What is Pink Eye? What are the Symptoms of Pink Eye?

Conjunctivitis, commonly referred to as “pink eye,” is an inflammation of the thin, transparent membrane (conjunctiva) that covers the white part of the eye (sclera) and the inner surface of the eyelid. Patients often recognize this condition by symptoms such as eye redness, watering, and a stinging sensation. Waking up one morning, looking in the mirror, and seeing your eye inflamed, red, and stuck together can catch you off guard—much like finding nowhere to take shelter from sudden rain on a busy street. Known among the public as “eye cold” or “pink eye,” this manifestation of conjunctivitis can significantly affect daily life.

How Does Conjunctivitis (Eye Cold) Occur?

Conjunctivitis (eye cold) begins when the conjunctiva is exposed to various factors. Viruses, bacteria, allergens, and even chemical substances disrupt this membrane’s integrity, leading to inflammation. If we compare our eye to a window of a house, the conjunctiva is like a thin layer protecting the frame and sill of this window. Just as a small crack in the sill can expose the inside to wind, rain, and harmful factors, a similar situation occurs when the conjunctiva is irritated. When this thin membrane is inflamed, redness, burning, watering, and similar symptoms appear quickly.

What Are the Symptoms of Conjunctivitis?

The most typical symptom of conjunctivitis is redness. The inflammation of the conjunctiva causes the blood vessels there to dilate, which can be likened to the intense red appearance in the eyes after a sleepless night—only more pronounced and persistent. However, the symptoms are not limited to redness:

• Watering (Excess Tears): When viruses or allergens irritate the conjunctiva, the eye responds by producing more tears than usual to protect itself. This can be likened to a faucet with a worn-out washer constantly dripping.
• Stinging and Burning Sensation: Patients often complain of a discomfort as if there were grains of sand in their eyes. This feeling is due to the inflamed tissue rubbing against the surface and stimulating nerve endings.
• Itching: In allergic conjunctivitis, itching is the dominant complaint. Think of it like the itching and sneezing that start in your nose when you stay outdoors for a long time in summer. If the same allergens affect your eyes along with your nose, conjunctivitis becomes almost inevitable.
• Discharge (Purulent or Watery): In bacterial conjunctivitis, there is a thick, yellow-green discharge. In viral conjunctivitis, the discharge is clearer or slightly whitish. Much like the difference between dirty water sprayed everywhere from a burst pipe and clean water from a faucet, the nature of the discharge can give us clues about the cause.
• Eyelid Swelling and Waking Up with Sticky Eyes: The tissues around the eye also react to this inflammation, and swelling and eyelids sticking together in the morning are frequently observed.
• Light Sensitivity (Photophobia): Especially in viral conjunctivitis, if the cornea is also involved, sensitivity to light may develop.

Each of these symptoms offers clues about the course and cause of the condition. However, a definitive diagnosis often requires an examination by a specialist.

What Types of Conjunctivitis Are There?

• How Does Viral Conjunctivitis Occur?

Viral agents, especially adenoviruses, are among the most common causes of conjunctivitis. A viral infection in the patient’s nose or throat can easily spread to the eye. Similar to how warm air intended for one room of a house can unintentionally flow into another, there is always a risk of infections in the body spreading to different organs. Viral conjunctivitis generally causes a clear, watery discharge and pronounced redness. This form is quite contagious; shaking hands with an infected person or sharing towels can lead to rapid outbreaks.

• What Characterizes Bacterial Conjunctivitis?

Bacterial conjunctivitis is commonly related to bacteria such as Staphylococcus aureus, Streptococcus pneumoniae, or Haemophilus influenzae and is characterized by a thick yellow-green discharge. In fact, you may wake up to find so much pus that your eyelids are stuck together. This situation resembles the difficulty of cleaning the burnt residue at the bottom of a pot forgotten on the stove. Antibiotic eye drops are frequently used in its treatment.

• Why Does Allergic Conjunctivitis Occur?

Allergic conjunctivitis starts upon exposure to environmental triggers such as pollen, house dust mites, animal dander, or chemical substances. The body perceives these substances as harmful and reacts excessively. We may see severe itching, watering, and sometimes a stringy mucus discharge in the eye. Just as continuous sneezing and a runny nose in spring are due to pollen irritating the nasal mucosa, the same mechanism affects the surface of the eye in conjunctivitis.

• In What Conditions Do Chemical and Mechanical Factors Cause Conjunctivitis?

The eye is sensitive, and it becomes irritated when exposed to chemicals or foreign bodies. For instance, if pool chlorine is not balanced properly, it can trigger inflammation in the conjunctiva. Also, spending long periods in dusty or windy environments can lead to a conjunctivitis-like condition caused by small particles adhering to the eye’s surface. It’s like leaving the window of our house open in a strong wind, letting dust and leaves blow in and create chaos; similarly, the eye quickly reacts to these irritants.

What Are the Factors That Cause Conjunctivitis?

