What is Conjunctivitis?

Also known as Pink Eye or Madras Eye, Conjunctivitis is a common eye infection, especially prevalent in children under five. It is an inflammation of the conjunctiva which is the clear membrane that covers the outermost layer of the eye and the inner surface of the eyelids.

Conjunctivitis can be alarming because it can make the eyes extremely red and swollen and consequently looks quite painful. It also spreads rapidly. The good news is that it’s a fairly common condition and usually causes no long-term eye or vision damage.

If a person or child has symptoms of pinkeye, however, it’s important for them to see a therapeutically qualified optometrist or doctor. Depending on its cause, conjunctivitis can clear up without treatment, but often some form of medication is required.

What are the Signs and Symptoms of Conjunctivitis?

Red eye (hyperaemia), irritation (chemosis) and watering (epiphora) of the eyes are symptoms common to all forms of the condition, however, the pupils should be normally reactive and visual acuity still regular.

The different types of conjunctivitis can have different symptoms that can vary from child to child. One of the most common symptoms is discomfort in the eye. It may feel as if there’s something stuck in the eye. The eye and inner eyelid become plainly red, giving it its common name of ‘pink eye’.

This condition can also cause discharge from the eyes, which may cause the eyelids to stick together when the child wakes up in the morning. This can be frightening for any child. Additionally, some kids experience swollen eyelids or sensitivity to bright light.

What Causes Conjunctivitis and is it Infectious?

This condition is often contagious in that it is most commonly caused by an infection that is usually viral in nature, but sometimes bacterial. A person with conjunctivitis will remain infectious as long as there is a discharge from their eye or eyes.

Conjunctivitis can be contracted through contact with the discharge from the eyes, nose or throat of an infected person, through touch, coughing or sneezing.
It can be spread when children swim in contaminated water or share infected towels.

Doctors usually recommend keeping children diagnosed with contagious conjunctivitis out of school, childcare, or away from other children in general for a short time until it clears. Another thing to watch is keeping little hands from rubbing an infected eye as someone who has pinkeye in one eye can inadvertently spread it to the other eye by touching the infected eye, then touching the other eye.

Occasionally, however, conjunctivitis can be due to an allergic reaction, in which case it is not contagious. This form can be brought on by allergens in the environment or the air and itchiness and tearing are common symptoms.

What are the Different Types?

There are several different forms of this condition, including:

1.   Allergic
2.   Bacterial
3.   Viral
4.   Chemical or Irritant
5.   Neonatal


Allergic conjunctivitis occurs most often in children who have other allergic conditions, such as hay fever. Triggers can include:
ragweed pollen,
animal dander and
dust mites.
Anybody prone to allergic conjunctivitis should keep windows and doors closed on days when the pollen is heavy and limit allergy triggers in the home by frequent dusting and vacuuming.


Bacterial conjunctivitis due to common pyogenic (pus-producing) bacteria causes marked grittiness/irritation and a stringy, opaque, greyish or yellowish mucopurulent discharge that may cause the lids to stick together, especially after sleep. Another occasional symptom is severe crusting of the infected eye and the surrounding skin.


Viral conjunctivitis is often associated with an infection of the upper respiratory tract, a common cold, and/or a sore throat. Its symptoms include excessive watering and itching. The infection usually begins with one eye, but may spread easily to the other.

Chemical or Irritant

Chemical eye injury is due to either an acidic, alkaline or other toxic substance getting into the eye. Alkalis are typically worse than acidic burns. Mild burns will produce conjunctivitis while more severe burns may cause the cornea to turn white. Treatment is to flush the eye with large volumes of water and local anaesthetic eye drops can be used to decrease the pain.


Neonatal, or Inclusion Conjunctivitis of the Newborn (ICN) is often defined separately due to being caused by different organisms. This form may be contracted by newborns during delivery or in their first 30 days of life from contact with viruses or bacteria.


Viral conjunctivitis usually goes away without any treatment.

If a therapeutically qualified optometrist or doctor thinks that the pink eye is due to a bacterial infection, antibiotic eye drops or ointment will be prescribed.

In the case of allergic conjunctivitis, anti-allergy medicine may be prescribed, which comes in the form of pills, liquid, or eye drops.


It can sometimes be a challenge to get children to tolerate eye drops several times a day. Drops should be placed on the inner corner of the child’s closed eye so that when the child opens the eye, the medicine will flow into it. This can be done when the child is asleep, if necessary. Antibiotic ointment is also available which can be applied in a thin layer where the eyelids meet and will melt and enter the eye.


These simple steps can be taken to avoid infection:

• Wash hands often with warm water and soap and teach children to do the same.
• Don’t share eye drops, tissues, eye makeup, washcloths, towels, or pillowcases with other people.
• Avoid anyone that has it, or is showing signs of conjunctivitis.
• Throw away any contaminated items like gauze or cotton wool balls after they’ve been used. Wash any towels or other linens that have been used by a patient in hot water, separately from the rest of the family’s laundry, to avoid contamination.

If symptoms do not improve after 2 to 3 days of treatment, or after a week when left untreated, it is advisable to call us for an immediate appointment.

Call Insight Optometrists and speak to a therapeutic optometrist if you have any questions or concerns regarding contraction or treatment of conjunctivitis.


1. The Royal Children’s Hospital, Melbourne