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The Informed Parent

The Red Eye: Is It Pink Eye?

by Laura Murphy, M.D.
Published on Jul. 28, 2003

Does a red eye always mean “pink eye”? And what exactly is meant by the term “pink eye”? Does it always require antibiotic treatment? These are very common questions, and stem from some confusion that exists regarding the terms.

When people use the term “pink eye”, they are usually referring to an eye infection that causes a red eye with discharge, one that needs prescription antibiotic eye drops to clear. They are describing a condition called conjunctivitis, which means inflammation of the conjunctivae, one of the layers of the eye. In fact, there are several types of conjunctivitis, each requiring a different form of treatment.

The type that most are familiar with is bacterial conjunctivitis. With this condition, the patient has eye redness, occasional swelling around the eye, and always a thick purulent discharge. Often children will wake in the morning with their eyelids matted together by the thick and copious discharge. This infection is usually caused by common bacteria such as staph or strep. Although it can be unsightly, the infection usually responds well to prescription antibiotic eye drops. Occasionally, children will develop an ear infection along with the conjunctivitis. So it is important that they be evaluated by a doctor before initiating therapy. It is also important that the doctor have the opportunity to differentiate this from the other types of conjunctivitis to ensure the proper treatment. Newborns can also acquire bacterial conjunctivitis. The most serious types are caused by chlamydial and gonococcal infections. Newborns receive a prophylactic eye treatment soon after birth to prevent these infections.

Another type of conjunctivitis is viral. This also can lead to a red eye, but is usually characterized by a watery, not thick, discharge. It is also usually clear or white, instead of the pus-like discharge seen with the bacterial infection. With viral infections, other symptoms may also be present, such as fever, runny nose, cough, or sore throat. Like bacterial, this can affect one or both eyes, though is usually bilateral. One common example, adenovirus, can cause community outbreaks of a viral illness with conjunctivitis through contaminated swimming pools. In general, viral conjunctivitis will resolve on its own. It certainly does not require antibiotic drops.

A third type of conjunctivitis is allergic. The hallmark of allergic conjunctivitis is itching. In fact, without itching, it would be difficult to diagnose a red eye as allergic in origin. In addition to the itching, the patient will also complain of increased tearing, though usually not of discharge. Not surprisingly, this will tend to occur in patients with other allergic symptoms. There are several different types of eye drops designed for this condition that can be very helpful and can be used on an as-needed basis. Cool compresses can also offer much relief, in addition to avoiding whatever is suspected as the offending agent.

How to prevent getting pick eye? The best answer is through good hand washing. The above infections are spread by direct contact, with the hands being the most important contact surface for spreading disease. So, while it is difficult to completely avoid pink eye, early recognition and initiation of proper treatment along with always maintaining good hand washing habits can often limit its impact.

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