Disease Description (Causes and Symptoms)
- Definition: Inflammation of the conjunctiva (the mucous membrane covering the surface of the eye and the inside of the eyelids), commonly causing redness (red eyes), discharge (eye crust), itching·burning·foreign-body sensation, tearing, and light sensitivity/glare.
- Main causes: Bacteria (common bacteria, gonococcus), viruses (such as adenovirus), chlamydia, herpes simplex virus (HSV), fungi·parasites, allergies (including atopic allergies), and irritants (chemicals, dust, ultraviolet light).
- Overview of pathophysiology: When a pathogen (or antigen) invades the conjunctiva, local inflammation and vasodilation occur, along with mucous·purulent discharge. Some pathogens (e.g., adenovirus, gonococcus, HSV) can invade not only the conjunctiva but also the cornea, causing keratitis·ulcers and posing a risk of vision impairment.
- Clinical findings: Eye redness, discharge (watery/mucoid, like clear watery tears, or purulent), eye crust (worse in the morning), itching·pain·foreign-body sensation, and sensitivity to light. The pattern of onset, nature of the discharge, and accompanying symptoms (e.g., whether an upper respiratory tract infection is present) vary depending on the cause.
Treatment Methods (Standard Treatment · Precautions · Self-Care)
- General principles
- Identifying the cause is important: Treatment (antibiotics, antivirals, antiallergic agents, etc.) varies depending on the cause.
- For mild cases (nonspecific·viral), conservative treatment and observation are standard.
- Immediate ophthalmology care is needed for severe symptoms, corneal involvement, reduced vision, or high-risk groups such as contact lens wearers·newborns·immunocompromised individuals.
- Medication treatment (general examples)
- Bacterial: Topical antibiotic eye drops (broad-spectrum antibiotic eye drops/ophthalmic ointment). For contact lens-related cases or concern about Pseudomonas aeruginosa, a potent antibiotic (e.g., a fluoroquinolone) may be selected. If gonococcal infection is suspected, systemic antibiotics (e.g., a single-dose/short-term injectable or oral regimen recommended by a doctor) and hospitalization may be considered.
- Chlamydia: Systemic antibiotics (a single dose of azithromycin or doxycycline, etc.) + topical management (as directed by an ophthalmologist).
- Viral (adenovirus): Symptomatic treatment (artificial tears, cold compresses) and hygiene management. Additional ophthalmologic treatment is needed if there is corneal involvement (punctate epithelial lesions).
- Herpes simplex (HSV): Antiviral medication (oral acyclovir, etc.) and topical ophthalmic antiviral treatment (as directed by an ophthalmologist).
- Allergic: Topical antihistamine/anti-inflammatory (nonsteroidal)·maintenance mast-cell stabilizers (olopatadine, ketotifen, etc.) and artificial tears. In severe cases, a specialist may consider topical steroids (under the direction of an ophthalmologist).
- Newborns: Tests such as bacterial culture and Gram staining are performed. Erythromycin ointment is used as a general prophylactic eye medication. If gonorrhea is suspected, systemic antibiotics (e.g., ceftriaxone or as directed) and inpatient treatment through collaboration between pediatrics and ophthalmology.
- Procedures/surgery: Generally unnecessary. Surgical treatment may be considered if complications such as chronic conjunctival scarring or lacrimal sac·tear duct problems occur.
- Precautions and contraindications
- Do not use steroid eye drops without the direction of an ophthalmologist (risk of worsening infection·corneal ulcer).
- Remove contact lenses immediately and do not use them until diagnosis·treatment are completed. Disinfecting·replacing the lens solution and case is also recommended.
- Prevent transmission through hand hygiene and separate use of personal items (towels, pillows).
- Self-care
- Relieve symptoms with cold compresses (for allergies·swelling) or warm compresses (to remove eye crust or when blocked).
- Relieve irritation with artificial tears.
- Visit an ophthalmologist immediately if symptoms worsen (reduced vision, severe pain, marked light sensitivity, high fever, persistent purulent discharge, etc.).
Checklist Before an Outpatient Visit (Items to Prepare · Information Helpful for Medical History — Including Example Questions)
- Items to prepare/record
- Date symptoms began and their progression (including whether fever·upper respiratory symptoms are present)
- Nature of the discharge (clear/mucoid/purulent), changes during the day, and whether there is eye crust in the morning
- Recent eye drops·oral medications taken (especially antibiotics, steroids) — medication name·dose·start date
- Whether contact lenses are used (type·time last worn) and lens-care habits
- For newborns, delivery history (the mother’s history of sexually transmitted infections, whether prophylactic medication was administered)
- Photos (if possible) — photos taken early in the symptoms can help with diagnosis
- Whether an immunosuppressed state is present (diabetes, HIV, long-term steroid use, etc.)
- Things to do before the visit
- Remove the lenses and bring them with the case (for testing if necessary)
- Bring any eye drops/ointments currently being used to the hospital
- If symptoms are severe, make an emergency visit or ophthalmology appointment immediately
- Information useful to tell the doctor in advance at the visit (examples)
- “When did the symptoms start, and how did they begin?”
- “Is there anyone in your family, school, or workplace with the same symptoms?”
- “Have you worn contact lenses recently? How do you clean·store them?”
Examples of General Questions to Ask the Doctor
- What are the common side effects of this medication (prescribed eye drops/oral medication)? What adverse reactions should I watch for?
- When should the symptoms normally start to improve? When should I return if there is no improvement?
- How long is the contagious period? When can I return to work/school?
- What hygiene·care measures should I follow at home (towels·pillows·handwashing, etc.)?
Examples of Condition-Specific Questions
- Which type is suspected for my conjunctivitis—bacterial, viral, or allergic? Are additional tests (culture, PCR) needed?
- When can I wear contact lenses again? How should I handle the lenses and case?
Brief prognosis summary: Most people recover without complications with appropriate treatment and hygiene management, but ophthalmology care is important for newborns·contact lens users·cases with corneal involvement because of the risk of serious complications such as reduced vision.