When 'Pinkeye' Becomes Red Eye
Twice this week I've seen patients with simple viral pink-eye. It's usually caused by the same virus that causes the common cold, hence the expression 'cold in the eye'.
When it came time to counsel and discharge the patients they both asked, "What about the antibiotics?" Each had been referred to my clinic by an outside provider who was not an ophthalmologist, and both had already been prescribed an expensive, broad-spectrum antibiotic eyedrop. Hmmm...should I continue the use of antibiotic eyedrops for viral pink-eye?
The concern is superinfection, a second bacterial infection piggybacked on top of the viral infection.
I do not find the specter of superinfection persuasive and usually do not superprescribe antibiotics. Healthy folks with an uncomplicated common cold usually do not start taking Amoxicillin or Zithromax, right?
Most healthy folks have an intact immune system, that's how they got pink-eye in the first place! The same inflammatory cells mobilized to attack a virus will pounce on a bacteria with even greater ferocity. Compared to viruses, bacteria are huge, clumsy targets.
I also worry about something called medicomentosa. All eyedrops sting when applied to inflamed eyes. The chemistry of antibiotics are especially prone to further irritate the eye, making it appear even more inflamed. Should the patient return to clinic 2 days later with an intensely red eye it could be difficult to determine with confidence its true cause - it might simply be a reaction to the antibiotics eyedrops. It often is!
Contracted a case of viral pink-eye? Wash your hands frequently, avoid contact with others, and use preservative-free artificial tears to keep the eye comfortable. Things should resolve (just like a cold) in 5-7 days.
Related Topics: Antibiotics: Good Choice for Pinkeye?, Back-to-School Health Checkup
Technorati Tags: pinkeye, antibiotic eyedrops
When it came time to counsel and discharge the patients they both asked, "What about the antibiotics?" Each had been referred to my clinic by an outside provider who was not an ophthalmologist, and both had already been prescribed an expensive, broad-spectrum antibiotic eyedrop. Hmmm...should I continue the use of antibiotic eyedrops for viral pink-eye?
The concern is superinfection, a second bacterial infection piggybacked on top of the viral infection.
I do not find the specter of superinfection persuasive and usually do not superprescribe antibiotics. Healthy folks with an uncomplicated common cold usually do not start taking Amoxicillin or Zithromax, right?
Most healthy folks have an intact immune system, that's how they got pink-eye in the first place! The same inflammatory cells mobilized to attack a virus will pounce on a bacteria with even greater ferocity. Compared to viruses, bacteria are huge, clumsy targets.
I also worry about something called medicomentosa. All eyedrops sting when applied to inflamed eyes. The chemistry of antibiotics are especially prone to further irritate the eye, making it appear even more inflamed. Should the patient return to clinic 2 days later with an intensely red eye it could be difficult to determine with confidence its true cause - it might simply be a reaction to the antibiotics eyedrops. It often is!
Contracted a case of viral pink-eye? Wash your hands frequently, avoid contact with others, and use preservative-free artificial tears to keep the eye comfortable. Things should resolve (just like a cold) in 5-7 days.
Related Topics: Antibiotics: Good Choice for Pinkeye?, Back-to-School Health Checkup
Technorati Tags: pinkeye, antibiotic eyedrops
49 Comments:
how do you know you have "viral" pink eye and do not need anti-biotic drops???
Hopefully your eye doctor would tell you whether it was more likely viral (watery discharge) rather than bacterial (goopy pus discharge...yecchh!)
The Adeno Detector is a 10 minute office based test that can determine viral from bacterial pinkeye. That way, patients with a viral infection could avoid toxicity, allergies, and resistance. Also, viral disease is very contagious whereas bacterial is less contagious, especially when antibiotics are provided. Bacterial superinfection is very uncommon.
I have been exposed to someone who has an "extremely contagious" case of pinkeye. The Drs office made him wear gloves out of the clinic so he didn't touch anything and was dragging out the Lysol before he got out the door. (never heard of that before...) What is the incubation period for viral pinkeye??? Is there one? I was around him approx. 4 days ago and am asymptomatic. Am I in the clear? What about carrying and passing to others?
A couple weeks ago, I had some eye irritation that I was concerned was a result of some bacteria that I may have been exposed to fixing a sewage line in my house. I noticed my left eye was very red and my right eye eventually got red also. Doctor gave me some antibiotics and it didn't seem to be really working. They started me on some other stuff that I took for 5 days.
