Conjunctivitis: Symptoms, Treatments, and Allergies

Q: Conjunctivitis: Symptoms, Treatments, and Allergies

Hello Hank： It is difficult to assess your condition based solely on your description. <br>If your symptoms persist, it is advisable to consult an ophthalmologist. <br>Conditions like yours may not improve with erythromycin or artificial tears. <br>You might need some antihistami

What type of conjunctivitis? What medications are used for conjunctivitis?

Hello Dr.
Gao, my eye issue is as follows: On February 20, I noticed a significant increase in floaters in my left eye, so I went to a medium-sized hospital for a retinal examination, which included dilation.
After returning home, I mistakenly used wet wipes containing Benzalkonium Chloride and Polyaminopropyl Biguanide to wipe around my eyes (with my eyes closed) before taking a shower.
That day and the next morning, both eyes were red and swollen, but there was no significant pain or itching.
There was no noticeable discharge, but my tears increased.
On February 21, I went to the same hospital's ophthalmology department for a check-up.
The doctor suggested it might be conjunctivitis and prescribed Chloramphenicol and VISCONE.
I used the drops four times a day for eight days, and by early March, I felt some improvement.
However, since the doctor prescribed a seven-day course, I stopped the medication for three days.
After three days, I still woke up with very red eyes.
I used the medication for another four days, and on March 8, I felt much better, so I stopped again.
But two days later, on March 11, my eyes were red again in the morning and evening.
Concerned, I returned to the same hospital's ophthalmology department on March 12.
One doctor mentioned that there might have been some irritation but did not rule out an infection.
He suggested that the previous eye drops, which contained trace preservatives, might not have been suitable, so he switched my medication to Erythromycin ointment, to be applied once before bed, along with BSS artificial tears four times a day.
After applying the ointment at night, I felt better the next day, as if it was the right treatment.
However, after two consecutive days, the area around my eyes remained red and slightly swollen.
Overall, there hasn't been much change in my eyes; if there has been improvement, it is very slight.
There is still no pain or itching, but I wake up with red eyes.
Upon closer inspection, the corners of my eyes are red, and there are some blood vessels in the sclera.
The inner lower eyelids are also red.
After using the Erythromycin for four days, I noticed that my eyes feel sticky and gritty, possibly due to the ointment.
I would like to ask Dr.
Gao, as this has been going on for nearly four weeks, and I have been using eye drops for over ten days, followed by four days of Erythromycin.
I do not have any cold symptoms; if it were viral, shouldn't it have resolved by now? After using the antibiotic for another four days, my eyes have not shown significant recovery.
I suspect it might be allergic conjunctivitis.
Currently, aside from some redness and swelling around my eyes, I feel no other discomfort.
Given the ongoing COVID-19 pandemic, I really do not want to go back to the hospital.
Can I stop the Erythromycin ointment after seven days and just use artificial tears? I am mostly working from home and paying close attention to hygiene.
If it is allergic inflammation, will it gradually heal on its own? Are there any more suitable medications? I would greatly appreciate your advice, thank you very much, Hank.

Hank, 60~69 year old female. Ask Date: 2020/03/16

Dr. Gao Pilin reply Ophthalmology

Hello Hank: It is difficult to assess your condition based solely on your description.
If your symptoms persist, it is advisable to consult an ophthalmologist.
Conditions like yours may not improve with erythromycin or artificial tears.
You might need some antihistamines or corticosteroid eye drops or ointments to alleviate your symptoms.
However, these medications require a doctor's prescription.
If you are concerned about going to a hospital, you can visit a clinic for an examination, which I believe will help improve your condition.
If your symptoms are stable and not worsening, you may choose to monitor the situation, as allergies can sometimes resolve on their own.
The ophthalmology department at Puzi Hospital in Taiwan is available: Monday, Tuesday, Thursday, and Friday mornings from 8:00 AM to 12:00 PM, and Wednesday afternoons from 2:00 PM to 4:30 PM.
Please note that online responses are for reference only, and it is essential to seek medical care at a healthcare facility if necessary.
I hope to have the opportunity to assist you.
Dr.
Gao Pilin

Reply Date: 2020/03/16

More Info

Dear Hank,
Thank you for sharing your detailed experience regarding your eye condition. Based on the symptoms and treatments you've described, it seems you may be dealing with conjunctivitis, which can be either infectious (viral or bacterial) or allergic in nature. Let's break down the situation and explore the possible causes, treatments, and recommendations for your recovery.

Understanding Conjunctivitis
Conjunctivitis, commonly known as pink eye, is an inflammation of the conjunctiva, the thin, transparent membrane that lines the eyelid and covers the white part of the eyeball. The condition can be caused by various factors, including:
1. Infectious Causes:
- Viral Conjunctivitis: Often associated with upper respiratory infections and can be highly contagious. Symptoms typically include redness, watery discharge, and irritation.

- Bacterial Conjunctivitis: Characterized by a thicker, often yellow or green discharge, and can also be contagious.

2. Allergic Conjunctivitis: Triggered by allergens such as pollen, pet dander, or dust mites. Symptoms include redness, itching, and watery discharge, often accompanied by other allergic symptoms like sneezing or nasal congestion.

Your Symptoms and Treatment
From your description, it appears that you initially experienced redness and swelling in both eyes after using a wet wipe containing certain preservatives. This could indicate a reaction to the chemicals in the wipe, leading to either irritant conjunctivitis or an allergic reaction. The absence of significant pain or itching suggests that it may not be a typical infectious conjunctivitis.

The treatment you received, including chloramphenicol and later erythromycin ointment, indicates that your doctors were considering a bacterial infection. However, given that you have not seen significant improvement after several weeks of treatment, it raises the possibility of an allergic component or a reaction to the preservatives in the eye medications.

Recommendations Moving Forward
1. Continue Using Artificial Tears: These can help alleviate dryness and irritation. They are safe to use and can provide symptomatic relief.

2. Complete the Course of Erythromycin: If your doctor prescribed a 7-day course, it’s advisable to complete it unless you experience adverse effects. Monitor your symptoms closely.

3. Consider Allergic Conjunctivitis: If you suspect that your symptoms may be due to allergies, consider over-the-counter antihistamine eye drops. These can help reduce redness and itching associated with allergic reactions.

4. Avoid Irritants: Stay away from potential irritants, including smoke, strong odors, and allergens. If you have known allergies, try to minimize exposure.

5. Follow Up with Your Doctor: If symptoms persist beyond the course of treatment or worsen, it’s essential to consult your eye care provider. They may recommend further evaluation, including allergy testing or a different treatment approach.

6. Hygiene Practices: Continue practicing good hygiene, such as washing your hands frequently and avoiding touching your eyes, to prevent any potential spread of infection.

Conclusion
While it’s understandable to be cautious about visiting a hospital during the pandemic, your eye health is important. If your symptoms do not improve or if you experience new symptoms, such as increased pain, vision changes, or significant discharge, please seek medical attention. Your eye care provider can offer tailored advice and treatment options based on a thorough examination.

I hope this information helps clarify your situation and provides some guidance on managing your symptoms. Take care, and I wish you a speedy recovery.

Best regards,
Doctor Q&A Teams

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