ASK THE PINK EYE GUY
Robert Sambursky, MD earned his undergraduate degree from Brown University and his advanced degrees from Boston University. He completed his medical internship at Mount Auburn Hospital and completed both his ophthalmology residency and cornea fellowship at Wills Eye Hospital in Philadelphia. One of the architects of the RPS Adeno Detector, Dr. Sambursky also has co-authored numerous articles in various medical journals. He continues to run an active ophthalmology practice in the Sarasota area, where he treats hundreds of pink eye patients every year.
Please see Dr. Sambursky's answers to common conjunctivitis questions below.
Sue from Indianapolis asks: What is "pink eye"?
Also known as "acute conjunctivitis", pink eye is an inflammation that can be caused by infections from bacteria or viruses. Allergies can also cause a form of conjunctivitis. Plus, it can sometimes be brought on by eye injury or a reaction to eye drops or medication.
John from Trenton asks: What happens if I take antibiotics that aren’t really needed?
The human body builds up a resistance to antibiotics and that can make the drugs less effective when your body really needs them. The symptoms can remain longer because the infection is not being properly treated. This can cause more serious short-term and permanent problems, including light sensitivity, loss of sensation, and vision loss.
Tywanda from Georgia asks: I think I have pink eye, for the past three days I wake up with crutty eyes, discharge and pain behind my eye lids. Should I go to the emergency room?
If you develop pain, decreased vision, or significant light sensitivity then you should immediately visit an emergency room or consult with a physician. If not, a trial of lubrication with artificial tears may suffice but if the conditions persist more than a few days, you should seek medical attention.
Amanda from Portsmouth, NH asks: What percent of conjunctivitis cases are from viruses?
Acute conjunctivitis is typically caused by either a virus, bacterium, or an allergy. Approximately 30-50% of conjunctivitis cases are viral, 40-60% bacterial, and 10-20% allergic. A study by Stenson revealed that 84% of 700 consecutive cases of untreated acute conjunctivitis that were subjected to conjunctival cultures and scrapings led to a presumptive etiologic diagnosis based on standard microbiologic and cytologic criteria. Of these 583 cases, 264 were bacterial, 245 were viral, 51 were allergic, and 17 were chlamydial. Essentially, this suggests about 45% bacterial, 45% viral, and 10% allergic. Reference: Stenson S, Newman R, Fedukowicz H. Laboratory studies in acute conjunctivitis. Arch Ophthalmol. 1982;100(8):1275-7.
Richa Singh from India asks: My hubby got viral conjunctivitis 8 days ago, as diagnosed by an eye surgeon. On the first day he was put on topical steroid therapy, but then discontinued as symptoms were worsening. Since then he is on an antibiotic, antiallergic and lubricating eye drops, but to no relief. His whole eye is swollen, red and he has episodes of acute pain on which NSAIDs are totally ineffective. Even Tramadol takes time to act. There is NO corneal involvement, confirmed by two eye surgeons. What else can be done to help him out?
The most aggressive form of viral conjunctivitis is that associated with Adenovirus. It can lead to a protracted course that may last 3-5 weeks. Even without corneal involvement it may cause significant swelling to the conjunctiva and surrounding lids. Because topical steroids can lead to increased contagiousness, they are typically avoided in mild to moderate conditions, but they are useful if there is significant swelling or pain or corneal involvement. Generally, a moderately strong topical prednisolone or dexamethasone maybe necessary 4 times daily for 1-2 weeks if the condition is severe. Supplemental refrigerated artificial tears are useful to ease discomfort. Antibiotics will provide no added value. Patients with severe disease are at risk to develop chronic dry eyes, vision loss, and light sensitivity.
Marc Frederiksen, OD from Plover, WI asks: Hello. I am an optometrist in central Wisconsin. I am having a little battle with our day care about "pink eye". If a child has a red eye, they are removed from the center until 24 hrs after eyedrops. A sign is posted on the classroom door that says "Pink Eye was diagnosed on a child in this classroom on (date)." What I can't get through to them is that "pink eye" is viral and is almost always very contagious long after the 24 hr time. Last winter I called an ophthalmologist that has kids that attend there and he said "don't even bother, I tried to explain it but didn't get anywhere." All I got from the owner was "I can understand your concern but the guidelines state...". Can you shed any light on this??? Last time it was in her classroom she got it in both eyes because a kid returned too soon. This is a daycare that has 200 kids (some rooms have 20 kids). Thanks so much!
