Pink Eye Treatment and Medications

Pink eye, also called conjunctivitis, is an inflammation of the conjunctiva, which are the membranes that line the inner surface of the eyelid and cover the white parts of the eye. It is one of the most common and treatable eye conditions, according to the Centers for Disease Control and Prevention (CDC). The most common causes are viral and bacterial infections. Viral and bacterial conjunctivitis occur equally, according to a report published in 2018. Viral conjunctivitis occurs more often in the summer and bacterial in the winter and spring. Treatment is dependent on the cause of conjunctivitis, although most cases resolve on their own within a few weeks.

What is pink eye?

Pink eye is most common in young children, however, people of any age can get pink eye, according to KidsHealth.org. Pink eye is highly contagious and can quickly spread in schools and playgrounds as well as from one family member to another.

Viral and bacterial infections are the most common causes of pink eye. Still, it can also be caused by allergies or irritants, such as a foreign body in the eyes, chlorine in pools, or smoke. The same bacteria that cause chlamydia and gonorrhea can also cause pink eye.

Pink eye symptoms can vary, depending on the cause. Common symptoms, according to Johns Hopkins Medicine, include:

• Red eyes

• Gritty feeling in one or both eyes

• Itching, irritation, or burning sensations

• Clear, thin drainage and increased tearing

• Stringy or thick, green discharge from eyes

• Eyelids matted together when first waking

• Swelling of eyelids

• Blurred vision

• Flu-like symptoms including cough, sore throat, fatigue

There are several different forms of conjunctivitis. These include:

• Viral: Conjunctivitis can result from exposure to viral infections that are associated with the common cold or other upper respiratory infections, such as measles or the flu. Viral pink eye clears up without treatment, usually after the fifth day. Over-the-counter medications, such as lubricating eye drops and decongestants, can reduce surface swelling and itching.

• Bacterial: This is the most common type of conjunctivitis during the winter months. It can be spread without direct contact with the infected person, as the bacteria can live on surfaces. The most common types of bacteria that cause pink eye include staphylococcus aureus, Haemophilus influenza, streptococcus pneumonia, and Pseudomonas aeruginosa. Bacterial conjunctivitis usually produces a thick eye discharge or pus. Your doctor might prescribe antibiotic eye drops or ointments, and treatment can take one to two weeks.

• Gonococcal and chlamydial conjunctivitis: The same bacteria that causes these sexually transmitted infections can also cause pink eye. Newborns can be exposed as they pass through the birth canal. Women who are pregnant and might have been exposed to gonorrhea or chlamydia should get tested and treated before giving birth. This type of pink eye frequently progresses quickly and can lead to corneal dislocation. Another sexually transmitted infection, eye herpes or the herpes simplex virus, can sometimes be mistaken for pink eye, according to the American Academy of Ophthalmology.

• Giant papillary conjunctivitis: This type of pink eye usually impacts both eyes and often affects people who wear soft contact lenses. Symptoms include itching, heavy discharge, tearing, and red bumps on the inside of the eyelid, which can lead to contact lens intolerance. Treatment includes not wearing contact lenses, at least until the infection has completely cleared. Some people might need to switch to a different type of contact lens.

• Non-infectious conjunctivitis: Irritants can cause this type of pink eye. These can include chemicals, facial or eye makeup, air pollution, diesel exhaust, smoke, and chlorine in swimming pools. Some ingested substances, such as turmeric and eyebright, can also cause it.

• Allergies: The most common type of allergic conjunctivitis is red, itchy eyes. Allergies to pollen, animal dander, mold, dust mites, cosmetics, and contact lens solutions might result in pink eye. Eye drops containing antihistamines could offer symptom relief. Allergic conjunctivitis may appear seasonally or perennially, depending on the allergen.

Most cases of pink eye, including bacterial conjunctivitis, will resolve on their own without treatment in seven to 14 days, according to the American Academy of Ophthalmology. Most treatments are meant to relieve discomfort; however, antibiotics are frequently used to treat bacterial, gonococcal, and chlamydial conjunctivitis.

How is pink eye diagnosed?

Your physician can usually diagnose pink eye based on an examination of your eyes, a description of symptoms, and your health history. The different types of conjunctivitis have similar symptoms, however, your doctor can often determine the cause of pink eye without laboratory tests. Doctors rarely take samples of eye discharge for further testing, according to the CDC.

Having a red or irritated eye does not always indicate you have pink eye however, if you have a discharge coming from your eye, you should talk with your healthcare provider. Infants, those who wear contact lenses who have symptoms for 12-24 hours after removing contacts, and those with weakened immune systems should seek medical advice at the first sign of conjunctivitis according to the Minnesota Department of Health.

