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Conjunctivitis

About conjunctivitis

The two most common types of conjunctivitis are infective (viral and bacterial) and allergic conjunctivitis. Infective conjunctivitis makes up just over a third of all eye problems in the UK each year.

Types of conjunctivitis

Conjunctivitis is categorised into three main types.

  • Allergic conjunctivitis.
  • Infective (viral and bacterial) conjunctivitis.
  • Irritant (chemical) conjunctivitis.

Symptoms of conjunctivitis

Conjunctivitis can affect one or both of your eyes. The symptoms of conjunctivitis include:

  • redness of the white of your eye
  • pain in your eye, such as a burning sensation, throbbing or aching
  • blurry vision caused by pus around your eye
  • pus in your eyes – this may cause them to stick together in the morning and be difficult to open
  • a gritty feeling in your eye that may cause an itching or burning sensation
  • watery eyes

If you have allergic conjunctivitis, you may have hay fever symptoms, such as sneezing, a runny, itchy nose and itchiness at the back of your throat.

If you have infective conjunctivitis, you may have cold-like symptoms, such as a fever and sore throat.

Some of these symptoms can be caused by problems other than conjunctivitis. If you have any of these symptoms, see your GP for advice.

Causes of conjunctivitis

Allergic conjunctivitis

You’re more likely to get allergic conjunctivitis if you already have allergies.

If you’re allergic to plant pollens that are released at the same time each year, you may get seasonal allergic conjunctivitis. All year round (perennial) allergic conjunctivitis can be caused by house dust mites and animal fur.

You may get a form of allergic conjunctivitis, called giant papillary conjunctivitis, if you use contact lenses and are allergic to them, or if you have had eye surgery. See our FAQs for more information.

Using eye drops and eye make-up can cause inflammation of your eyelids and is called contact dermatoconjunctivitis.

Viral conjunctivitis

Viruses are a common cause of conjunctivitis. The virus most often associated with conjunctivitis also causes the common cold (adenovirus). You may have infective conjunctivitis if you have a cold or have come into contact with somebody who is coughing or sneezing.

Bacterial conjunctivitis

You can get bacterial conjunctivitis in any of the following ways.

  • Coming into contact with somebody who already has conjunctivitis.
  • If you have an upper respiratory infection, such as sinusitis or a common cold. Your sinuses are air-filled spaces within the bones of your face that open up into the nasal cavity. Sinusitis is swelling of the sinuses that surround your nose.
  • Touching your eyes with unwashed hands.
  • Using eye make-up and facial lotions that are contaminated.

Neonatal conjunctivitis affects newborn babies and can be caused by a blocked tear duct or by an infection passed on by the baby’s mother if she has chlamydia or gonorrhoea when giving birth, even if there are no symptoms of infection. Neonatal conjunctivitis can cause permanent eye damage if it isn’t treated quickly. See our FAQs for more information.

Irritant (chemical) conjunctivitis

Chemical conjunctivitis can be caused by a number of things including:

  • toxic chemicals
  • chlorine in a swimming pool
  • air pollution
  • contact lenses and their cleaning solutions

Diagnosis of conjunctivitis

Your GP will ask about your symptoms and examine you. He or she may also ask you about your medical history.

Your GP may take a swab of your eye. This will be sent to a laboratory to be tested and help identify the cause of your conjunctivitis. He or she may also refer you to an ophthalmologist (a doctor who specialises in eye health), although this is very rare.

Treatment of conjunctivitis

Treatment of your conjunctivitis will vary depending on what caused it.

Self-help

If you use contact lenses, don’t wear them until your conjunctivitis has completely cleared up. It’s also important not to rub your eyes and to make sure you regularly wash your hands. Don’t share pillow cases, towels or go swimming until your conjunctivitis has completely cleared up.

If you have allergic conjunctivitis, try to stay away from or not use whatever is causing your allergic reaction. A cool compress, such as a facecloth soaked in cold water, may help to soothe your eyes.

Infective conjunctivitis usually settles without treatment within about two weeks. You may find it helps to wipe away any discharge from your eyelids and lashes with cotton wool soaked in water. Although infective conjunctivitis is contagious, you don’t necessarily need to take time off work and if your children have conjunctivitis, they can still go to school.

Medicines

If you have bacterial conjunctivitis, your GP may prescribe you antibiotic eye drops (or ointment for children). You can also buy these medicines over the counter from a pharmacist.

Antihistamine medicines or eye drops may help if you have allergic conjunctivitis. These will give you rapid relief from your symptoms. Your GP may also prescribe a type of medicine called mast cell stabilisers, in the form of eye drops. Mast cell stabilisers work by stopping allergy cells from releasing substances that cause swelling and inflammation. These are more effective for long-term relief of allergic conjunctivitis but may take a few days to start working. You can take antihistamines at the same time as mast cell stabilisers to give you immediate relief while you wait for the mast cell stabilisers to work.

Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist or GP for advice.

Conjunctivitis caused by a virus usually clears up on its own without the need for medicine. This usually takes no longer than two weeks.

