts in one eye, but usually spreads to the other after a couple of days.

Soon both are red – hence the common name ‘red eye’ – and laced with swollen blood vessels. The lining of the eyelids also looks pinker than usual and the eyes are itchy, painful and often filled with a sticky, stringy discharge. Sometimes your eyes may be ‘stuck’ together when you wake up, sometimes you may feel a foreign body in the eye and some people may develop photophobia – extreme sensitivity to bright light.

Conjunctivitis is invariably caused by an allergy or a bacterial or viral infection, but there are other reasons why our eyes become inflamed. Overuse of ophthalmic medications, contact lenses and eye drops are frequent causes of chronic conjunctivitis.

Some people find that smoke, fumes or the chlorine in swimming pools can trigger redness and watering. Newborn babies sometimes develop conjunctivitis soon after birth, a condition known as neonatal ophthalmia, and small children may also be susceptible to eye infections.

Research shows that most cases of conjunctivitis clear up within about five or six days, but antibiotic medication does make you recover faster, so it’s wise to see your GP. Your doctor can diagnose which type of infection you have. For instance, you could be suffering from chlamydial conjunctivitis, which is treated with tetracycline ointment and tablets to ensure that the infection does not spread. Children with conjunctivitis should always see the doctor.

Bacterial conjunctivitis is caused by streptococcus, staphylococcus or haemophilus bacteria, picked up from your own skin or from someone else with the condition. The discharge may contain pus, which can glue the eyelids together in the morning.

Viral conjunctivitis is often part and parcel of the common cold and caused by an adenovirus. It’s highly contagious and can sweep through schools and offices, spreading like wildfire on contaminated fingers, towels and swimming pool water. It can spread to the cornea, causing inflammation.

Chlamydial conjunctivitis is caused by chlamydia trachomatis, an organism that can cause the sexually-transmitted disease, chlamydia. The discharge is sticky and again, the cornea may become infected.

Allergic conjunctivitis is common in people who suffer from hayfever, asthma and eczema and is often triggered by pollen, dust mites or cosmetics. Red itchy eyes and a stringy discharge are the symptoms of allergic conjunctivitis.

Treatments

Left to run its own course, conjunctivitis will clear up within a few weeks, but treatment and good hygiene will speed up recovery and make those days bearable.

Bathe the eye gently with cotton wool soaked in boiled cooled water to remove the stickiness and wash your hands afterwards to stop infection spreading. Two thirds of cases will clear up after about five days, but antibiotic drops or ointment, prescribed by your GP, may be needed.

Viral conjunctivitis fails to respond to antibiotics, so it’s important to bathe the eyes regularly and keep to strict hygiene guidelines – wash your hands after bathing the eyes and don’t share face cloths or towels. Use drops to soothe the eyes.

Chlamydia conjunctivitis is treated with antibiotic tablets and ointment to make sure the infection is contained and doesn’t spread, while allergic conjunctivitis is treated with antihistamine drops.

Other causes

Not all eye infections are due to allergies, bacteria or viruses. One of the commonest causes is irritation of the lid margins, known as blepharitis. This is characterised by red, itchy eyelid rims surrounded by scaly skin. Blepharitis is associated with dandruff or eczema and tends to recur. It is also exacerbated by central heating, air conditioning, flying, and long hours working at a computer screen, rarely blinking.

You can buy over-the-counter treatments for blepharitis, but it’s advisable to go to your GP. The usual treatment is medicated pads and ointment containing antibiotics, which is applied to the edges of the eyelids with cotton wool.

Sometimes the base of an eyelash follicle will become infected, leading to a stye, a small pus-filled abscess on the rim of the eyelid. It usually forms a head within a couple of days and it will eventually drain spontaneously, but if it is painful, apply warm compresses to help the pus discharge.

Then there are ‘dry eyes’. In the healthy eye, tears wash over the cornea and evaporate or drain away through the tear duct. This gossamer layer of fluid works with the eyelids like a windscreen wiper, washing away bacteria and keeping the eye free of infections.

Ophthmalogists now believe that tear film abnormalities, made worse by lid inflammation, aging, central heating, air conditioning, flying and computer work, lead to dry eyes and a build up of bacteria.

Specialists advise people with ‘dry’ eyes to close their eyes for a few minutes every hour to re-establish the tear film and clean the margin of the lids every day with a moist cotton bud. Blinking quickly and rubbing the eyes helps smear tears across the front of the eye.