You should also seek care if you experience:

• Eye pain

• Reduced or blurry vision

• Sensitivity to light

• Inability to open the eyelid

• Severe headache or nausea

Most people begin the diagnostic process with their primary physician. For more severe cases, your doctor might refer you to an eye doctor, such as an ophthalmologist or optometrist, who specializes in eye diseases. During the examination, your doctor might ask questions such as:

• When did your symptoms begin?

• Do you have continuous discharge from your eye or only at certain times of the day?

• Do you have symptoms other than in your eyes, such as fever, coughing, sore throat, nasal congestion, or sneezing?

• If you wear contact lenses, and if so, when was the last time you wore them?

• Are you experiencing sensitivity to light, blurry vision, or tenderness around the eye?

• Are you experiencing a headache or nausea?

• Have you had any recent trauma to the eye?

It is essential to answer the questions as completely as possible, so your doctor can make an accurate diagnosis.

Once you have received a diagnosis, you might want to ask your doctor questions, such as:

• Is my pink eye contagious? If so, what steps should I take to avoid spreading it to other people?

• Do I need to stay home from school or work? If so, for how long?

• What can I do at home to relieve symptoms and discomfort?

• What can I do to prevent pink eye in the future?

Pink eye treatment options

Pink eye is treated based on the underlying cause. Treatment might include:

• Antibiotic drops or ointments

• Steroid drops or ointments

• Allergy drops for eyes

• Oral antibiotics

• Artificial tears

There is no treatment for viral conjunctivitis other than using eye drops to relieve discomfort.

Your doctor might also suggest cleaning your eyelids and around your eyes every few hours with a cotton swab soaked in lukewarm water. You should use a separate cotton swab for each eye and discard them after each use. Warm compresses placed on the eyes might also help relieve itching and discomfort. If you are experiencing sensitivity to light, wearing tinted glasses could help.

Pink eye medications

Treatment for pink eye is dependent on the underlying cause. Some of the different types of drugs used include:

Ophthalmic antibiotic eyedrops

• Bleph 10 (sulfacetamide sodium)

• Moxeza (moxifloxacin)

• Polytrim (polymyxin/trimethoprim)

• Bacticin (bacitracin)

• AK-Poly-Bac, Polycin-B, Polysporin Ophthalmic (polymyxin-bacitracin)

• Besivance (besifloxacin)

• Ciloxan (ciprofloxacin)

• Quixin, Iquix (levofloxacin)

• Ocuflox (ofloxacin)

You might experience side effects, such as stinging or burning in the eyes when first applied. You could also experience temporary blurred vision, especially after applying ointment to your eyes.

Topical antihistamines

Antihistamines work to relieve symptoms of allergic conjunctivitis symptoms, such as redness and itching. Examples of these include:

• Patanol, Pataday (olopatadine)

• Lastacaft (alcaftadine)

• Bepreve (bepotastine)

• Optivar (azelastine)

• Elestat (epinastine)

These might cause burning or stinging in your eyes, headache, stuffy nose, a bad taste in your mouth, and sensitivity to light.

Mast cell stabilizers

These work to stop cells from releasing histamines and can reduce eye itching caused by allergies. These include:

• Alocril (nedocromil)

• Alomide (lodoxamide tromethamine)

• Alamast (pemirolast)

Side effects consist of throat irritation, coughing, and skin rashes.

Ocular steroids

Your doctor might suggest ocular steroids if other medications do not offer relief. These are prescription eye drops. These drops are often used as a last resort as they can increase pressure in your eyes and increase the risk of cataracts. Before prescribing ocular steroids, your doctor should check for viral eye infections.

Over-the-counter topical antihistamines and decongestants

• Naphcon-A, Ocuhist (pheniramine maleate/naphazoline): Side effects include hyperemia and chemosis.

• Zaditor, Alaway, Zyrtec Itchy Eye, Claritin Eye (ketotifen fumarate): These drops relieve itching and redness, are generally well-tolerated, and can be used for children as young as three years old.

What is the best pink eye medication?

There are several treatments for conjunctivitis, but there is no "best" medication. What works for one person might not work for another. Everyone reacts differently to medicines. Your doctor will take your medical condition, medical history, and other medication you are taking into consideration when suggesting a treatment for you. When looking at standard dosing, it is important to keep in mind that interval frequency and duration of treatment may vary based on the severity of each patient’s case.

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Best medications for pink eye