Unfortunately, each state has its own school health policies. This problem will be raised at the October 2010 Annual School Health Conference. Many school health policies encourage mismanagement of conjunctivitis and spread of the disease. In my practice, we test all patients presenting with acute conjunctivitis for the presence of Adenovirus. Even the Red Book and Pediatrics Online from the AAP recommend isolation for patients with the Epidemic Keratoconjunctivitis typically caused by Adenovirus (http://www.pediatriccareonline.org/pco/ub/view/Point-of-Care-Quick-Reference/397107/2.1/red_eye_pink_eye). Since it is so highly contagious and may cause significant morbidity, I will isolate positive patients for 5-7 days after confirming the condition with a rapid test. If the test is negative, I allow a child to return after 24-48 hours on topical antibiotics. It is impossible to determine which cases of Adenoviral conjunctivitis will proceed to Epidemic Keratoconjunctivitis during the first 7-10 days when most patients present with conjunctivitis, thus it is important to isolate all cases of Adenoviral conjunctivitis.
Brittney Smalley from US asks: Hello, I keep getting what looks to be pink eye, but I'm starting to think it may be an allergic reaction to my makeup. How can I tell the difference between the two? My eyes all of a sudden stated creating endless amounts of light yellow mucus that no matter what I did, wouldn't stop, my eyes kept tearing, so I took my contacts out, washed off all my makeup, then that night my eyes got stuck closed from the mucus as I slept. I put in an antibiotic eye drop I had from a "pink eye" infection I had two or three weeks ago, but I'm going crazy trying to figure out why its keeps happening so often. Can you PLEASE help me?? Does this sound more like allergic pink eye or bacterial?
Recurring problems tend not to be infectious, especially in a contact lens wearer. Seasonal allergic conjunctivitis is typically a bilateral (both eyes) condition that is very itchy with a watery discharge. Most likely, the problem is directly related to contact lens use. A contact lens is a foreign body to the eye and if there is underlying dry eyes, it can lead to chronic low grade inflammation associated with foreign body symptoms and mild discharge and crusting. A protein build up on the contact lens can lead to an allergic variant where the eyelids become sensitive to these proteins and leads to a condition called giant papillay conjunctivitis. It is worth visiting an eye specialist to have a dry eye test (Schirmers Test) and examination of the superior eyelids to look for the presence of giant papules. Treating the underlying condition will improve these symptoms.
Gino from EL Paso asks: Hello. I developed pink eye about four days ago. I went to our local eye care facility and saw a specialist. THe doctor ran a strip on my lower eyelid that turned my tears into highlighter yellow. After a few minutes, she told me that I had a viral pink eye, and told me that it could last up to two weeks. Today my wife and I went in to see her doc about an irregular pap smear. Our jaws hit the floor when she said that my wife had tested positive for gonorrhea. Her and I both have zero symptoms. My wife and I have a monogomous relationship, and have had NO contact with any other people for well over two years. Even her doc mentioned that the lab could have contaminated the results, but now I am worried that my eye problem was misdiagnosed. Could I have bacterial pink eye due to gonorrhea? Or should I trust what the eye doc told me originally? Was that paper strip test a test for viral conjunctivitis? Any info you could provide would be greatly appreciated.
Gonorrhea is known to cause a severe form of pinkeye. It typically causes copious discharge, pain and blurred vision. This is a vision threatening condition. Viral conjunctivitis tends to have a red eye with tearing and irritation but not the copious discharge, vision loss, or pain. The strip that was placed in your eye contained fluorescein. It helps accentuate areas that lack epithelial cell integrity. It can also help elucidate the presence of follicles (small lymph node like bumps on the inside of the lower eyelid) that are more commonly seen with a viral infection. It is not, however, a specific indicator of a viral infection. It seems unlikely that you have ocular gonorrhea but in light of your history, it may be worth starting a topical antibiotic because of the potential severity of such an infection. The treatment for systemic gonorrhea requires an intramuscular injection.
Jackie from Illinois asks: I have bacterial pink eye in both of my eyes, and I have started my antibiotic drops. The crusting and oozing has stopped, and my eyes only itch a little bit, but my eyes are still extremely red. When will my eyes look normal again?
