Facts vs Myths: The Truth About Pink Eye (Conjunctivitis)

What is Pink Eye?

Pink eye, also known as conjunctivitis, is an inflammation or infection of the conjunctiva - the thin, transparent layer of tissue that covers the white part of the eye and lines the inside of the eyelids. It causes the conjunctiva to become swollen and reddened, resulting in the characteristic pink or reddish coloration that gives this condition its name.

There are three main types of pink eye:

• Viral conjunctivitis - caused by adenovirus infection
• Bacterial conjunctivitis - caused by bacteria like Staphylococcus aureus or Streptococcus pneumoniae
• Allergic conjunctivitis - caused by allergies to substances like pollen or animal dander

Pink eye is very common and contagious. It spreads easily through contact with eye discharge from an infected person or contaminated hands or objects. Proper hygiene is important to avoid contracting and spreading conjunctivitis.

Can You Get Pink Eye from Poop?

This is a common myth - while poop can certainly harbor bacteria that cause pink eye under the right circumstances, pink eye does not spread through contact with feces alone. Here are some facts:

• Pink eye is mainly spread through contact with infected eye discharge (tears, mucus), not feces.
• Fecal-oral transmission is more associated with intestinal infections like diarrhea.
• Bacteria that cause pink eye need direct access to the eyes to cause infection. Poop alone will not transmit it.
• However, poor hygiene after using the bathroom, like not washing hands, could spread bacteria to the eyes and cause conjunctivitis.

So while pink eye does not directly come from poop, proper hand washing after using the bathroom is still important to prevent the spread of infection. Fecal bacteria can get into the eyes through unwashed hands.

What Causes Pink Eye?

The most common causes of infectious pink eye include:

• Adenoviruses - viral conjunctivitis accounts for about 80% of cases of pink eye. Over 50 types of adenoviruses can cause it.
• Bacteria - the most common bacteria are Staphylococcus aureus and Streptococcus pneumoniae. They account for about 20% of cases.
• Allergens - substances like pollen, pet dander, dust mites, mold spores, and others can trigger allergic pink eye.
• Irritants - pool chlorine, cosmetics, smoke, and other irritants can cause chemical conjunctivitis.

Pink eye can also be caused by a sexually transmitted infection like chlamydia or gonorrhea. Newborns can get a form of conjunctivitis from passage through the birth canal if the mother has an STD.

How Do Adenoviruses Cause Pink Eye?

Adenoviruses are extremely contagious viruses that can survive on surfaces for weeks. They spread through close contact with infected people and contaminated objects and hands.

Once adenovirus particles get into the eyes, they attach to and enter epithelial cells on the conjunctiva. There, they replicate and trigger inflammation by activating the immune system. This results in pink, swollen, irritated eyes.

Viral pink eye symptoms tend to appear about 5-12 days after exposure to the virus. They last about 7-14 days as the immune system clears the infection.

How Do Bacteria Cause Pink Eye?

Bacteria are also easily spread through contact with discharge from infected eyes or hands and objects touched by someone with bacterial conjunctivitis.

Once in the eye, bacteria attach to and multiply on the conjunctiva, provoking an immune response. Increased blood flow and leakage of fluids into the conjunctiva leads to inflammation and the telltale pink color.

Bacterial pink eye can develop 1-3 days after exposure. Mucus discharge is common and symptoms last around 7-10 days if untreated.

Who is Most At Risk for Pink Eye?

While anyone can get pink eye under the right conditions, some groups are at higher risk:

• Young children - frequent touching of eyes and faces facilitates spread. Schools are a common source of outbreaks.
• Healthcare workers - at risk due to contact with infected patients and contaminated equipment.
• Caregivers - at risk when caring for others with pink eye.
• Contact lens wearers - improper lens hygiene promotes bacterial growth.
• People with chronic eye issues - increased susceptibility due to existing damage or dryness.
• Newborns - at risk due to passage through birth canal if mother has an STD.

Those with compromised immune systems like cancer patients, transplant recipients, and people with HIV/AIDS are also more likely to contract conjunctivitis.

What Are the Symptoms of Pink Eye?

Common symptoms of pink eye include:

• Pink or reddish color in the whites of the eyes
• Watery, itchy, burning eyes
• Feeling like something is in your eye(s)
• Swollen, crusty eyelids
• Increased tear production
• Pus or discharge from the eyes
• Crusting of lashes or lids, often worse in the morning
• Sensitive to light

Viral and bacterial pink eye generally cause similar symptoms, but bacterial conjunctivitis is more associated with yellowish discharge while viral discharge is often waterier. Allergic conjunctivitis symptoms may affect both eyes and also cause nose symptoms like sneezing and itching.

When to See a Doctor

Mild cases of viral pink eye can be managed at home. But see an ophthalmologist or optometrist if you have:

• Moderate to severe swelling, pain, sensitivity to light
• High fever
• Double vision
• Difficulty opening the eyes
• Recurring conjunctivitis

Bacterial pink eye requires antibiotic drops/ointments so always visit a doctor if that is the suspected cause.

How is Pink Eye Diagnosed?

A doctor can often diagnose pink eye just based on the characteristic symptoms. They may also:

• Ask about your symptoms and onset
• Examine your eyes for redness, swelling, discharge
• Test vision and eye movement
• Check for light sensitivity
• Swab discharge to identify the organism causing infection
• Invert eyelids to check for inflammation

Lab tests may be done on a discharge sample to confirm adenovirus or identify the bacterial species. Your doctor may also check for other eye problems with imaging or other tests.

