Conjunctivitis

Introduction

Conjunctivitis is an inflammation of the conjunctiva, the thin transparent membrane that covers the white of the eye and the inner surface of the eyelids. It manifests as eye redness, tearing, itching, or secretions. It is one of the most common ophthalmological conditions encountered in consultations. The majority of conjunctivitis cases are benign, but some forms can be highly contagious or complicate a more serious underlying medical pathology, requiring rapid medical advice.

If you experience redness or eye discomfort, contact your primary care physician first. If they are unavailable, Docadom offers an emergency consultation by a home doctor: call 021 845 45 45 or use our application available on the App Store and Google Play.

Who is at risk?

Conjunctivitis can affect all ages. Children are particularly affected (daycare, school, imperfect hand hygiene). Contact lens wearers are at risk of severe infectious conjunctivitis. Allergic individuals frequently develop seasonal (pollen) or perennial (dust mites, pet hair) conjunctivitis. Professionals exposed to dust, smoke, or chemicals, as well as prolonged screen users (dry eye syndrome), are also concerned.

Symptoms of Conjunctivitis

Conjunctivitis manifests as localized, often bilateral ocular signs, which vary depending on the cause.

Main Symptoms

• Diffuse eye redness, predominant at the periphery of the eye.

• Abundant tearing, clear or purulent.

• Secretions: purulent (bacterial), clear and stringy (viral or allergic).

• Itching, highly suggestive of an allergic cause.

• Foreign body sensation or feeling of sand in the eye.

• Swelling of the eyelids, sometimes significant.

• Moderate photophobia.

• Transient blurred vision, which improves after blinking or washing.

• Pre-auricular adenopathy (lymph node in front of the ear), suggestive of viral conjunctivitis.

When to Consult in an Emergency?

An emergency consultation or rapid ophthalmological advice is necessary in case of:

• Decreased vision, intense eye pain, or marked photophobia — call 144 if vision drops suddenly.

• Conjunctivitis in a contact lens wearer.

• Very abundant purulent secretions (suspicion of gonococcus).

• Symptoms persisting beyond 7 to 10 days despite appropriate treatment.

• Conjunctivitis in a newborn or an infant.

• Ocular trauma or chemical exposure.

What to do before calling Docadom? Contact your primary care physician first, who can refer you to an ophthalmologist if necessary. If they are unreachable or if you need a home doctor outside of opening hours, call Docadom at 021 845 45 45 or make your request directly from our smartphone application (App Store and Google Play). In case of a sudden decrease in vision or eye trauma, dial 144 without delay.

Causes of Conjunctivitis

Viral Conjunctivitis

This is the most common cause, highly contagious. Adenoviruses are responsible in the majority of cases, sometimes associated with a cold or pharyngitis. Symptoms combine redness, clear tearing, and pre-auricular adenopathy.

Bacterial Conjunctivitis

It is marked by abundant purulent secretions, sticking the eyelids together upon waking up. The main pathogens are Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, and more rarely Neisseria gonorrhoeae or Chlamydia trachomatis.

Allergic Conjunctivitis

Intense, bilateral itching, chemosis (conjunctival edema), clear tearing, often associated with allergic rhinitis or allergic asthma. It can be seasonal (pollen) or perennial (dust mites, animals).

Irritant Conjunctivitis

Caused by chlorine in swimming pools, tobacco smoke, pollution, dust, cosmetics, chemical vapors, or intense wind and sun.

Other Causes

Dry eye aggraved by screens, neonatal conjunctivitis (emergency in newborns), conjunctivitis associated with a systemic disease (Kawasaki, Stevens-Johnson, graft-versus-host disease).

Diagnosis of Conjunctivitis

The diagnosis is essentially clinical, based on medical history and examination. Complementary examinations are sometimes necessary.

Diagnostic Methods

• Medical history: unilateral or bilateral nature, duration, associated signs, history of contact lens use, infectious contact, trauma, background history.