Once the eye begins to heal, it can take up to 7-10 days for the redness to subside. Unlike viral infections, bacterial conjunctivitis is not associated with significant complications.
Taylor from Kansas asks: I have a two year old son. He had an ear infection and pink eye and was treated with 10 days amoxycillin and tobramycin .3% every 4 hours for 5 days. All of his symptoms went away. 12 days later his eye symptoms returned, swollen and green/yellow discharge. He also had a runny nose. I took him to urgent care, was told he had a viral infection and was given the same eye drops. Instructed to give them every 3 hours for 3 days. Again all of the symptoms went away. Now 3 days after quiting his eye drops, his eye symptoms have returned to one eye. Please advise. Is there another treatment option?
In a young child with recurrent "infections," it is important to visit a doctor to rule out the possibility of a blocked tear duct. It is also possible that this could be caused by other inflammatory conditions. It seems least likely to be caused by an infection. I recommend that your son is evaluated by a pediatric ophthalmologist.
Megan from Delaware asks: If my eye lid is still a little swollen but my eyes aren't red, do I still have pink eye?
Pink eye causes inflammation of the membrane that lines the inside of the eyelid. Therefore, in a pink eye diagnosis, you would expect any eyelid swelling that is present to be associated with a red eye. Isolated swelling of the eyelids is not likely to be pink eye.
Lisa from Arizona asks: I have a viral version of pink eye. Do I still need to throw out my new mascara, even though I only used it once three days before any symptoms presented themselves?
Viral conjunctivitis is extremely contagious. If you used the mascara within 24 hours of developing symptoms, I recommend that you discard the makeup to prevent reinfection.
Candice from South Carolina asks: Hi, I have bacterial pink eye and it started about 3 days ago with clear discharge and now yellow discharge, with very itchy eyes and high sensitivity to light. I was given antibiotic drops to take for 7 days. I've been on the drops now for 2 days with no relief or change in discharge. Also when I take the drops (which are a white cream color) they leave a thick white film in my eyes that clumps ups and irritates my eyes very badly. Is this normal? Is there another treatment option or medicine I can take? I have thrown away all my makeup and have not worn any since getting the infection. I just want it to go away, it feels like sand in my eyes. Please help.
In most cases, bacterial conjunctivitis responds in 72 hours and shows signs of improvement. Older antibiotics such as tobramycin or gentamycin, that are frequently prescribed, can lead to toxicity of the ocular surface and further irritation of the eye. Newer antibiotics such as Vigamox, Zymaxid and Besifloxicin work the best and are the most tolerated. Anytime you have inflammation and place drops in the eye, it is not uncommon to have a build up of material in the corners of the eye that develop into crusts. However, this should not cause pain. If you are not better or are getting worse after 3 days, I suggest that you see an ophthalmologist. Your symptoms of light sensitivity suggest you may have corneal involvement which may be related to the antibiotic itself and is more common with a viral infection which would also explain why the antibiotics are not helping.
Lindsey Wallace from Minneapolis, MN asks: Hi, I was recently diagnosed with bacterial pink eye. I completed my 5 day therapy of gentamycin eye drops. However my eyes still have a bit of a bloodshot look to them and one eye is a little sore as some of the bloodshot lines are quite red. I no longer have crusting or discharge in the morning and no exceptional itchiness. Is my pink eye gone or is it lingering? My main question is that I used brand new eye makeup and contacts after my antibiotic therapy was completed and I want to know whether this is safe to continue to use even though my eyes still appear somewhat red. I still have some antibiotic drops as well, should I use more of these?
It is important to first discover if what you have is actually pink eye. In most cases, contact lens wearers with a "pink" eye actually have a contact lens related dry eye, contact lens overwear syndrome, or contact lens induced allergies causing their symptoms. If, however, it is truly bacterial pink eye, then it is not unusual for the redness to persist for about 7-10 days. Most importantly, the eye is no longer signficantly tearing or producing discharge. Makeup use is discouraged until the eye is no longer red and tearing.
Pam Walker from Ohio asks: I had pink eye. Now I have a red bump on the inside of my eyelid. I have stopped taking my drops. Took them for 7 days. What is this? Would I still be contagious?