Viral vs Bacterial Conjunctivitis

It can be difficult to distinguish between viral and bacterial pink eye just on symptoms. But there are some clues doctors use:

• Viral pink eye - Watery discharge, moderate redness, sensitivity to light, scratchy feeling, may have cold symptoms
• Bacterial pink eye - Thick yellow/green discharge, more eye pain and swelling, crusting of lashes/lids, may have sinusitis

Discharge testing and lab analysis can identify the organism to confirm viral or bacterial pink eye when the clinical picture is unclear.

What's the Treatment for Pink Eye?

Viral Conjunctivitis

There is no specific treatment for viral pink eye - most cases resolve on their own. Self-care measures include:

• Cool compresses and eyedrops to ease discomfort
• Oral antihistamines for itching and swelling
• Avoiding contact lenses until symptoms resolve
• Proper handwashing to avoid spreading infection
• Not touching or rubbing eyes to prevent spread
• Disinfecting household surfaces to limit transmission

Over-the-counter drops may help constrict blood vessels in the eye to reduce redness. Doctors sometimes prescribe anti-inflammatory drops as well.

Bacterial Conjunctivitis

Bacterial pink eye requires treatment with antibiotic eyedrops or ointments including:

• Ciprofloxacin
• Gentamicin
• Tobramycin
• Erythromycin
• Azithromycin

Apply as directed, usually several times a day for 7-10 days. Pain relievers can also provide comfort until antibiotics take effect. Follow up with your doctor to confirm resolution.

Allergic Conjunctivitis

Treatment involves avoiding the allergen and using anti-allergy medications like:

• Antihistamine eyedrops like azelastine or olopatadine
• Decongestant eyedrops to reduce swelling
• Oral antihistamines
• Steroid eyedrops in severe cases

Refrigerated artificial tear drops can also help soothe itching and irritation.

How To Prevent Pink Eye

You can reduce your risk of developing pink eye by:

• Washing hands frequently with soap and water
• Not touching eyes with unwashed hands
• Using good contact lens hygiene and proper disinfecting solution
• Disinfecting surfaces touched by infected individuals
• Using a clean washcloth and towel each day
• Not sharing makeup, eye drops, etc.
• Staying home from work/school when infected

Face masks may also limit droplet spread. Getting adenovirus vaccines can help prevent infection in military populations at high risk.

When is Pink Eye Contagious?

Pink eye is very contagious especially in the early stages. Infectious conjunctivitis spreads by:

• Touching discharge from an infected person's eye then touching your own eye.
• Using contaminated makeup, eyedrops, facecloths, etc.
• Contact with respiratory droplets from an infected person coughing or sneezing.

Adenoviral pink eye is contagious before symptoms appear and remains so as long as discharge is present, up to 14 days. Bacterial pink eye is contagious for 7-10 days until antibiotic treatment is completed.

How Long Does Pink Eye Last?

Untreated viral pink eye typically lasts 1-2 weeks, though it can persist for over a month. With antibiotics, bacterial pink eye improves within a few days and resolves within 7-10 days.

Allergic conjunctivitis lasts as long as exposure to the allergen continues. Symptoms may start to improve within days after eliminating the trigger but can wax and wane with seasonal allergies.

Can You Get Pink Eye Again After Having It?

Unfortunately yes, it is possible to develop conjunctivitis more than once. Reasons recurrence may happen include:

• Re-exposure to someone with infectious pink eye
• Being infected with a different adenovirus type than before
• Getting bacterial pink eye after recovering from viral pink eye
• Ongoing exposure to an allergen
• Not completing the full antibiotic course for bacterial conjunctivitis

Practicing good hygiene and avoiding re-exposure to pathogens or allergens reduces the risk of recurrent pink eye.

Is Pink Eye Serious?

Pink eye is generally not a serious condition. Most viral and bacterial conjunctivitis resolves readily with self-care or antibiotics. However, complications can occasionally develop, including:

• Corneal ulcers - open sores on the cornea due to bacteria that can impair vision.
• Corneal scarring - permanent clouding of the cornea following ulcer healing.
• Spread of infection deeper into the eye or to other areas of the body.
• Allergic reactions resulting in corneal damage if sensitivities are not identified.

Prompt treatment helps prevent complications. Seek emergency care if you experience severe eye pain, vision changes, or sudden loss of vision.

Common Pink Eye Myths

There are many myths and misconceptions about pink eye. Here are some facts:

• Myth: Pink eye is caused by poor hygiene. Fact: While washing hands helps prevent spread, pink eye is caused by viruses, bacteria, and allergens.
• Myth: You can catch it from pets. Fact: Humans and animals have different strains. Pets do not directly spread human conjunctivitis.
• Myth: Wearing contact lenses makes it worse. Fact: This is false - contacts themselves do not change the course of pink eye.
• Myth: Pink eye always requires antibiotics. Fact: Only bacterial pink eye needs antibiotic drops. Viral and allergic types do not respond to antibiotics.
• Myth: Pink eye is life-threatening. Fact: Conjunctivitis rarely causes permanent damage or serious complications in healthy people.

Knowing the facts about pink eye helps avoid misinformation and unnecessary use of antibiotics. See a doctor to get appropriate treatment based on the cause.

The Bottom Line

Pink eye is a common eye infection that spreads easily through contact with discharge from infected eyes. While uncomfortable, viral and bacterial pink eye generally resolve within 1-2 weeks with proper care. Seek medical advice for appropriate diagnosis and treatment, especially if bacterial infection is suspected. Practicing good hand washing and hygiene helps prevent recurrent conjunctivitis.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.