6 Different Types of Conjunctivitis and How To Treat Them

Conjunctivitis, or more commonly known as pink eye, is an inflammation of the transparent membrane lining the eyelids and the white part of the eyeball. As blood vessels become inflamed, they engorge and become more visible over time. 

Symptoms of Conjunctivitis

• Swelling of the conjunctiva (layer that lines the white part of the eye) and eyelids
• Increased tear production, itching, irritation and burning
• Discharge in the form of mucus or pus 
• Large amount of crusting of the eyes 
• Blocked tear ducts
• Swollen lymph nodes – indicative of a viral infection 

Types of Conjunctivitis

1. Viral Conjunctivitis 

Viral conjunctivitis usually occurs simultaneously with other symptoms of a respiratory infection. Infections can first occur in one eye, before spreading to the other eye. Discharge is usually watery and not thick. Viral conjunctivitis is highly contagious and is different from non-contagious allergic conjunctivitis. Some patients will experience swollen lymph nodes near the ears and under the jawbone. 

2. Allergic Conjunctivitis

Allergic conjunctivitis attacks both eyes and causes tearing, swelling, and itching. There is a high tendency for allergic conjunctivitis to occur with a symptom of other allergies such as allergic rhinitis, eczema, and asthma due to the oversensitivity of the immune system, triggering a series of allergies due to the same antibody, immunoglobulin E (IgE), being produced. 

3. Bacterial Conjunctivitis

The most classic symptom seen is the presence of visible pus that can cause the eyelids to stick together. 

4. Chlamydial Conjunctivitis

Chlamydia is a bacterial genital infection that can be passed through childbirth in untreated or asymptomatic mothers. This type of inclusion conjunctivitis leads to symptoms presenting five days to two weeks after birth, where there is swelling of the eyelids, discharge of pus and redness of the eyes. 

5. Gonococcal Conjunctivitis 

Gonorrhoea is a sexually transmitted infection caused by the bacteria, Neisseria gonorrhoea. Gonococcal conjunctivitis is an ophthalmic infection with mucopurulent discharge with swollen eyelids and is usually a predominant disease of neonates. Similar to chlamydial conjunctivitis, untreated mothers can infect neonates during childbirth. Symptoms can occur much quicker than chlamydial conjunctivitis, which can happen two to five days after birth. Sepsis, bacteraemia and complications of the central nervous system may also occur in newborns. 

In adults, it is extremely rare and may be associated with gonococcal urethritis caused by other sexually transmitted diseases. 

6. Neonatal Conjunctivitis 

Newborns can develop puffy and tender eyelids within one day to two weeks after birth. This may be caused by irritation from topical antimicrobial tear drops or an infection passed maternally during childbirth, leading to a blocked tear duct. 

Treatment of conjunctivitis

Treatment for conjunctivitis depends on the cause as summarised below: 

Bacterial conjunctivitis 

• Antibiotic drops to treat conjunctivitis caused by a bacterial infection. These eye drops will need to be applied to the inside of the eyelid every 4 hours for at least 5 days. A warm cloth is usually used to relieve irritation. 
• Chlamydial conjunctivitis is usually treated via oral antibiotics
• Gonococcal conjunctivitis: Intravenous antibiotics are administered immediately, especially in newborns as they risk developing corneal sores of the eye, which can lead to blindness

Allergic conjunctivitis 

• Antihistamines to reduce swelling and inflammation 
• Avoiding substances (allergens) that cause the allergic trigger 

Other types of conjunctivitis

• For conjunctivitis caused by irritants, flush the eyes immediately with water to wash the allergic substance out of the eyes for at least 5 minutes. Seek medical intervention if symptoms do not improve after 3 hours. 
• Use eye drops to shrink congested blood vessels 

Complications 

In some cases, an infection may spread to the cornea, which can cause inflammation and scarring to the cornea, leading to serious sight implications. Therefore, one should seek medical attention if eye pain, blurred vision or light sensitivity persists. In newborns, this is extremely essential as it can lead to ophthalmia neonatorum, a serious types of conjunctivitis that can lead to blindness.

How to relieve symptoms and prevent the spread of conjunctivitis  

• Keep eyes clean by not touching your eyes with unwashed hands.
• Change your pillowcase every day until the infection subsides. Wash bedding with warm water. 
• Use a warm compress and leave it over your swollen eyes for a few minutes. This can help to soften and remove crust.
• Limit contact with others if diagnosed with viral conjunctivitis as it is highly contagious.