A bump on the inside of the eyelid is not usually related to pink eye. If your "pink eye" was unilateral (only occurred in one eye), it was not likely pink eye at all. A stye, or chalazion, is a blocked gland that creates a swollen eyelid and an irritated eye, which is often mistaken as pink eye. If it persists, I suggest that you visit an eye doctor to determine exactly what it is.
Alli from New Jersey asks: I woke up this morning with red eyes and yellow gunk on the inside corners, and they felt really swollen and it was painful. I was instructed to put a warm, wet towel over my eyes, and did so for about 5 minutes. After taking off the towel and waiting a few minutes I looked in the mirror again and my eyes werent red anymore, only glassy and puffy and feeling a little sore. I also have cold symptoms like a runny nose and headache. Do I really have pink eye? And is whatever I have contagious?
Crusting in the corner of the eyes can happen from a variety of conditions. In pink eye, the white part of the eye, the sclera, is typically very red and the tearing is frequent. Sometimes, a systemic cold or flu can give mild symptoms that mimic pink eye. Also, eyelid problems, such as blepharitis, are more associated with swelling and crusting in the morning. This condition is not contagious. However, if your eye continues to be red, crusty and painful, it is important to have this evaluated by an eye care specialist.
Maria-Teresa Rosanio from New York asks: I got a conjunctivitis on March 21, which actually reactivated on March 28, my eye was so swollen that was almost closed. I was treated first in the Ear & Eye hospital emergency and diagnosed with viral conjunctivitis and preseptal cellulitis. Later it passed to the right eye but in a more benign way (the right eye is OK now). I was treated with oral antibiotics for 14 days, plus Besivance and Tobramycin drops and Erythromycin Ointment on the eyelids in both eyes. The tearing was continuos for two weeks. The eye is still watering a little bit but the light swelling and pink in the eye doesn't go away. This is very frustrating since it seems it will never go away. I am concerned about the drops because I understand they have side effects. Am I being treated properly or is there any other more aggressive treatment? The doctor told me that there is nothing for the virus itself and that eventually it will go away. She expects this week when she will sees me that she will be able to take me out of the drops. Thanks so much for your advice/recommendations.
While there is no FDA approved treatment for viral conjunctivitis, there are other options for treating a viral infection. What is strange is that if it is viral, there would be no need for oral or topical antibiotics. You could have been tested with a rapid in-office test which could have confirmed this diagnosis. Since you did not get better quickly, despite using 3 different antibiotics, leads me to believe that you did probably have a virus. Adenoviral infections are notorious for causing persistent or even permanent light sensitivity, reduced vision, irritation and contact lens intolerance. Most likely you have developed a transient dry eye as a result of the condition and/or inflammatory deposits on your cornea. In these cases, it is often useful to begin aggressive treatment for dry eyes using cyclosporine or a steroid. It is best to have a cornea specialist evaluate you.
Melissa from Egg Harbor Township asks: I want to know if my kids are having allergy issues or pink eye. my son has had mucus in his eyes for 2 days, but his eye isnt swollen or pink yet.
Usually, allergic conjunctivitis (pink eye) is characterized by a bilateral (both eyes), watery, red eye with significant itching. Infectious conjunctivitis tends to have more thick discharge and the eyes are more likely to be stuck shut in the morning. Swelling of the lids is a nonspecific symptom and common to both conditions. However, infectious conjunctivitis would not be expected to present without signficant redness along with the discharge. Dry eyes or mild allergies can produce a small stringy discharge and can present without much redness. Without progression to a significant red eye, it is more likely to be allergic, especially if there is any associated itching.
Laurie from Long Beach asks: I have sensitive red eyes all the time (I'm 40). A few days ago one I woke up with one eye super red and it began to ache as the day went on. I started using my kids pink eye drops (polymixin B sulfate and trimethropin ophthalmic solution). It seemed to be helping but last night it got uncontrollably itchy and I woke up this morning after 3 days and it was little crusty/gooey and more red than ever! Should I stop the drops? Can I do more harm with them? It's Mothers day too :( Thanks.
Usually the clinical story of chronic red, burning or irritated eyes suggests an underlying problem such as dry eyes. Significant itching is the hallmark of allergies. The initial improvement you experienced using the "pink eye" drops was likely related to their lubricating effect. Typically, medication allergies or toxicities develop after a few days and is consistent to your description. I recommend stopping your child's medication and simply using preservative free tears. If there is no improvement over a few days, you should see an eyecare professional for an evaluation.
