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Pink Eye Treatment: It's Not as Difficult as You Think

pink eye

Pink eye is very common, even though the general public calls it that way, it's known to eye care professionals as conjunctivitis.

The conjunctiva is a membrane or tissue, that covers the white part of the eye (sclera). Normally it shows a few vessels making the eye look fairly white.

In Some instances, this tissue becomes inflamed and this condition is known as conjunctivitis.

Generally when people say they have pink eye, they mean a conjunctivitis that is due to a virus or more rarely to a bacteria.

Those can be extremely contagious. As a matter of fact one of them is called epidemic conjunctivitis because when it strikes, it i very easy to catch, people in same communities tend to spread it, in schools, offices, or households.

pink eye conjunctivitis
Bilateral conjunctivitis

For the eye doctor, the cause of the conjunctivitis can be a bit difficult to diagnose initially because they present with a lot of common features:



-puffy eyelids


bacterial conjunctivitis

After a few days or sometimes only a few hours, the presentation guides the diagnosis. Let's start with the easy one: bacterial conjunctivitis presents as a bilateral eye redness with extremely purulent thick discharge. The good news is that since the causative agent is a bacteria, antibiotics work extremely well. Some patients don't even need antibiotics, treatment can only be supportive with artificial tears, and the condition will be self limiting and heal on its own.

A more tricky one to diagnose and treat is viral conjunctivitis. Depending on the virus, redness can be minimal or marked, it usually starts in one eye and shortly after affects the other eye. It is very challenging for the clinician to identify the virus responsible for the pink eye. History is key: we typically ask patients about contact with someone having the same condition. The extent of the signs and symptoms can guide the clinician. (Some in office testing exist to specifically diagnose adenovirus conjunctivitis)

All eye doctors are very worried about adenovirus. This type of pink eye is extremely contagious, patients are very symptomatic and if nothing is done, the body immune response can leave scars in the cornea that can permanently result in vision loss.

Until recently we didn't really a good treatment. Mainstay was observation, supportive treatment with artificial tears or anti-allergy eye drops to help with itchiness. If the patient develops scars, clinicians would use steroid eye drops, sometimes for months to control those scars and limit permanent damage.

There is no drug in the US with FDA approval for pink eye (except some very specific cases) . Some doctors use off label anti-viral medication but no clinical study has been done to assess efficacy.

A more recent approach is the use of diluted betadine in the office.

The protocol is now standardized: after local anesthesia with eye drops, some diluted betadine is applied to the eyes, know as a betadine wash. We then ask patients to roll their eyes for about a minute. After that time, the eyes are thoroughly rinsed with eye wash. The patient is then sent home with steroid eye drops to help with inflammation created by the betadine.

Betadine has been used for years in the operating room to prepare surgical areas. It is also used in ophthalmology to prepare for eye surgery. This compound is known to kill viruses and is only minimally toxic to the cornea.

My personal experience with the betadine protocol for pink eye has been great. Pink eye resolution happens much faster and I haven't seen as much corneal scaring as what we typically used to see without that treatment .

If you have pink eye, go see your eye care professional, be mindful about its highly contagious nature. Do not share pillows, towels, and try not to touch your eyes. If one of your family members develop similar symptoms, do not wait and have them see your eye doctor for prompt treatment.

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