See our common questions for more information about ways to ease your symptoms.

Prevention of conjunctivitis

There are a number of ways you can prevent the spread of conjunctivitis. Some examples are listed below.

  • Change your pillow cases regularly.
  • Use clean towels and washcloths, and don’t share them.
  • Wash your hands regularly.
  • Avoid contact with people that have conjunctivitis.
  • Clean your contact lenses correctly.
  • Replace your eye make-up products regularly.
  • Try to not touch your eyes with your hands.
     

Is there anything I can do to help ease my symptoms when I have conjunctivitis?

Answer

Yes, there are lots of things you can do to help reduce the symptoms of your conjunctivitis.

Explanation

If you wear contact lenses, it’s important that you don’t wear them while you have conjunctivitis. You can begin to wear them again 24 hours after you have finished your treatment as long as your symptoms have cleared up.

If your conjunctivitis has been caused by a virus, a warm compress may help to soothe your symptoms.

If your conjunctivitis has been caused by an allergy, the following may stop your symptoms getting worse.

  • Try to stay away from what it is that you’re allergic to.
  • On days when the pollen count is high, try to keep windows in your house and car closed.
  • Wear wraparound sunglasses.
  • Place a cool compress over your eyes.

If you’re allergic to dust mites it may help to:

  • wash your bed linen regularly
  • fit a mattress with a cover that doesn’t let dust mites through it
  • use synthetic pillows

There are also things you can do to stop your symptoms from spreading or getting worse.

  • Wash your hands regularly.
  • Don’t rub your eyes.
  • Don’t share towels or pillows.
  • Avoid swimming at public swimming pools.
  • Clean away any discharge from your eyelids and lashes using cotton wool soaked in water.

If you have any questions or concerns about conjunctivitis, speak to your GP.

What's the difference between a sticky eye and conjunctivitis in babies?

Answer

A sticky eye in newborn babies is common and often clears up without treatment within a year. Neonatal conjunctivitis is more serious and can be a sign of a severe infection. It’s important that you contact your GP as soon as possible if you think your baby has conjunctivitis.

Explanation

One in five newborn babies are born with a blocked tear duct. This is usually because their tear drainage system has not fully developed. Your baby may have more watery eyes than would appear normal. His or her tears may appear thicker than usual and may become crusty when they dry. This is commonly known as sticky eye. The medical term is congenital nasolacrimal duct obstruction. Sticky eye usually clears without treatment within a year as the tear drainage system opens up and fully develops.

The symptoms of conjunctivitis can include watery eyes, just like with a sticky eye, so it can sometimes be difficult to tell the difference between the two conditions. However, with conjunctivitis your baby may also have:

  • puffy, red and tender eyelids
  • watery, bloody or thick pus coming from the eyes
  • red eyes

It's important to speak to your GP to find out if your baby has conjunctivitis or sticky eye.

Neonatal conjunctivitis can be the result of an infection passed to your child at birth. Although you may have no symptoms when your baby is born, you may still have bacteria in your vagina that can cause neonatal conjunctivitis. The two most serious infections are chlamydia and gonorrhoea, which can develop into a severe eye infection and could eventually lead to loss of sight.

Why are contact lens wearers more prone to getting conjunctivitis?

Answer

The chemicals and preservatives in contact lenses and their cleaning solutions can cause your eyes to become irritated and itchy. This type of conjunctivitis is called giant papillary conjunctivitis. A giant papillary is a large red bump under your eyelid.

Explanation

An allergic reaction to a contact lens or the chemicals used in contact lens cleaning solution can cause irritation of your eyelid. Debris on the contact lens can sometimes scrape the eyelid triggering giant papillary conjunctivitis. If you have giant papillary conjunctivitis, you may have one or more of the following symptoms.

  • Itching and burning in your eyes.
  • Excessive mucus production.
  • Blurred vision caused by mucus sticking to your contact lens.
  • You may notice your contact lens move when you blink.

It's important to see your GP or optometrist (a health professional who examines eyes, tests sight and dispenses glasses and contact lenses) if you have any of these symptoms so that he or she can examine your eyes and exclude any other eye conditions. Occasionally, you may need to be referred to an ophthalmologist for further diagnosis and treatment. An ophthalmologist is a doctor who specialises in eye health, including eye surgery.

Not cleaning your contact lenses thoroughly and wearing them for too long can increase your chances of getting giant papillary conjunctivitis.

You will need to stop wearing your contact lenses if you have giant papillary conjunctivitis. Also, you may need to change the products you use to care for your lenses. Sometimes you may need to switch to different contact lenses altogether.

Often you won’t need any treatment as your symptoms will probably start to reduce as soon as you remove your contact lenses. To help soothe your eyes, place a cold compress (a facecloth soaked in cold water) over your affected eye(s). Also make sure you don't rub your eyes no matter how itchy they are. Occasionally, if your symptoms are particularly bad, your GP may prescribe an antihistamine medicine.

If you have any questions or concerns about giant papillary conjunctivitis, talk to your GP or optometrist.