Anyway, both my eyes still seem a bit red. I don't have any discharge or anything. I'm not sure if I just never noticed them being red before or if there is something serious going on here.
I work on computers all day long so maybe I've always had dry red eyes prior to this infection and just never noticed.
Is this possible? Should I see an eye doctor? What kind of eye doctor should I see?
accourding to my doctor i hav a very conagous bcterial pinkeye from a minnor bacterial ifection of the sinuses....in any case after a few days on antibiotics my ears have started to hurt agian. his worys me but im sure if they just up my antibiotics evrthing will be fine(ewww goopy pus is distgusting indeed)
I had though that I had gotten something in my eye when removing my acrylic nails. I have been putting antibiotic drops in my eye because my doctor said that it might be pinkeye. My eye is so inflamed and red and has been for 3 days with no sign of improvement. What should I do ?
Anyone with specific questions about their own eye conditions, please post on our Eye and Vision Disorders: Bill Lloyd, MD message board. :-)
i dont know what happened but yesterday when i wore my contacts, my eye started getting irritated. but i didnt take them off and i left them in for a little while more.
when i took one of my contacts out it had this clear gooey stuff on it. & i didnt know what it was.
my eye was still getting irritated & it became red, watery and sensitive to light & my other eye became red by not as irriated as my left eye.
the next day came and i woke up & couldnt open both my eyes because they were stuff together because of dried up tears, i guess.
i haven't put my contacts on today, but its still a little red & at times it gets irritated just staring at something too long.
i have no idea whats going on & what i should do. so please help.
They thought that my daughter had
pink eye. She wears contacts and one morning she woke up and her eye was mattering and the white part was red. It then spread to the whole outside of her eye, it looked like she got hit in the eye. We were prescribed tobradex drops. The inside of her eye cleared up but the outside looked awful. Well it finally cleared up and she put in a new pair of contacts and the next day it started all over again in the same eye. Now it looks like she has been hit in the eye. We started the tobradex. It burns her eyes. But what about the outside, what could be going wrong. HELP
My colleagues are concerned--is viral pink eye contagious?
Dear anonymous above,
According to the information linked in Dr. Lloyd's article, viral pinkeye is highly contagious.
WebMD Blog Administrator
do you get pinkeye more often if you've had it before?
More Pinkeye Information.
I think you're taking this new pink eye to red eye far to lightly.
Last year I contracted what the doctors thought was pink eye gone wild. My eyes were tomato red, extremely light sensitive, swollen with an eye pressure of 53!. My head felt like it was going to explode. It has taken a year on Prednisone and other pressure lowering medications. My sight has not returned to where it was before, nor, am I told. will it ever.
Eliza Ankum, age 54
How long is conjuntivitus contagious for? And is there a time period before you see symptoms that it is contagious.my brother had it 3 weeks ago and came over to my house and now i have it. Is it possible that i contracted it from him and had it for 3 weeks before i saw symptoms?
I had "pink eye" exactly one month ago in conjunction with "H" flu and am still having redness, pain, swelling, goopy discharge, and occasional sharp pain in my eyes. I have been on two different antibiotic drops which helped somewhat with the redness and itching, but I am still having far too much discomfort. What gives?
I have HIV and recently my eyes have started to bother me. They are red and itchy and I wake up at night sometimes to scratch them. It's horrible. I've been to an eye doc and he says it's just allergies, but I'm not so sure. I am a healthy man living with HIV and aside from my scary eyes I'm just fine. How do I know if my condition is caused by the HIV or if it's something else?
I went to a physician a little over a month ago for conjuctivits. He gave me drops and told me to use them for five days...I did as instructed. About a week after I stopped the drops my eye was getting irritated and pink again, so I went back to the same doctor..that time he gave me ointment and told me to use it for five days. I did as instructed and my eye seemed to clear up. I went back to using my contacts and noticed that the same eye just kept getting irritated. Last week I went to my actual eye doctor and told her about the conjuctivitis. She looked at my eye and said that I actually had Keratitis (swelling of the cornea). It can be caused by conjuctivitis, or it can be mistaken for it. Needless to say, I'm back on drops (TorbaDex) and have to use them for seven days. Also, I can't wear my contacts until I get the ok from my eye doctor, and now I have to replace my makeup for a third time. This has been going on for over a month...if you're having reoccuring pink-eye/conjuctivitis symptoms, please go see an eye doctor (optometrist or opthamologist) and really get it checked out.
