Conjunctivitis ("pinkeye")

Conjunctivitis literally means an inflammation of the conjunctiva. The conjunctiva is the clear layer on the outside of the eye, lying over the sclera (the "white part"). The three most common types of conjunctivitis (commonly called "pinkeye") are infectious, allergic, and contact-lens/giant papillary conjunctivitis (GPC)

Infectious conjunctivitis

Infectious conjunctivitis is most commonly caused from either bacteria or viruses. Bacterial conjunctivitis typically presents with a red, painful eye; milky/pus-like discharge; tearing, and possibly slight blurriness; crusty eyelids; bumps on the inside of the upper lids (called papillae) light sensitivity. It is usually treated with antibiotic eye drops. Anti-inflammatory drops (like steroids) are frequently used as well. Viral conjunctivitis has similar presentation except that the discharge is usually clear rather than milky. Also, rather than papillae, we see the formation of different inner lid bumps called follicles. Viral conjunctivitis is usually treated with artificial tears, as there are no broad-spectrum anti-viral medications (the same reason why there's no cure for the flu). Sometimes antibiotics are prescribed to prevent a simultaneous bacterial infection.

Allergic conjunctivitis

• Red, itchy eye
• Mucus/ropy tears
• Inflammation of adnexa & lids
• GPC
• Tx: antihistamine drops/pills; mast-cell stabilizers; steroids/other anti-inflammatory drops; cold compresses, artificial tears.

Giant Papillary Conjunctivitis (GPC)

While either bacteria or allergies can cause papillae (inflammatory bumps) on the inside of the lids, the most common cause is from contact lens overwear. This is one of the reasons that most eye doctors want to see all contact lens patients every year, even if everything seems fine. Initially there are no symptoms, other than the eyes getting a little drier at the end of the day with the contacts in. Eventually, contact lens wear may become intolerable as the papillae become larger. The main danger of GPC is an increased likelihood to getting bad infections, as the eyes get very dry and the bumps scratch the cornea.

For mild cases, usually a switch to a more disposable lens, or even daily disposable lenses. More advanced cases require the patient to discontinue contact lens wear altogether; further, they are frequently treated with anti-inflammatory drops or mast-cell stabilizers.