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An excerpt from the book Taking Care of Your Eyes.

Taking Care of Your EyesAt one time or another, nearly everyone has had pink eye, or conjunctivitis (kun-junk-tih-VI-tiss). In fact, this is one of the more common reasons people go to an eye doctor. The word conjunctivitis means "inflammation of the conjunctiva" (kon-junk-TI-vuh). The conjunctiva is the thin membrane that covers the white part of the eye (sclera) and the undersides of the eyelids. "Inflammation" means that this membrane is red, irritated or swollen.

Conjunctivitis is not a disease, but simply a reaction to something that is irritating the eye. There are many conditions that can cause it. Usually, but not always, it results from a viral or bacterial infection, but it can also be caused by allergy, irritants such as air pollution, smoke or noxious fumes, or minor trauma as from contact lenses, a scratch, or even a loose eyelash.

Why Is Your Eye Red?

Healthy conjunctiva is transparent. It only looks white because the sclera under it is white. (On the undersides of the lids it looks pink because the tissues under it are pink.) Buried within the conjunctiva are many tiny blood vessels that normally don't show. When there is a conjunctival inflammation or irritation, the blood flow to these vessels is increased, engorging them and making them visible against the white background - thus the term "pink eye." The reddish color is almost never due to actual bleeding.

Is Pink Eye Contagious?

Sometimes yes, sometimes no. It depends on what is causing it. Infectious conjunctivitis (caused by bacteria or viruses) can be contagious; but if the cause is an allergy or irritant, it is not. Any time you aren't sure, it is a good idea to assume it's contagious. That means not touching your other eye after rubbing the pink eye, washing your hands after touching the eye or lids, and disposing of tissues used to wipe the eye.

Do You Need a Doctor?

Most causes of conjunctivitis are not serious and tend to clear up on their own. Some resolve after a few days, but viral infections may last several weeks and an allergic reaction may go on for months. If your eye feels scratchy and uncomfortable, it's all right to try a mild over-the-counter lubricant, which may provide temporary relief. But do not use any medication that contains corticosteroids (steroids for short), because if you have an infection, they can make it worse. Used without supervision, steroids can also lead to serious eye problems, such as glaucoma, cataract, or even blindness.

If the eye redness and irritation come on when you or a family member has or has recently had an upper respiratory infection (cold, fever, runny nose), the culprit is likely to be the same "bug." If it's a virus, treatment will not usually be helpful. But for a bacterial infection, which often causes a gooey or pus-like discharge or a crusty mattering on the lids, you may need to have an antibiotic eyedrop or ointment prescribed.

If both eyes are red, an allergy or atmospheric irritant may be the cause. Be alert to this possibility and you may be able to identify and avoid the offending substance. A seasonal allergy is likely if the eyes get red and itchy around the same time each year. If you are bothered a lot, medication can be prescribed to relieve the symptoms.

If you wear contact lenses and develop conjunctival irritation and redness that doesn't clear up in several hours after removing the lenses, it could indicate that they are causing a problem that requires treatment. Sudden, profuse tearing with lids that tend to want to close suggests that there is something in the eye or that the eye has been scratched or has a corneal infection.

If these symptoms don't subside within a few hours, your eye should be examined. The same holds true if your child comes running in from outdoors with a red, tearing eye. This almost certainly means that the eye has been scratched or that there is a foreign body in it.

Conjunctivitis can occur in association with certain systemic diseases. And sometimes a red eye is not conjunctivitis at all, but a sign of a corneal problem or an internal eye condition that needs prompt medical attention. This includes iritis, uveitis (inflammations deep within the eye), and one uncommon type of glaucoma.

Do not ignore a persistently red eye in the hope that it will go away. If the symptoms are irritating and last for more than a few days, or especially if your eye is painful or if there is a lot of discharge, the problem may not be trivial. Any time you are not sure whether a red or pink eye is serious, it is always better to be safe and have your eye examined.

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