Conjunctivitis is an inflammation of the membrane covering the inside of your eyelids and the outer part of your eye. Commonly called "pink eye," conjunctivitis is generally not serious but can be highly contagious.

Conjunctivitis causes the following symptoms in one or both eyes:

• Redness and tearing
• Itching
• Swollen eyelid
• Discharge (watery or thick)
• Crust that forms overnight
• Sensitivity to light
• Gritty feeling

Conjunctivitis is most often the result of viruses, such as those that cause the common cold. Other causes can be bacterial infections, allergies, chemicals, irritation from contact lenses, or eye injury. Viral and bacterial conjunctivitis are very contagious.

If you have conjunctivitis in both eyes, with itching and a clear discharge, allergies are likely the cause. Swollen glands and a clear or mucous usually indicate a virus, while a thick, crusty discharge is a sign of a bacterial infection.

Your health care provider may use a lamp for closer examination, or gently swab a stain across the surface of your eye. They may test your vision or measure the pressure in your eye, to rule out glaucoma.

Conjunctivitis is generally not a serious problem and often will go away by itself. You should still, however, consult your health care provider. Chronic conjunctivitis, if left untreated, can cause permanent eye damage.

Treatment varies according to the cause of inflammation. Bacterial conjunctivitis is generally treated with antibiotics. Forms of conjunctivitis caused by viruses do not respond to antibiotics, but antihistamines and anti-inflammatory medications may help relieve your symptoms. Cool compresses may help reduce itching and swelling.

Drug Therapies

• Viral conjunctivitis: Cool compresses three times daily for 1 - 3 weeks. You may also use antihistamines to relieve inflammation. Trifluridine 1% drops, every 2 hours. You may also need oral or topical acyclovir.
• Allergic conjunctivitis: Avoid contact with allergen. Treat with cool compresses, over-the-counter or topical antihistamines, NSAIDs (particularly ketorolac), and possibly mild corticosteroids.
• Bacterial conjunctivitis: Trimethoprim sulfate and polymixin B sulfate drops, 1 drop 3 times daily for 1 week, or polymixin B-bacitracin ointment. Fluoroquinolones as second-line therapy. Tobramycin (0.3%) or gentamicin as drops, or 10% sodium sulfacetamide as drops, every 4 hours.

Complementary and Alternative Therapies

Alternative therapies can help relieve your symptoms. You must, however, be careful that any solution or compress you put on your eye is sterile. Remember, too, that you can spread conjunctivitis from one eye to another, so avoid your other eye while treating the affected eye. If you have a mild case of conjunctivitis, begin with compresses. For a moderate case, use a compress and an eyewash. Many people find relief with a boric acid eyewash or compress. Boil 1 tsp. boric acid in 1 cup water, cool, and apply with a sterile eyecup or washcloth.

Nutrition and Supplements

Doses listed are for adults. Decrease by one-half to two-thirds for children, at the recommendation of a health care provider.

Vitamin A (10,000 IU per day), vitamin C (250 - 500 mg two times per day), and zinc (30 - 50 mg per day) strengthen your immune system and help you heal faster.

Herbs

Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Compresses and eye washes are external treatments. You can make a compress with a clean cloth, gauze pads, or cotton balls soaked in a solution and then applied over the eyes. You can apply eye washes with an eye cup or a sterile dropper.

Compress: Use five drops of tincture in ¼ cup boiling water or steep 1 tsp. herb in 1 cup boiling water for 5 - 10 minutes, strain, and cool. Soak cloth or gauze in solution, and apply over the closed eyes for 10 minutes, three to four times a day.

• Eyebright (Euphrasia officinalis): helps fight infection and dry up excess fluid.
• Chamomile (Matricaria recutita): helps fight infection.
• Fennel seed (Foeniculum vulgare): helps fight infection.
• Marigold (Calendula officinalis): soothes irritation.
• Plantain (Plantago lanceolata, P. major): astringent and soothing. The fresh leaves are the most effective plant part.
• Flaxseed (Linum usitat issimum): as a soothing poultice made with 1 oz. of bruised flaxseed steeped for 15 minutes in 4 oz. of water, wrapped in cheesecloth, then applied directly to the affected eye.
• Grated fresh potato has astringent (drying and disinfecting) properties. Wrap in cheesecloth and apply.

Use above herbs singly or in combination: Mix equal parts together then steep 1 tsp. herb in 1 cup of boiling water to make a tea. Cool before administering to the eye.

Eyewash: goldenseal (Hydrastis canadensis) and boric acid: 10 drops of goldenseal tincture with 1 tsp. of boric acid in 1 cup of boiling water; strain, and cool.

Homeopathy

Although very few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of conjunctivitis based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account your constitutional type -- your physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual.

• Euphrasia -- for conjunctivitis with large volumes of watery tears that burn the face and may in time become a thick discharge. Despite the production of watery tears, the individual may complain of a dry, gritty sensation in the eyes.
• Argentum nitricum -- for red, swollen eyes with pus-like discharge and splintering pains.
• Pulsatilla-- for conjunctivitis with yellow-green discharge and itchy eyes that may accompany or immediately follow a cold. The eyelids tend to stick together, and symptoms generally improve with cold compresses. This remedy is most appropriate for individuals who tend to be irritable and have mood swings.
• Belladonna -- for the first stages of conjunctivitis, including the sudden onset of burning, bloodshot eyes, swollen eyelids, and hypersensitivity to light. The eyes are generally hot and throbbing to the touch.
• Sulphur -- for burning, pain, and redness of the eyes accompanied by a yellow discharge with foul odor. The eyes are often crusted together, and the individual is usually very hot and thirsty.
• Apis mellifica -- for red, burning eyes and excessive swelling that feel better with cold applications.

Acupuncture

Treatment may be administered for pain relief and relieving congestion.

Viral and bacterial conjunctivitis are both very contagious. Family members should use separate towels. Wash your hands often. Children should generally be kept home from school and day care.

Be sure to follow your health care provider's advice about using any medications, particularly if you have been given antibiotics or corticosteroids. If you wear contact lenses, keep them clean to avoid further irritation and future infections. Do not wear them until your eyes have healed.

People with allergy-related conjunctivitis sometimes develop a severe form with a stringy discharge, swollen eyelids, scaly skin, and significant discomfort. This needs aggressive treatment to prevent scarring of the cornea.

In most U.S. hospitals, medication such as silver nitrate is routinely administered to the eyes of newborns to prevent conjunctivitis from developing from bacteria in the birth canal.

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