• Viruses: Especially adenovirus, herpes simplex virus, and rarely other viral agents.
• Bacteria: Common bacteria such as staphylococci, streptococci, Haemophilus.
• Allergens: Pollen, house dust, mold, animal dander, the contents of perfumes or cosmetic products.
• Chemical Substances: Pool chlorine, cleaning agents, smoke, spray paints.
• Contact Lenses: Contact lenses that are not properly cleaned or are worn for too long can easily carry pathogens causing conjunctivitis.
• Autoimmune and Systemic Diseases: Although rare, various immune system problems and systemic disorders in the body can cause symptoms similar to conjunctivitis.

How Does Conjunctivitis Spread?

Viral and bacterial conjunctivitis spread quickly, especially in communal living spaces. If a person does not cover their mouth or nose when sneezing, droplets can easily infect nearby surfaces and people. Shared towels, makeup items, and pillowcases also provide a suitable ground for transmission. It’s akin to a small drop of sugar on the kitchen counter attracting ants and quickly turning into an entire ant colony; a tiny factor can lead to widespread transmission in a short time.

How Is Conjunctivitis Diagnosed?

The diagnosis of conjunctivitis is often made through clinical observation. During an eye examination, an ophthalmologist evaluates the appearance of the conjunctiva, the type of discharge, and accompanying symptoms, and usually arrives at an accurate diagnosis. If necessary, more advanced examinations may be performed:

• Conjunctival Culture: Especially if a bacterial cause is suspected, a sample taken from the eye is cultured in a laboratory to determine which bacterium is responsible.
• PCR Test: The polymerase chain reaction (PCR) method can be used to detect viral agents like adenovirus.
• Cytological Examination: In cases of allergic conjunctivitis, a swab is examined under a microscope to detect cell types such as eosinophils.

These tests are particularly used in persistent or recurring cases, or when standard treatments fail. In a standard case, an eye specialist usually diagnoses the condition with a simple examination and immediately starts a treatment plan.

What Methods Are Used to Treat Conjunctivitis?

Viral Conjunctivitis Treatment

• Viral conjunctivitis often resolves on its own if the immune system is adequate. Patients are usually advised to use artificial tear drops, cold compresses, and sometimes anti-inflammatory drops for symptomatic relief. Just as it is pointless to use antibiotics for a mild cold, antibiotics are ineffective in viral conjunctivitis. However, if the clinical picture is severe, the doctor may prescribe antiviral drops or ointments under supervision.

Bacterial Conjunctivitis Treatment

• The mainstay of bacterial conjunctivitis treatment is antibiotic eye drops and ointments. The treatment typically lasts between 7 and 10 days. Patients with heavy discharge are advised to clean the eye regularly. Much like cleaning a dirty surface with patience and the right cleaner, eye discharge should be intermittently cleaned with sterile wipes or clean water. This prevents the infectious agent from lingering in the tissue for long periods and speeds up recovery.

Allergic Conjunctivitis Treatment

• Treatment for allergic conjunctivitis begins by identifying and avoiding the allergen. However, for triggers like pollen that are difficult to avoid, eye drops containing antihistamines or mast cell stabilizers are used. In severe cases, the ophthalmologist may prescribe short-term steroid-containing eye drops. These medications are like firefighters who quickly extinguish a burning building in the eye. However, because long-term use of steroids can have undesirable effects, they must be used under medical supervision.

Supportive Measures

• Cold Compress: Extremely effective for reducing swelling and discomfort in the eye.
• Artificial Tear Drops: Helps keep the eye surface moist, alleviating stinging and burning.
• Regular Eye Cleaning: Using a sterile cloth or cotton swab to clean around the eye is especially important when there is heavy discharge.
• Taking a Break from Contact Lens Use: Refraining from using lenses until the conjunctivitis subsides prevents infection spread and recurrence.

What Precautions Should Be Taken to Prevent the Spread of Conjunctivitis?

• Hand Hygiene: Washing hands frequently and correctly is perhaps the most important preventive measure. One should be as meticulous as a surgeon preparing for an operation, especially before touching the eyes.
• Avoid Sharing Personal Items: Shared use of towels, makeup products, and pillowcases is a primary cause of infection spread.
• Avoid Touching the Eyes: Touching the eyes with hands or unclean items allows germs to settle directly in the conjunctiva.
• Clean Common Areas: Regularly cleaning frequently touched surfaces in crowded environments such as schools, dorms, and offices reduces the spread of infection.
• Respiratory Hygiene: To prevent viruses from spreading through droplets, the mouth and nose must always be covered when sneezing or coughing.
• Contact Lens Care: Contact lenses should be regularly disinfected, recommended disinfectant solutions should be used, and lenses should never be shared.

What Complications Can Occur If Conjunctivitis Is Neglected?

If a simple case of conjunctivitis is left untreated or overlooked, it can lead to serious problems. Some patients avoid seeking professional help for a long time, thinking it will go away on its own. However, conjunctivitis can sometimes threaten the cornea—the transparent layer over the pupil. The cornea is the part that enables light to enter the eye clearly, and prolonged conjunctivitis can progress to more severe conditions like keratitis (corneal inflammation).

