red eye

Watch your eye

Your Health
DR GITA MATHAI

What do people fear most? When do they rush to a doctor? Apparently the greatest fear is death, followed by loss of vision and cancer, probably in that order. This is the reason why people rush to a doctor when anything goes wrong with their eyes.

The current epidemic of conjunctivitis (also called Madras / Delhi eye, pink / red eye, or joybangla) has people really worried. Not only is the infection uncomfortable — the eyes are red, itchy and swollen — but also it spreads like wildfire.

Conjunctivitis occurs when the transparent membrane that lines the eyelids and part of the eyeball becomes inflamed and red. This may be due to an allergy, infection, a foreign body or blocked tear duct. The redness appears because the small blood vessels in the conjunctiva react to it. If the infection is severe the conjunctiva may be swollen. The eye may then feel gritty and itchy, shed tears and have a yellow or white discharge.

Infection is often due to a seasonal bug — an adeno or influenza virus. It may be associated with a cold or sore throat. These infections are self-limiting. Cold or warm compresses applied to the eyes can be soothing. It does not really require any treatment with eye drops and clears up spontaneously in three or four days.

The discharge in bacterial conjunctivitis can be yellow and purulent (containing pus). This requires antibiotic eye drops. These are effective when applied every two or three hours. An eye ointment may be applied at night.

Infectious conjunctivitis (viral or bacterial) can spread rapidly within a classroom, home or community. Contrary to popular belief, just looking at an affected person does not cause the infection to spread. The virus or bacteria gets transferred from the infected person’s eyes on to table tops, books and other frequently used items. If an uninfected person touches a contaminated surface, and then his or her eyes, the infection is transferred. Wearing dark glasses reduces photophobia due to the infection and prevents people from touching and rubbing their own eyes.

If you develop conjunctivitis:

• Don’t touch your eyes. Don’t itch or scratch

• Wash your hands often

• Use a clean towel which must be changed daily. Don’t share towels

• Change your pillow cases everyday

• Don’t share eye cosmetics or personal eye-care items (like mascara and kajal)

• Apply a compress to your eyes by soaking a clean cloth in water and applying it gently to your closed eyelids. Don’t touch both eyes with the same cloth. This reduces the risk of spreading red eye from one eye to the other

• Clean the crusts from the eyelids with a solution of 1 part of baby shampoo to 10 parts of warm water

• Stop wearing contact lenses until the infection completely clears up.

Children with viral conjunctivitis rapidly transmit the infection to their classmates. They should stay at home if infected and return to school only when the eyes no longer have a discharge. This may take around a week.

During the process of birth, a baby’s eyes can become contaminated by organisms present in the birth canal. An antibiotic ointment or drops are usually applied soon after birth to the infant’s eyes to prevent infection. In ancient civilisations, these infections were recognised and treated by applying a few drops of expressed breast milk to the baby’s eyes. Breast milk contains high concentrations of immunoglobulin which can protect against infection.

Sometimes, the tear ducts in babies are blocked. This occurs because either they are not yet fully developed or have been partially blocked by debris during the process of birth. This causes constant tearing of the affected eye and can result in a secondary infection. It usually clears up spontaneously by the age of one year.

All cases of conjunctivitis are not caused by infection. Allergy to substances like pollen, dust or chemicals can also cause the mucous lining of the eyes and airways to respond by releasing chemicals like histamine. This can result in itchy, red and watery eyes, a running nose and sneezing.

Non-steroidal anti allergy eye drops containing sodium chromoglycate are usually all that is needed to clear this. The eyes may respond faster to over-the-counter steroid eye drops but if the diagnosis is wrong, they can cause a flare up of the infection.

Chemicals like chlorine in swimming pools or detergents in soap and shampoo can cause a conjunctivitis-like response. Flushing the eye with clean water usually cures the problem within a day.

Dust particles, saw dust and other foreign bodies can be accidentally imbedded in the eye. An eyelash may also grow inwards. Both these cause constant irritation, redness and watering. If this occurs, you need to consult an ophthalmologist.

Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in