I went to the doctor 5 days ago because my left eye was red and I was concerned I may have pink-eye. Surely enough I was diagnosed with bacterial conjunctivitis. I've been taking the prescribed eye drops but its only getting worse and now both eyes are reddish-pink and now I have a slimy discharge. Is this normal for bacterial or could it be viral? I cant afford to miss much more work.
I went to the Dr. today he didn't even give me a name of what i had just told me that i had a infection in my eyes and that it is contagiuos. Could this have been a casue of someone else having the infection or was it my contacts.
My 3 1/2 year old son has been ill with fever and his eye became red and swollen. We took him to the MD after 48 hrs and he dx as peri orbital cellulitis. He perscribed drops and liquid antibiotic. What is this and how serious??
Can viral pink eye cause a swelling of the salivary glands?
For those of you with specific questions, please visit Dr. Lloyd's message board.
Thank you!
My wife doesn't have the pink eye virus but her eye is real red and swollen around the lid. She mention that the eye watered alot. What could this be? and what treatment is recommented?
My entire eye is red, the right one. and i can barely even open it, its extremely sensitive to light. i dont know why though, i dont think i've done anything to stress my eye or anything. the left eye is starting to hurt, i can open my left eye in the light for a little while but theni have to close it. anybody have a clue?
last year i got a job in a dental office by the 3rd day i had to the a sick day cause I woke up and i couldn't open my eyes and had to get dressed in the dark the doc's didn't tell me what it was just gave me drops so I went to my eye doc he and i don't get along at all anyways he said i had a lot of scaring on my corena and said if i get another one i can lose my vision so i went to eye specialist he didnt say anything like that so I was so confused anyways a year later same thing happened to me and i went to the er and they gave me the same drops(anitbotic)well now i've come to the conclusion that it's my contatcs I was wearing my 2 weeks contacts for 4 weeks instead of 2 weeks but I WAS TOLD BY MY EYE DOC to do this i have given my eyes a rest from contacts for 2 months now I plan to go to a new eye doc for my contacts
I dont remember getting pink eye but my top lid on the inside by my nose is swollen, painful, and it itches. do you know what this could be?
My right eye is so red. It waters constantly. And the light makes me want to keep it closed. What is this? Ive never had this before.....
I have had the flu for 11 days and yesterday my right eye got red & had puss in it & starting being very sensitive. I washed the outside w/ hot water to get rid of the puss and several minutes later, there was puss again. Do I have pinkeye or something else? I found a bottle of Tobradex & wondered if I could use that as I'm too sick to leave my home right now. I don't need to infect anyone else with what I have....flu or pinkeye.
Thank you.
I VE HAD RED EYE OR PINK EYE FOR MORE THEN A MONTH WHAT SHOULD I DO ?IVE BEEN TO THE DR 4 TIMES AND NOTHING !!!!!!!!!
I went to the doctor 4 days ago with pinkeye. Because of my symptoms she said it sounds like viral pinkeye but she gave me antibiotic eye drops anyway. I have been taking them but I know better to take antibiotics for a virus. Should I keep taking them will it help?
When you have pink eye is it in one eye and really red all over, Hurts, dry swollen? or could it be something else... What would i do to make it feel better?
My daughter woke up this morning and her left eye is very red, not pink.I do plan on taking her to the docs. Is there anything that I should be sure to ask them?
I have had the inside of my eye irritated since september of 07 and now it is feb 08 i went to the dr. three times now and have been to the eye dr.three times now i can not get rid of this they have prescribed tobradex vigomox and lubricating eye drops what the heck is going on any one have any answers. i get told that it is dry eye its pink eye its conjunctifitis
I have gotten pink eye many times ever since I was a little girl. And as far as a bacterial condition is concerned (since I'm not so sure I've ever had or had to treat viral), antibiotics help but are really unnecessary and expensive. The best thing that I have found to do is to take a wet cotton ball soapy with tear-free baby shampoo and gently sweep it across the white part of your eye where the main infection grows, where it is most red, but avoid the pupil (which can be painful if touched or scratched). When you feel like your done cleaning your eye, rinse it out real good with cold water and pat it dry with a clean towel. It stings a little bit the first few times you do it just because the shampoo is killing the bacteria on your eye, but if you do this 3 to 5 times daily for a few days, your eye will clear up in no time, and it sure is a lot less expensive than having to get antibiotics. Hope this helps someone cause I know it always helped me.
