Red, watery, matted shut in the morning, and just uncomfortable. "Pink Eye" as we so affectionately label an infection or inflammation of the eye, is so common this time of year. But for such a common ocular ailment, it is surprising how little the average person really knows about it. For curious minds, here is what you are really dealing with:
“Pink Eye” is a slang designation, typically used to refer to any type of conjunctivitis.
Far and away the most common culprit is a virus, but bacterial and allergic conjunctivitis are also causes of a red, irritated eye that a trained eye care specialist will be able to detect.
Here's the thing about viral conjunctivitis: there is NO treatment that is curative.
That's right, when you go to a primary care doctor and they prescribe sulfacetamide, erythromycin or polytrim, those are antibiotics, and you have a virus. Do you know what an antibiotic does against a virus? Nothing.
Most patients that go to a walk-in clinic, or even their primary care provider are prescribed a low-strength, generic antibiotic for their viral conjunctivitis, and they aren't really educated as to why the doctor is writing this Rx. The antibiotic won't kill the viral infection. But your the doctor doesn't have any medicine they can give you anyway, and antibiotics are cheap. The thought is that “it can't really hurt”*, and they don't have anything that can really help.
*This idea of "not hurting" though is debatable with all the recent data of antibiotic resistance, but I digress.
If you see an eye care specialist for viral conjunctivitis, you won't be getting an antibiotic prescription.
What would really work better is a steroid eye drop at relieving the symptoms, and this is what I typically prescribe if my patients want an Rx to feel better faster. Steroids won't get rid of the virus either, but at least it lessens the redness and crusting so your eyes feel more normal. You will still be infected, and still be contagious (just as you are if you use an antibiotic drop), but your eye will feel better because it is less inflamed.
OTC treatments can be helpful, but not all of them are equally helpful.
Over -the-counter (OTC) moisturizing drops are a non-aggressive treatment option, used to simply flush viral cells off the eye. You can use any over-the-counter moisturizing drop, but I especially like preservative free tears due to their lack of toxic preservatives that could further irritate the eye.
Some patients may think of buying an OTC "pink eye" drop like Similasan. Similasan is just a lubricating drop with a small amount of vasoconstrictor action (shrinks the appearance of blood vessels temporarily) achieved with a belladonna extract . Yes, belladonna, so that means if you get an enlarged pupil while using this stuff you used enough to actually dilate your eye. Again, it will not treat the virus. It just moisturizes your irritated eye and superficially makes your redness decrease (temporarily) by shrinking the diameter of the blood vessels on the eye's surface.
I personally like preservative free artificial tears better than these "red eye relief" drops that are misleadingly packaged with a "pink eye" label as if they were some sort of treatment, because at least with preservative free lubricants there are no irritants or dilators on board that could make your eye feel worse.
If you are a contact lens wearer, it is best to avoid lens wear while you are infected.
Not just for your own comfort but because bathing the contact lens in viral cells all day long, will lock those viral cells against your eye's surface with nowhere to go, and will just keep you infected longer.
Only a trained doctor with the correct equipment to examine the eye can differentiate your conjunctivitis from viral, bacterial, or allergic.
There are many other things that can cause the eye to become red and inflamed like uveitis (inflammation inside the eye), episcleritis, contact lens side effects, and foreign bodies. A trained eye doctor with a special microscope called a slit lamp can differentiate between the various causes of an inflamed eye. The treatments for these different types of "pink eye" are vastly different, so I can't encourage you enough to be seen by an eye care professional who can get your eyes back to normal and healthy as fast as possible.
So, the next time your eye is “pink”, red, or irritated…see your friendly neighborhood Eye Doctor.
Wishing you good health,
Dr. Amy