Conjunctivitis | Pokenga whatu

Also called 'pink eye'

Key points about conjunctivitis

  • Conjunctivitis (pokenga whatu) is a common eye condition that affects both adults and children.
  • It's an inflammation of the protective membrane that lines your eyelids and the whites of your eye (conjunctiva).
  • It can be caused by:
    • a bacterial infection
    • a viral infection
    • allergies or something irritating the eye.
  • Treatment depends on the type of conjunctivitis.
Conjunctivitis in left eye
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The 3 main types of conjunctivitis are bacterial, allergic and viral . Bacterial and viral conjunctivitis are both infectious types of conjunctivitis that can spread easily.

Bacterial conjunctivitis

This is caused by a bacterial infection and is common in infants and children. Typical symptoms include a sticky yellow or green ‘gunk’ or discharge, most noticeable as a crust on the eyelids on waking up. It's highly contagious (easily passed on to someone else).

Allergic conjunctivitis

Conjunctivitis caused by allergies can be seasonal, occurring at certain times of the year (if due to pollen or grasses), or continuous or ongoing (if caused by allergens such as dust mite or pets). Allergic conjunctivitis is not contagious. Read more about allergic conjunctivitis.

Viral conjunctivitis

This is often caused by the same virus that causes the common cold and other respiratory infections, eg, measles and the flu. It usually begins in one eye, then spreads to the other eye shortly after. It tends to cause redness, sensitivity to light and a thin watery or white mucous discharge. Viral conjunctivitis is very contagious.

Other causes

Inflammation of the conjunctiva can also be caused by direct contact with irritant chemicals in cosmetics, chlorine from swimming pools or preservatives (even some in eye drops). People who wear contact lenses can get eye irritation due to the lens or contact lens solutions and are also more likely to get eye infections.

Typical symptoms of conjunctivitis are redness, discharge and an uncomfortable feeling in one or both eyes. If you're experiencing any sharp pain or any loss of vision in one or both eyes, seek medical attention from your healthcare provider or opthalmologist immediately.

Bacterial conjunctivitis

This generally affects one eye at first but is then easily spread to both eyes. It produces a thick, sticky white, yellow or green discharge throughout the day. When you wake up you may notice this discharge causes your eyelids to stick together.

Allergic conjunctivitis

Both your eyes will generally be 'watery’ and itchy. Your eyelids may be swollen and puffy. It tends to be more common if you have other allergies such as hay fever, asthma or eczema. You may also be sneezing more often and have a blocked nose.

Viral conjunctivitis

This tends to cause a thin watery or white mucous discharge that usually begins in one eye, then affects the other eye shortly after. Your eyes may have a burning feeling, feel very gritty and be sensitive to bright light. It may happen at the same time you have a viral infection such as a common cold, with a cough or sore throat, and can be present for many weeks.

The treatment for conjunctivitis depends on what's causing it.

Bacterial conjunctivitis

Bacterial conjunctivitis is usually mild and will get better on its own within a week.

  • You can remove any discharge from eyelids and lashes with disposable cotton pads soaked in water or a clean facecloth.
  • You can use lubricating eye drops for relief from any discomfort.
  • Antibiotic eye drops aren't usually necessary but may reduce how long the infection lasts.
  • If the infection is more severe or lasts longer than 5 days, antibiotic eye drops or eye ointment may be necessary.
  • Bacterial conjunctivitis is very contagious. Find out how to reduce the spread of bacterial conjunctivitis by reading the section on self-care for conjunctivitis below.

Allergic conjunctivitis

Anti-allergy eye drops or antihistamine tablets can reduce the allergic response and relieve the symptoms, but this type of conjunctivitis only gets better when you avoid the cause of the allergy, eg, dust mites.  

  • You can use lubricating eye drops for relief from any discomfort, or to help flush the allergen causing the problem out of your eyes.
  • Antibiotic eye drops won’t help allergic conjunctivitis.

Read more about hay fever and allergic conjunctivitis.

Viral conjunctivitis 

There is no effective treatment for common viral conjunctivitis. It generally gets better on its own over a few weeks.

  • Lubricating eye drops can give some relief from any discomfort.
  • Clean away secretions from eyelids and lashes with disposable cotton pads soaked in water.
  • Viral conjunctivitis is contagious. For information about how to reduce spreading viral conjunctivitis, read the next section on self-care for conjunctivitis.

Both viral and bacterial conjunctivitis are forms of contagious conjunctivitis, which means they can spread from one eye to another and from one person to another.

You can care for yourself and your tamariki by following these steps:

  • Wash your hands with soap and warm water regularly and especially before touching your eyes.
  • Dry your hands with a clean (or disposable) towel.
  • Gently wipe away any pus, crust or discharge with a disposable cotton swab or disposable cotton-pad soaked in water. Cotton wool balls are not ideal because they can leave small cotton fibres in your eye which will make things worse. Surgical swabs from your pharmacy or disposable make-up removal pads are best.
  • Wipe your eye once, from the side nearest your nose to the outside, then throw the swab away. Continue with a clean swab or pad until your eye is clean.
  • Wash and dry your hands again.

To avoid spreading conjunctivitis:

  • Wash your hands if you touch your eyes.
  • Don’t share towels or flannels with others and use a clean towel daily.
  • Wash your pillowcases, sheets and towels in hot water.
  • If you're wearing makeup, throw away your eye cosmetics like mascara. Don't use the eye makeup testers in stores. Don’t share cosmetics or other personal items like sunglasses, reading glasses, contact lenses and lens containers.
  • Avoid swimming in chlorinated pools.

Contact lens users

  • Don't wear lenses while you have conjunctivitis and for 48 hours after your symptoms have gone.
  • Throw away any used disposable lenses.

If you're using non-disposable lenses, thoroughly clean your lenses and sterilise your lens cases before re-using.

Young children and conjunctivitis

It's best to keep young children with infectious conjunctivitis home from daycare or school if the eye is sticky or weeping because the discharge is contagious. They can return when the eye is no longer pink. Read more about conjunctivitis in children.(external link)

Remember, conjunctivitis will often get better by itself. However, if you have any concerns, check with your healthcare provider.

Conjunctivitis in children(external link) KidsHealth, NZ
Conjunctivitis(external link) Auckland Eye, NZ

Resources

Conjunctivitis (pink eye)(external link) Health New Zealand | Te Whatu Ora NPHS, 2022

References

  1. Causes, complications and treatment of a red eye(external link) BPAC, NZ, 2013
  2. Conjunctivitis(external link) BPAC antibiotic guide, NZ, 2023 
  3. Conjunctivitis(external link) Auckland Eye, NZ, 2018
  4. Conjunctivitis (pink eye)(external link) Health New Zealand | Te Whatu Ora NPHS, 2022

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