My son who is 5 spiked a 103 temp last night. When he got up today, his eye was slightly pink and he was congested. Tonight, he spiked another temp and his eye is bright red with green and yellow discharge. He is complaining that it is sensitive to light and it "hurts'. He can not get into the doctor until tomorrow. I am concerned that this may be more serious than "pink eye". I have never heard od spiking temps with pink eye. Is it possible that he may have something more serious? Or just run of the mill pink eye?
Is it okay to wear contact lenses when you have pink eye?
My wife wears prescription contacts. It seems she caught an infection in her right eye,and now it infected both eyes. She can not open her eyes, due to her eyes being tired and she complains, the light bothers her vision, and stings when she tries to open them. I open her eyes to clean them, and tears come down like water from a faucet. She refuses to go to the hospital to get treatment. Is there any home remedy or treatment, that could help her eyes get better?
I wear contact lenses regularly, Since last night iam having redness in my right eye and it wasn't watering last night but after i got up this morning it became more reddish and is been watering frequently. Please let me know the cause of the same.
Hoping for a quick reply...
for the better part of the year my husband has been having a small amount of pus in the corner of his eye. That is it, there is no pain or discomfort it's just there all day everyday and we don't know what it is or how to treat it.
if I have a red eye do I go to my regualr doctor or an eye doctor?
I wear contacts. have been to 3 diff doctors. 3 weeks oral antibiotics, 3 weeks eye drops. eyes still red, and drippy. went to acupucturist. felt much better. had appt. w allergist. No specific allergies. but he prescribed eye drops that burn and made sit. worse. One doctor said I had cat scratch fever. I am getting seriously tired. could this be "chemical" irritation? I am a colorist/hairstlyist.
I wear contacts. have been to 3 diff doctors. 3 weeks oral antibiotics, 3 weeks eye drops. eyes still red, and drippy. went to acupucturist. felt much better. had appt. w allergist. No specific allergies. but he prescribed eye drops that burn and made sit. worse. One doctor said I had cat scratch fever. I am getting seriously tired. could this be "chemical" irritation? I am a colorist/hairstlyist.
my sister has had a red eye for about two weeks then he other eye has become red too what could that bee
I was working in the garden pulling weeds yesterday, later that night my right eyelid became red and swollen, this morning the swelling is over my entire eye and lower part also. What can I get to relieve the swelling?
I started having pinkeye for the first time in the middle of December. I went to a doctor and he said that's what it was and gave me an oral medication and eye drops. The problem seemed to clear up approx. a week later. But then about 2 or 3 weeks later, it came back again. This time I couldn't even get to sleep there was so much drainage from my eye. I went to another doctor and she said that it was just pinkeye too. She gave me the same oral medication but different eye drops. Again, the problem cleared up, again. Then, like it did before, it came back another time, about 3 weeks later, like the last time. This time I went to an Ophthalmologist and he said it was just pinkeye too. HE didn't give me an oral medication, but I got 2 different kinds of eye drops. The problem went away to a point, but I could still feel it in my eyes, and was certain it wasn't gone. Then it came back again. I went back to the Ophthalmologist, and this time he took a scraping of my eyes to see if anything would grow on it, and nothing ever did. He prescribed an eye ointment, which didn't seem to work very well at all. Today, 6 months later, I am still having eye problems. It's the same every time it comes back, except for the fact that it jumps from one eye to the other. It's in my left eye now, and the time before that it was in my right eye, ect. I am constantly washing my hands, and changing my pillowcases, but nothing seems to be keeping it away. Is this a normal thing for some people? Do some people get reoccurring pinkeye like this? Or could it possibly something else? I would keep going to different doctors, but the copay is a lot and so are the meds, and I can't keep affording meds that don't work in the end anyways. What should I do about this?
Ok, i have eye discharge(pus), my eye is watery, irritated, my lower lid hurts when i blink, my eye is also red. What could it be?
I wear contacts and late one night my left eye became really red. I took off my contacts thinking it was because they were just drying out. The next day, my left eye was not only red but also irritated and was sensitive to light. I went to an opthalmologist and she said it might be the Opti-free solution I was using for my contacts. (Question is, how come my eye only reacted like this now after using the solution for so long?) She said that she had some other patients with the same condition and they were all using Opti-free. She gave me a prescription for Tobradex eye drops. After a good night's rest my eye felt a lot better.
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