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Viral Conjunctivitis

"You have conjunctivitis" the eye doctor informed his concerned patient.

"Don't I have pink eye ?" the patient questioned.

"Yes" the doctor responded.

Although this may sound confusing both doctor and patient here are correct. The patient does have conjunctivitis an inflammation of the conjunctiva....and because her eyes are a deep reddish-pink in color she also has pink eye .


Pink eye is really a layman's term that generally describes an eye that is red and inflamed. The redness could be caused by any number of reasons but most commonly it's due to a bacterial or viral infection. However a pink eye could also be due to problems with contact lenses allergies dryness fungal infection systemic illness or medications ultraviolet radiation

or even cancer. Merely stating that a person has pink eye leaves many questions unanswered as to its cause.

So what is the conjunctiva that is inflamed in conjunctivitis? Here's an illustration.

Picture a ping-pong ball. Now picture a ping-pong ball wrapped in Saran Wrap. The ball represents the eye ball itself; the Saran Wrap is the conjunctiva. Describing it more fully the conjunctiva is a thin transparent membrane covering the surface of the eye. It begins at the outer edge of the cornea (the transparent dome-shaped window covering the front of the eye) covers the visible part of the sclera (commonly known as "the white of the eye") and lines the inside of the eyelids. Within this membrane are tiny blood vessels that are nearly invisible to the naked eye.

The conjunctiva is particularly vulnerable to infection because of its exposure to the environment. Particles floating in the air can trigger allergies or cause the conjunctiva to become infected. Also when we inadvertently rub our eyes we often inoculate ourselves with bacteria viruses and any other toxic material that happen to be hitching a ride on our unclean hands. As a matter of fact rubbing the eyes with contaminated hands is a very common mechanism of catching the common cold and the flu.

Once the virus or bacterial particles are in the eye they become mixed in with the tears. Like driftwood flowing in a river s current the bacteria or virus particles are washed down into the throat as the tears drain from the eye. Once in the throat they are home free to cause illness. Needless to say frequent hand washing especially during cold or flu season goes a long way to keep us healthy.

Conjunctivitis spreads easily and quickly. Here s a typical sequence of events: I have conjunctivitis. I rub my eyes. I touch a doorknob or shake hands with you. You rub your eyes. You have conjunctivitis.


Adenovirus

Viral infections of the conjunctiva are extremely common. Of all the viruses that can cause conjunctivitis adenovirus the ever-present virus that lurks in our nose throat and upper respiratory airway is probably the most common. Adenovirus can spread like wildfire and the infection can cause significant discomfort to an individual. Unfortunately it can also persist for weeks.

Frequent hand washing is important as adenoviruses are hearty. A virus from an infected person can survive on a counter top refrigerator handle or door knob for several days just waiting to be picked up by its next victim.

If there were one eye infection more deserving of the term pink eye it would be adenoviral infection for the inflammation in these infections causes the eyes to turn a very pink color.


Type I herpes simplex

Another not-uncommon cause of viral conjunctivitis is the herpes virus. Type I herpes simplex better known as above-the-waist herpes has at one time or another infected over 90% of the population. This form of herpes which is not the sexually-transmitted form of the disease initially manifests as a flu-like illness in childhood. The problem is in most people the virus remains in the body existing in a dormant state in the nervous system. Periodically usually during times of stress the virus becomes activated and causes infection usually in the form of cold sores of the lip skin rashes or eye infections.

Currently there are no medications to treat adenoviral infection but if it is caught early its discomfort can be minimized. There are several medications to combat (not cure) herpes eye infections. However the virus continues to run its course in some individuals being a major cause of severe corneal scarring that could require transplantation.

Most viral conjunctivitis although usually benign and self-limiting tends to follow a longer course than acute bacterial conjunctivitis lasting for approximately 2-4 weeks.


What's the best way to get a viral infection?

Don't wash your hands.

Another way that viral particles are passed from person to person is through respiratory droplets. When an infected person sneezes zillions of contaminated droplets enter the immediate airspace. These particles are picked up by air currents and can easily drift into another person s airspace and then inhaled. If some of these freely floating droplets happen to land on your conjunctiva there could be trouble ahead in the form of full blown conjunctivitis or worse yet a cold or the flu. Viruses can also be passed on through contaminated swimming pools and spas.


Treatment of conjunctivitis

Unfortunately there is no cure for either the adenovirus nor the herpes virus. Therapy against the adenovirus is directed at minimizing symptoms and tissue damage. Herpes medications can stop the infection in its tracks but the virus will continue to live in the nervous system.


See your eye doctor

If your eye is red swollen itchy painful or has a watery discharge it's important that you see your eye doctor right away. Don't assume that your eyes are red because you didn't get enough sleep or because you had too much to drink. If you do have an infection it's important that the fire is put out immediately before any tissue damage takes place.



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