Diana from Ontario asks: My two youngest kids had pink swollen eyes with a yellow discharge. I gave them an over the counter pink eye drop. They got all better in about three days. Their eyes returned to normal. Two days later my son's eyes went pink again but in a different way. There is no discharge or swelling. The white of his eyes are sort of a uniform salmon colour with no swollen veins. It looms quite strange. What do you think it is? He is four years old.
If both children had the same condition, it is much more likely to be an infectious process. However, an underlying "salmon color" denotes other possibilities. I suggest he get this examined by an eyecare professional.
Janette from Ohio asks: My pink eye symptoms presented on April 22nd. I began using tobramycin antibiotic drops on April 23rd as prescribed by a doctor the same morning. By the end of the day on the 23rd my eyes looked and felt normal. I continued using the drops as prescribed until April 27th when I put new contacts in. I woke up on April 28th with symptoms again. I used by drops religiously again until May 5th. I put new contacts in on the 5th and had no symptoms whatsoever until I woke up on May 11th with worse symptoms then my previous. I got new eye drops, Maxitrol, and am using them as prescribed, every 8 hours. My symptoms have lessened but are still present. Today is May 14th. Is it possible I'm resistant?
Contact lens use complicates the diagnosis of pink eye. In most cases, patients with a history of contact lens use who develop an irritated red eye, the signs and symptoms are related to contact lens overwear, a tight fitting contact lens, dry eyes, or a corneal related problem. Most likely it is not pink eye at all. You probably improved initially with tobramycin just because you were out of contacts and not because of the medication, hence the reason the symptoms returned as you began using contacts again. I suggest that you visit an eyecare professional to evaluate the fit of your contact lens and to make sure no underlying corneal deposits exist.
Lisa from California asks: I recently went to the ER because I thought I had a stye in my eye. I accidentally scratched it and it swelled up. When the doctor was ready to see me, she said there was an abrasion that's why it swelled up. She did some eye test on me with a black light, she didn't say much except that she was going to get an antibiotic eyed drop for me. When the nurse came in, not the doctor, she told me the doctor thought that I might have conjunctivitis. I don't have pink/red eyes, but the inner corner of my eyes are inflamed. Could it be possible that I have pink eye anyway, despite the fact that my eyes are as clear as day? Also note, they water a lot!
It is unlikely that you have pink eye without significant redness. An abrasion could explain swelling of the eyelid and tearing but is typically accompanied with significant pain and tearing. Also, an abrasion would not explain bilateral inflammation in the inner corner of your eyes. Often this type of swelling of the medial canthus (inner corner) is more allergic and typically itches. A trial of an antihistamine may work. Also, dry eyes can cause inflammation and irritation of this same area and lead to tearing. A trial with artificial tears usually works to alleviate those symptoms.
Brittany from Colorado Springs asks: Hi. Both my eyes are very red and swollen. They both have a yellow Goo coming out of them. When I wake up my eyes are like Goo and crusted shut. Sometimes my vision gets kinda smoky or cloudy but niether of my eyes itch. They both just kinda hurt. Is this pink eye? Or something else? I've had pink eye before but its never felt like this.
Pink eye caused by either a virus or bacteria, is associated with discharge and eyelid crusting. Itching is more of the hallmark for allergic conjunctivitis. If this is an acute condition, less than a week, it is likely pinkeye. However, if it is a chronic condition, off and on for weeks, then it may represent an underlying dry eye or other inflammatory state. If it persists more than a week or is associated with significant pain or vision loss, you should see an eyecare professional as soon as possible.
Katie from Illinois asks: Recently I went to the eye doctor. because my eyes were feeling itchy and had clear discharge crusting around the edges and hurt, however my eyes were not pink. The doctor said it was bacterial pink eye and gave me tobramycin to take 4 times a day for 3 days. I'm now on day six and my eye is still discharging and feels a little swollen. Should I keep taking the antibiotics? I haven't worn contacts in a week. (To preface this I do wear daily disposable contacts and I had severe pink eye twice, once in november when I had pneumonia and once two years ago when I got mold from a basement in my eye.)
