Red itchy eyes which are hard to open in the morning may be a sign. A possible reason is bacterial conjunctivitis, an infection of the clear film that covers the whites of the eyes and lines the inner surfaces of the eyelids.
Although we see that many cases are mild, in the case of management of bacterial conjunctivitis is important as redness may also present with viral conjunctivitis, allergies, corneal infections and other eye conditions. Also it may not help to use antibiotic eye drops without knowing the cause and at the same time such practice may play a role in the increase of unnecessary antibiotic use.
Understanding the signs, etiologies and proper bacterial conjunctivitis treatment will help you determine which is which when to try home care for your eye issue and when to seek out an ophthalmologist’s care.
What Is Bacterial Conjunctivitis?
Bacterial conjunctivitis is a result of bacterial infection in the conjunctiva. It may present in one eye first which later involves the other. Symptoms report redness, irritation and discharge.
The bacterial infection discharge is usually a thicker variety as compared to the watery discharge which is common in many viral infections. It may collect at the eyelashes and cause the lids to stick together post sleep. Also, discharge by itself is not a sure fire sign of what is causing conjunctivitis as symptoms do present alike.
The types of bacteria that cause it may differ by age and present health issues. We see Staphylococcus aureus, Streptococcus pneumoniae and Haemophilus influenzae as very common agents. Also some bacteria may cause more severe or atypical forms of the illness.
Symptoms of Bacterial Conjunctivitis
Symptoms of eye bacterial conjunctivitis may present very suddenly and may affect either eye or both. Redness is a common sign because the infection causes inflammation which in turn makes the small blood vessels in the conjunctiva more visible.
A person may have a grating, burning or uncomfortable sensation in the eye which at the same time may be more teary. Also thick white, yellow or green discharge may present and dried discharge may form around the eyelashes over night.
Mild puffy eyelids may also present. Also some report of temporary blurry vision which is a result of discharge or tears that cover the eye. Vision usually returns to normal after a blink or gentle cleaning of the discharge. As for a persistent reduction in vision, very present eye pain or great sensitivity to light, these are not usual in simple conjunctivitis and should be brought to the attention of an eye doctor right away.
| Feature | Bacterial Conjunctivitis | Viral Conjunctivitis | Allergic Conjunctivitis |
| Discharge | Often thick or mucopurulent | Usually watery | Usually watery |
| Eyelids stuck on waking | Common | May occur | Less typical |
| Itching | Usually mild or absent | Mild irritation may occur | Often prominent |
| Redness | Common | Common | Common |
| One or both eyes | Either | Often begins in one eye | Usually both |
| Antibiotics | May be prescribed when appropriate | Not effective | Not indicated |
Because these present similarly, an ophthalmic exam may be done before starting treatment. The American Academy of Ophthalmology also notes that it is a practice to stay away from the use of antibiotics in the case of viral conjunctivitis that in fact do not respond to antibacterial medications.
What Causes Bacterial Conjunctivitis?
Bacteria get in the eye if contaminated hands come in contact with the eye or rub the lids. Also infection may be passed through use of the same items which come into the eye like towels, pillowcases, make up or eye care products.
Poor care of contact lenses is also a large risk. Wearing lenses which are not meant for overnight use, using dirty lens cases or putting lenses in unsafe water increases your risk of getting an eye infection.
People that have blepharitis, eye lid or ocular surface issues, recent eye surgery, low immunity or frequent use of eye medications may also require more in depth medical evaluation when they present with conjunctivitis.
What Is Angular Bacterial Conjunctivitis?
Angular bacterial conjunctivitis in this case refers to a very noticeable inflammation at the inner and outer corners of the eyelids. In the past, Moraxella lacunata was identified in association with angular blepharoconjunctivitis and chronic conjunctival infection.
A person may see redness, irritation and discomfort at the corners of the eye. That which presents as persistent redness at the eyelid margins may have many causes and thus angular bacterial conjunctivitis may not be the diagnosis based on look alone. An ophthalmologist can assess the conjunctiva, eyelids and cornea before recommending treatment.
How Is Bacterial Conjunctivitis Diagnosed?
Diagnosis begins with a health and eye history which may include when the redness appeared, which eyes are affected, what kind of discharge is present, if the eyes are itchy, and if the patient wears contact lenses. Also we check the cornea and vision to rule out that what we are dealing with is in fact a more serious eye issue which may present with symptoms similar to that of conjunctivitis.
Laboratory testing isn’t necessary in all simple cases. But in serious infections which keep coming back, don’t respond to treatment, present in a newborn or which raise the risk of specific infections like gonococcal or chlamydial we may do conjunctival cultures or further tests.
Management of Bacterial Conjunctivitis
Appropriate management of bacterial conjunctivitis is based on the degree of infection, age, symptoms, contact lens use and also if there are suspected complications.