• Ophthalmological examination: conjunctiva, eyelids, cornea; assessment of visual acuity loss.

• Fluorescein test: to detect a corneal abrasion or keratitis.

• Slit lamp examination: detailed examination of the anterior segment, essential in case of doubt.

• Conjunctival swab: culture or PCR for severe or resistant forms.

• Allergy testing in case of recurrence.

Alternative Diagnoses

Several more serious conditions can begin with a red eye:

• Keratitis: damage to the cornea, painful, with a decrease in vision.

• Anterior uveitis: peri-keratic redness, marked photophobia.

• Acute angle-closure glaucoma: emergency, red and painful eye, decrease in vision.

• Foreign body or corneal abrasion: pain, asymmetry.

• Blepharitis: chronic inflammation of the eyelid margin.

• Dry eye: burning, feeling of sand, vision fluctuations.

Treatment of Conjunctivitis

Treatment depends on the cause. The majority of viral and allergic conjunctivitis heal without antibiotics.

Viral Conjunctivitis

Symptomatic treatment: eye washes with saline solution several times a day, artificial tears, cold compresses. Avoid contact during the contagious phase. Topical antivirals (acyclovir) are reserved for herpetic conjunctivitis.

Bacterial Conjunctivitis

Eye washes associated with antibiotic eye drops: fusidic acid (Fucithalmic®), tobramycin (Tobrex®), ciprofloxacin, azithromycin (Azyter®), rifamycin. Usual duration: 5 to 7 days.

Allergic Conjunctivitis

Avoidance of the allergen as much as possible. Antihistamine eye drops (levocabastine, azelastine, ketotifen, olopatadine), mast cell stabilizers, corticosteroid eye drops in severe forms, sometimes oral antihistamines.

Hygiene Measures

• Frequent hand washing, especially before and after contact with the eyes.

• Do not share towels, pillowcases, cosmetics, or eye drops.

• Remove contact lenses for the duration of the infection; discard those worn when symptoms started.

• Do not rub your eyes.

• Exclusion from school or work in highly contagious cases.

Prevention of Conjunctivitis

• Regular hand washing, especially during viral epidemics.

• Strict hygiene of contact lenses: appropriate solution, recommended wear periods respected.

• Regular eyelid cleaning in case of blepharitis.

• Limited exposure to smoke, pollution, and irritating products.

• Protective goggles in swimming pools, strong winds, or manual labor.

• Avoidance of known allergens, desensitization for severe allergies.

• Regular breaks in front of screens (20-20-20 rule).

Possible Complications

The majority of conjunctivitis cases heal without sequelae. Some forms may, however, be complicated by keratitis, a corneal ulcer (an emergency in contact lens wearers), a corneal abscess due to Pseudomonas or Acanthamoeba, chronic conjunctivitis, conjunctival scarring, or transmission to family and friends. In newborns, untreated gonococcal conjunctivitis can cause blindness.

When to Contact a Doctor for Conjunctivitis

The majority of conjunctivitis cases only require a simple consultation. Here is what to do:

• First resort: contact your primary care physician, who can prescribe appropriate treatment or refer you to an ophthalmologist.

• If your primary care physician is unavailable (evenings, weekends, holidays), Docadom offers an emergency consultation by a home doctor. Call 021 845 45 45 or make your request via our mobile application, available for free on the App Store and Google Play.

• In case of severity signs (decreased vision, intense pain, trauma, marked photophobia), call 144 without delay or go to the eye emergency department.

Conclusion: A Simple Diagnosis, Key Hygiene Rules

Conjunctivitis is a frequent and most often benign eye condition. It can be viral, bacterial, allergic, or irritating. It is characterized by eye redness, tearing, secretions, or itching, which can lead to complications like keratitis or corneal ulcer in certain at-risk situations.

In case of doubt or persistent symptoms, consult your primary care physician first. If they are not available, Docadom provides you with an emergency home doctor 7 days a week: call 021 845 45 45 or use our mobile application (App Store, Google Play) to request an emergency consultation.