Usually when someone is a contact lens wearer and they get a red, irritated eye, it is most often related to the contact use. Most bacterial conjunctivitis (pink eye) resolves or shows significant improvement by day 5 of treatment. It is possible that you have a viral condition which would explain the ineffectiveness of the antibiotic, but most likely it is related to contact lens use; either from dry eyes made worse by the contacts or contact lens overwear. It is worth having an eye care professional examine your cornea.
Amanda from Ohio asks: My husband went to the ophthamologist today. The doctor told my husband he had a viral infection in his eyes and then prescribed him maxitrol which says not to use for viral infections? Should I call the doctor and ask why or just give him the drops?
Some doctors give an antibiotic/steroid combination like Maxitrol to treat a viral infection because the steroid reduces inflammation and may make the eye feel better. Although there is symptomatic relief, it is not a good practice because steroids cause Adenovirus (the most common virus to cause pink eye), to become more infectious, and can lead to spread of the disease. Second, if the virus causing pink eye is Herpes Simplex Virus, the steroids may cause the infection to worsen and progress to a vision threatening corneal infection. Antibiotics are not effective against a viral infection.
Amanda from Lebanon asks: My son's sclera in both eyes is very red and irritated-looking. There is NO discharge or secretions and he does not seem bothered by it. I started administering drops for pinkeye as precaution but this actually seems to further irritate and hasn't helped.
Typically pinkeye is associated with a red eye and some form of irritation and discharge. Another condition called episcleritis causes a red eye without the discharge and discomfort. The treatment is different. Some pinkeye treatments contain active ingredients or preservatives that can cause irritation. Try using preservative free tears. If there is no improvement after a few days, he should be seen by an eyecare professional.
David from Pocono, PA asks: I have the following symptoms in ONE (right) eye. Began Monday, June 13 with minute crusty discharge on lids. Since then, the following: tearing, thin yellowish discharge, puffy or swelling of upper and lower lids, a bit of discomfort. What I do NOT show signs of: no fever, vision is not affected, other than tearing I am not sensitive to light. I have been flushing eye with a cold honey and water mixture. I am also flushing with contact all purpose solution. NO, not wearing contacts. I am assuming it is pink eye. Should I use cold or warm compresses? How should I treat it? Thank you, David
In general, the symptoms you are experiencing are very nondescript. Without a significant red eye, it most likely is inflammation of the eyelid called blepharitis. This condition is even more common in patients with a history of Rosacea. I would avoid placing any honey or other home remedies in the eye. Using preservative free articificial tears several times daily along with warm compresses would be a good first step. If you develop pain, decreased vision, or the current symptoms persist more than 1-2 weeks, you should be examined by an eyecare professional.
Patricia from Seattle asks: My daughter woke up to gooey, red, swollen, crusty eyes....what over the counter medicine should I get?
Since many conditions may present with crusty eyes a good first step is to simply try over-the-counter preservative free tears 4-6 times daily along with warm compresses a couple times a day. If the crusting persists beyond a week or she develops pain, decreased vision, or a significant red eye, then she should see an eyecare professional.
Crystal from Trinidad asks: My 3 year old has a cold where the mucus is a yellowish colour, about 3 days ago that same yellowish mucus began to come from the corners of his eyes. He has no pain and the eyes are not swollen. Should I take him to the doctor or should I wait a few days to see if it clears up? I have cleaned the eyes with unscented baby wipes. Should I be worried?
Normally, tears drain into the nose through two tear ducts. It is not unusal to get crusting at the corners of the eye during a cold because the lining of the nose swells and compresses the tear drainage ducts and this leads to a little reflux back into the eye. As long as there is no pain, vision loss, or a very red eye, it can be watched for a few days. Artificial tears may help. If there is no improvement, you should seek attention from an eyesore professional.
Seraphim from Oregon asks: I was diagnosed with bacterial pink eye 8 days ago in the left eye and given polymyxin b sulfate and trimethoprim drops. I am supposed to stop using them today, but my eye has not improved.In fact, the drops almost seem to make things worse. When I went to the doctor I had been tearing for hours with light sensitivity and redness, no itching. After using the drops for two days the tearing and light sensitivity left. The next five days I experienced a tiny amount of white crusting in the morning and redness. When I take the drops my eye starts burning, itching, and leaking. I am also having seasonal allergies, so its making it hard to determine what is going on. Should I continue the drops for longer than told to? Do I need to go back to the doctor? Is it possible my pink eye is gone and I'm just having normal seasonal allergies that are further irritated by the drops?
