‘Tis the Viral Pink Eye season!
As always, we are not big fans of the elusive term “pinkeye” but rather prefer the more accurate term “conjunctivitis” or inflammation of the conjunctiva (transparent skin covering the white part of the eye and inside of the eyelids). Regardless of the terminology, the why and how of the inflamed or infected eye is most important in determining a course of action.
Although there can be many causes of conjunctivitis, this time a year and especially in the last few weeks, we have seen a jump in cases of viral conjunctivitis which are often associated with upper respiratory congestion, fever, swollen lymph nodes, sore throat and other common cold symptoms. As all of our mucous membranes are connected, the initial viral infection can sometimes start in the eyes and spread to the upper respiratory system or vice versa. Either way, these viral infections can be extremely contagious!
There are several types of viral conjunctivitis and one of the most common strains currently making its rounds is called EKC, short for Epidemic KeratoConjunctivitis (one of the longest eyeball terms that we use!). EKC is usually caused by a member of the adenovirus family which has many aunts, uncles, and cousins within its lineage. As its name suggests, E(Epidemic) KC tends to be more catching and often causes more severe conjunctivitis than many other strains of viral conjunctivitis.
EKC and other forms of viral conjunctivitis do not respond to antibiotic treatment, however antibiotic eyedrops drops are unfortunately often prescribed for any and all types of conjunctivitis. When used for EKC or other viral conjunctivitis, antibiotic drops can actually increase the conjunctival redness and irritation.
So, what to do??
Proper diagnosis of viral conjunctivitis is the key to proper treatment. To an “untrained eye,” viral conjunctivitis can easily be confused with bacterial or allergic conjunctivitis, contact lens related conjunctivitis, or an environmental conjunctivitis. Unfortunately your local urgent care or general medicine practitioners do not have the equipment to properly evaluate and distinguish between the different types of conjunctivitis. Hence, if you are having an eye problem, see an eye doctor (Dr. Steve and Dr. Sarah) properly equipped and trained in diagnosis and treatment of all forms of conjunctivitis.
Viral infections usually “run their course” but during their course they can often cause a huge immune system response resulting in excessive eye redness, inflammation, swelling, decreased vision, etc. which can linger for weeks or months. After a proper viral conjunctivitis diagnosis has been made, treatment usually involves oral decongestants, cold compresses, preservative free lubrication drops and usually steroid (ex. Prednisone, Dexamethasone) eyedrops which can be very effective in reducing inflammation and preventing a long recovery. However, steroid eyedrop use requires close monitoring by an eye care professional. With proper care and treatment, most cases of viral conjunctivitis and EKC resolve within one to three weeks.
Another common question we are asked since 2020 is to what extent Covid 19 can cause viral conjunctivitis. In our experience and in most studies there have been very few cases of Covid 19 resulting in conjunctivitis – which is good! The older, more well-traveled viruses that we have faced for many years (millennia) seem to cause more eye involvement than any variant of Covid 19.
Please let us know if you have any questions regarding any type of pink eye or conjunctivitis.
Thanks for reading!
Dr. Steve and Dr. Sarah