Many easy to treat bacterial infections will go away on their own. The CDC reports that mild bacterial conjunctivitis may resolve without the use of antibiotics, often within a few days of onset although full resolution may take longer. Antibiotics may reduce the duration of infection in certain cases and also play an important role when there is discharge, certain bacterial causes or an increased risk of complications.
| Situation | Usual Management Approach |
| Mild uncomplicated infection | Eye hygiene, symptom relief and medical observation may be appropriate |
| Confirmed or clinically suspected bacterial infection requiring medication | Doctor-prescribed antibiotic drops or ointment may be used |
| Contact lens wearer with a red eye | Stop wearing lenses and obtain professional eye assessment |
| Recurrent or non-improving infection | Further examination and possible microbiological testing |
| Severe pain, vision reduction, marked light sensitivity or heavy discharge | Prompt ophthalmic assessment is recommended |
Bacterial Conjunctivitis Treatment
When medical intervention is appropriate, bacterial conjunctivitis treatment often with antibiotic eye drops or ointment which are prescribed by a health care professional of which that is qualified to do so. What medicine is used and for what length of time will vary based on clinical evaluation and individual case.
Patients are to take the medicine exactly as prescribed and see it through to the end. Do not pass along your antibiotic eye drops to someone else or use leftover medicine from a previous eye infection.
Antibiotics are for bacterial infections and do not help with viral or allergic conjunctivitis. Also do not start on steroids containing eye drops without an ophthalmologist’s supervision as steroids may in fact make some eye infections worse and also delay the diagnosis of more serious conditions.
For that which we put forward is that which has proven to be the best in bacterial eye infection treatment which is the identification of what is really causing the red eye as a first step as opposed to which medicine to use based only on symptoms.
Home Care During Recovery
Supportive eye care can improve your comfort during the recovery period. Of which, wash hands well before care and very gently wipe away discharge from the eyelids with a clean damp cloth or fresh cotton. Do not use the same material for the affected and the other eye.
Avoid the eyes, sharing of towels or use of eye make up during active infection. Contact lenses should be removed until the infection has run its course and an eye care professional says it is safe to put them back in. Also from the CDC practice good hand washing, do not touch the eyes and clean items that may have had the infection to reduce spread of infectious conjunctivitis.
How Can Bacterial Conjunctivitis Be Prevented?
Good health practices play a key role in reducing the spread. Before and after touching the face as well as when applying prescribed eye medications wash your hands. Do not share towels, washcloths, pillowcases, cosmetics or eye drops if you or someone else has an eye infection. Cosmetics which are used during an active infection may require to be replaced if they are a source of contamination.
Contact lens wearers should follow proper cleaning, replacement and storage instructions and also do not wear the lenses when eye redness, pain or unusual sensitivity occurs.
When Should You See an Eye Doctor?
Seek medical attention if you have eye pain that persists, persistent blurred or reduced vision, light sensitivity that does not improve, rapid increase in swelling or a lot of discharge.
Contact wearers who present with red or painful eyes should have a full evaluation as they may have a more serious corneal infection as opposed to simple conjunctivitis. Also prompt evaluation is important when symptoms present in a new born, infection reoccurs, symptoms get worse instead of better or in which initial treatment fails.
Conclusion
Bacterial conjunctivitises a large group of red, irritated and sticky eye conditions. In the great majority of cases we see good results, but not all red eyes are bacterial and thus do not respond to antibiotics in which case their use is inappropriate.
Effective management of bacterial conjunctivitis includes accurate diagnosis, sensible hygiene practices, appropriate bacterial conjunctivitis treatment when it presents and prompt evaluation of warning signs.
If redness, discharge or discomfort persists or is severe and associated with visual changes, see an ophthalmologist instead of self medicating. Early professional eye care is to determine which is simple eye bacterial conjunctivitis which may be treated at home from which more serious eye conditions that may require different bacterial eye infection treatment are ruled out.
At Vasan Eye Care, an ophthalmologist can assess the underlying cause of a red or infected eye and recommend treatment based on the individual condition.
Frequently Asked Questions
- Is bacterial conjunctivitis contagious?
Yes. Bacterial conjunctivitis may be caused when there is contact with the affected eye’s secretions or which has come into contact with your infected eye through your hands or personal items. To reduce your chance of passing the infection on practice good hand hygiene, don’t rub your eyes and also do not share towels, make up or eye care products.
- Does bacterial conjunctivitis always require antibiotics?
No. Some mild cases will resolve without antibiotics. But we may still recommend their use based on symptoms, the severity of the issue, risk factors, and which organism we think is the cause. An ophthalmologist will be able to tell if out of drops or ointment is what you need.
- How long does bacterial conjunctivitis last?
Mild bacterial conjunctivitis will see some improvement within a few days. The CDC reports that in the case of left untreated mild forms it may take up to 2 weeks for full recovery. Time to recovery is also a function of the cause, degree of the condition and what if any treatment is given.
- Can I use old antibiotic eye drops for conjunctivitis?
It is best to avoid using old prescriptions for eye drops. Many causes of red eye require different treatments, also at home use of leftover medication may have risk of infection. An eye exam will help to determine if antibiotics are really necessary.
- Is bacterial conjunctivitis dangerous?
Most cases do well without permanent issues. Serious complications are few but some bacteria may affect the cornea and damage vision. Very painful eye issues, decreased vision, intense light sensitivity or when symptoms are quickly getting worse should go in for ophthalmic care at that time.
- Can bacterial conjunctivitis affect both eyes?
Yes. Infection of one eye may present first which at a later stage may spread to the other eye as a result of handling both eyes with contaminated hands. Careful hand washing and also avoidance of excessive eye touch is a help in reducing the transmission.