Usually bacterial pink eye does not present with significant light sensitivity. However, after using the drops it sounds like both the light sensitivity and tearing improved suggesting a positive response to the drop. Pink eye often induces a component of dry eyes that is transient and likely is causing the morning crusting. By 1 week, any bacterial infection should be resolved. A trial of the polytrim drops and just using artificial tears every 4 hours should make you feel better over the next 1-2 weeks until the eye recovers. If you develop worsening pain, decreased vision, or significant light sensitivity, you should see an eyecare professional.
Tierany from Lebanon, PA asks: I was diagnose with strep throat yesterday and began my antibiotics (amoxicillin) a little over 24 hrs ago. This morning, I woke to my left eye completely crusted shut and a large amount of yellow-green discharge in the right eye. Earlier this evening, I noted redness in my right eye that quickly spread from the inside corner to the whole eye. I thought it was from the coughing bouts I've had, but I'm wondering now if it's pink eye, considering what I woke up with. I've never had it before and have no other symptoms. Can strep and pink eye be connected? And if it is pink eye, will the amoxicillin treat it or will I need drops?
Usually the type of Strep that causes Strep throat (Group A hemolytic Strep) does not cause pink eye. Adenovirus and Coxsackie virus however, are notorious for causing both pink eye and a sore throat. However, Adenovirus would not cause a rapid Strep Test to be positive. It is possible that there is a bacterial (Strep) and viral co-infection but it is less likely. Strep is exquisitely sensitive to amoxicillin. If you have Strep throat or pink eye related to strep, it will get better in a few days. If you are not better in 2-3 days, I would question the original diagnosis or think more about a co-infection.
Jill from Minnesota asks: If I use the antibiotic drops for pink eye more often than the prescribed 3x per day, like 8x per day, will the pink eye clear up sooner?
The half-life of the medicine allows the right concentration of the antibiotic to remain in the tears and penetrate the conjunctiva (lower eyelid) to kill the bacteria. More frequent use of the antibiotic will not accelerate the killing if the therapeutic level is already achieved.
Molly from New Jersey asks: I first got pink eye two weeks ago. I went to the doctor and he prescribed me antibiotic eye drops to take 4 times a day for 7 days. After 7 days, the pink eye was completely gone but in the mornings I had a little crisp in my eye. I stopped taking the eye drops because I completed my 7 days. But the next day it started coming back very slightly and I had more crust in the morning. So I took the eye drops for another day and the next day it was better again so I stopped. Then the next day after that it there was more crust in the eye again. Should I continue my antibiotics for another 7 days? Is it bad if I do?
The morning crusting is usually related to some persistent inflammation and not necessarily related to an ongoing infectious process. Sometimes pink eye can cause a transient dry eye that increases the crust. It is possible that the antibiotics are simply acting as a lubricant. It would be unlikely for you to have a bacterial pink eye that was not responsive by 7 days. I suggest that you try frequent artificial tears and not continue the antibiotic. Most likely it will gradually improve over the next week or two. If you develop decreased vision or pain, then you should see your doctor.
Jen from San Diego asks: Hi! I have had pink eye now for 2 weeks. Initially we attempted cipro drops for 5 days though the eye doctor thought the pink eye was viral in nature. I went back to the doctor and they stopped the drops and had me buy OTC preservative free lubricating drops to help with my swelling (which is my biggest complaint). After 5 days and very little decreased swelling, I called the doctor to update him as I was asked to and I was just ordered Vigamox drops, which are usually for bacterial infections. Why would these have been ordered if the cipro didn't help? Does Vigamox have an underlying use to help swelling? My eye is so sensitive that I wear my sunglasses to watch TV and even then it is hard to keep it open. I'm also 5½ months pregnant so maybe that's why it's taking forever?
Antibiotics are ineffective against a viral infection which would explain why cipro would not work. Vigamox is a stronger antibiotic that has no anti-inflammatory properties and still won't work against the viral form of conjunctivitis (pink eye). If you have viral conjunctivitis, the best measures are supportive treatments with preservative free artificial tears. In some cases, antiviral medications may be indicated to accelerate healing. By two weeks, you are outside the efffective time period for the antivirals.