Likewise, severe bacterial infections can spread around the eye or even to the orbital cavity. In such cases, serious medical intervention is required; the patient may need IV antibiotics and possibly hospitalization.

When Is It Absolutely Necessary to See an Ophthalmologist?

• Severe Eye Pain and Vision Loss: Normal conjunctivitis may cause mild stinging, burning, and slight blurriness, but severe pain and significant vision loss suggest a condition beyond conjunctivitis.
• Light Sensitivity and White Spots on the Eye: Some viral infections can involve the cornea, causing photophobia (light sensitivity) and white spots on the cornea. A specialist examination should be done without delay.
• Symptoms Persisting or Worsening Despite Treatment: If redness, swelling, and discharge are worsening despite prescribed antibiotics or drops, a different cause or a microbe with high resistance may be present.
• Eye Redness and Discharge in Newborns: If untreated, conjunctivitis can cause permanent eye damage in newborns. Early intervention is therefore crucial.
• Severe Symptoms in Contact Lens Users: If a lens user suddenly develops intense redness, pain, or blurred vision, urgent conditions like a corneal ulcer must be ruled out.

Conjunctivitis and Daily Life: What Should Be Noted?

• Taking Time Off from Work or School: In highly contagious viral or bacterial cases, a few days’ rest is recommended. This helps prevent the disease from spreading in communal spaces and allows the eye to rest.
• Use of Makeup Products: Those with conjunctivitis should thoroughly clean items such as mascara and eyeliner, or preferably replace them. Otherwise, the same germs can come into contact with the eye again.
• Nutrition and Rest: Improving overall body resilience is crucial in fighting any infection. A diet rich in protein, vitamins, and minerals, along with plenty of water and regular sleep, aids recovery.
• Avoid Rubbing the Eyes: When itching increases, people reflexively want to rub their eyes. This action can facilitate the spread of infection and worsen irritation. Just as scratching a mosquito bite more can make it redder and more swollen, the eye can similarly be harmed.

What Are Some Common Misconceptions About Conjunctivitis?

• “Conjunctivitis is not a serious disease; it will go away without medication.” True, some mild cases can resolve on their own. However, if an underlying bacterium or a serious virus is involved, delaying treatment can damage the eye’s sensitive tissues, including the cornea.
• “Chamomile water or tea compresses are always good.” Herbal treatments can do more harm than good if done without medical supervision. Improperly prepared herbal compresses increase the risk of infection.
• “We can use any eye drops on hand when our eyes are red.” Not every eye drop is suitable for every situation. Using antibiotic drops for a viral infection is both unnecessary and can lead to resistance.
• “It’s okay to sleep in contact lenses.” Wearing lenses longer than recommended significantly increases the risk of conjunctivitis. Since it prevents sufficient airflow to the eye surface, it creates an ideal environment for bacteria and viruses.

How to Prevent Conjunctivitis?

• Limit Contact with Your Eyes: Avoid touching your eyes. If you must, wash your hands with soap first.
• Avoid Sharing Personal Items: Makeup products, towels, and pillowcases should always be personal.
• Be Cautious in Crowded Spaces: During periods when the disease spreads in outbreaks, try to avoid contact and touching surfaces as much as possible.
• Proper Contact Lens Maintenance: Clean lenses daily, use disinfectant solutions recommended by your doctor, and discard lenses once their usage period is over.
• Strengthen the Immune System: A balanced diet, sufficient sleep, and regular exercise boost the body’s ability to fight infections.

Frequently Asked Questions

How Many Days Does It Take for Conjunctivitis to Heal?

Although it varies depending on the cause of the disease and the patient’s overall health, viral forms typically improve within 7-14 days. Bacterial cases usually show improvement within about 5-7 days with appropriate antibiotic treatment. Allergic conjunctivitis can persist as long as exposure to the allergen continues.

Is Conjunctivitis More Common in Children?

Yes, especially among children attending school or daycare, viral and bacterial conjunctivitis spreads quickly. Children’s immune systems are still developing, and due to inadequate hygiene in shared areas and a lack of hand-washing habits, they are more susceptible to the disease.

Is Conjunctivitis Dangerous During Pregnancy?

Conjunctivitis usually does not pose a direct threat to the baby during pregnancy. However, given changes in the immune system, it’s prudent for expectant mothers to consult an ophthalmologist if they notice any infection symptoms. A treatment plan can be adapted based on the stage of pregnancy.

Can Conjunctivitis Be Treated at Home?

In mild cases and following supportive measures recommended by a physician, home relief is possible. However, in bacterial or severe viral cases, medical assistance is essential. In prolonged conjunctivitis cases, incorrect practices at home can worsen the condition.

Is Conjunctivitis Linked to the Common Cold?

Many viral conjunctivitis cases occur along with or immediately after upper respiratory tract infections. As the immune system is weakened during this period, the body becomes more susceptible to various infections. Thus, both conjunctivitis and cold/flu infections are more common during seasonal transitions.