Nancy from San Marcos, Texas asks: My name is Nancy and I got pink eye Friday when I was cleaning the bathroom. Then the next day I was worried, so I bought Similasan Pink Eye Relief, and put it on every 2 hours. I also put a green tea bag on my right eye where I have pink eye but my mom said it only got worse. I’m only 11 and I feel like going to the Emergency Room. If you could help me please?
Pink eye is usually caused by a virus or bacteria. Typically you rub your eyes after coming into contact with the virus. If you were cleaning the bathroom, this sounds more like a chemical pink eye. Sometimes the fumes or accidentally getting cleaning fluids into your eyes can cause them to be very irritated. Using artificial tears is very good. If the chemical burns your cornea, you will experience pain and tearing. If this is the case, it is important to make sure that the eye does not get infected and if you are not better in 2 days, you should see an eyecare professional. Occasionally, viral pink eye starts suddenly, and this may have coincidentally occurred while you were cleaning the bathroom. Viral pink eye is highly contagious and you would want to know if you have this infection. Typically, a viral infection will start in one eye and then spread to the other several days later. The RPS Adeno Detector could rapidly differentiate these two conditions. Perhaps your primary care doctor or the local retail health clinic has access to these tests.
Michelle from NYC asks: I was diagnosed with bacterial pink eye 10 days ago. I took the eye drops as directed for 8 days and it immediately cleared up and got better. The day after I completed my treatment, I put in my contacts as usual. By the end of the day, my contacts started to feel itchy. Then little by little, my vision became cloudy due to yellow discharge. And over night, eyes crusted shut. Does this mean that the pink eye came back, didn't go away, or what? I absolutely hate wearing my glasses and just want to feel normal again. How safe is it to continue the drops? Thoughts?
Most likely you never had infectious pink eye at all. You probably got better from a combination of being out of the contact lenses and the lubrication provided by the antibiotic drops. It is very common for contact lens intolerance, usually related to poor fitting contacts, dry eyes, sleeping in them, or excessive wear, to mimic conjunctivitis. I suggest that you see your eye care professional to determine if the contact lens fit is appropriate, if you have significant dry eyes, or have a mild keratitis (inflammation of the cornea).
Angelica from Michigan asks: I've never had pink eye before but for the longest time I have had red itchy eyes and frequent yellow goo stuck to the insides of my eyelids and on my eyeballs. Sometimes it will be one eye or both and it always swells up. Is this some sort of long standing form of a slightly less serious pink eye? I do have allergies but I wanted to clarify that I shouldn't be worried about infection.
Most likely it is blepharitis, an inflammation of the eyelid that leads to itchy and burning eyes by causing a secondary dry eye. Try using warm compresses and using frequent artificial tears. Allergies certainly cause itchy eyes but it is usually bilateral and associated with a stringy white discharge and watery eyes. It does not sound like a chronic infection but if it persists or you develop pain or a change in vision, you should see an eye care professional.
Tim from Indiana asks: Hello, I began having pink-eye like symptoms six days ago. One eye is extremely swollen and extremely bloodshot; to the point that there is no detectible white area in the affected eye. I saw someone at an urgent care center three days after symptoms began. He prescribed an antibiotic (ciprofloxacin) and an anti-inflammatory (ketorolac tromethylamine). I have discontinued the use of the anti-inflammatory due to severe pain upon application, but have continued the use of the antibiotic. I believe the pink eye is viral, however it has not been confirmed and the symptoms have not improved over the six day period. Two questions; first should I be worried this is being caused by something other than viral pink eye, and second should I still be attending my summer classes?
Viral pink eye, especially when caused by adenovirus can be very aggressive. It does not respond to antibiotics and generally causes significant swelling. It is also highly contagious. During the first 7 days, it can be confirmed by a rapid test, the RPS Adeno Detector. Caught during this time, antiviral treatment can often reduce the duration and extent of the illness. After 7 days, the virus becomes less infectious but the symptoms can persist for 2 weeks because of a secondary inflammatory response. If you have viral conjunctivitis, you should be continuously washing your hands and disinfecting your house with dilute bleach solutions. A positive rapid test would confirm that you are likely still contagious.