Beware of ‘sore eyes’


What is “sore eyes”?

Sore eyes, medically known as conjunctivitis, is a highly contagious infection of the eyes, commonly cause by an adenovirus. There are several serotypes of adenoviruses.  The incubation period (from time of exposure to appearance of symptoms) is 5 to 12 days. The conjunctiva (thin lining of upper and lowers eyelids that extends to the rim of eyeballs) becomes irritated, inflamed, red, stinging, with watery discharge, and the eyelids could get stuck to each other following sleep. This usually starts with one eye and spreads to the other eye by eye-to-hand-to-eye contamination.  The lymph glands (body’s defense filter) behind the ears could be sore and enlarged in many cases.

How is “sore eyes” transmitted?

Acute viral conjunctivitis spreads very fast, from one eye to the other of the same person, and to other persons the patient comes near to. It is transferred from one person to another by droplet (air environment in the same room or house), fomites (items touched by the patient’s contaminated hands), and by direct hand-to-eye inoculation. Indeed, this is a very contagious disease. This condition can also be due to allergies or to irritants like dust, wind, smoke, fumes, intense sunlight, ultraviolet light of sunlamps, electric arcs, etc. Obviously this type of conjunctivitis is not contagious like the adenoviral ones.

Does this cause photophobia?

Yes, temporary photophobia (“fear,” oversensitivity to light) is present in many patients with acute viral conjunctivitis, together with the feeling that there is a foreign body in the affected eye. There could also be some residual corneal scarring following the conjunctivitis, which could even last up to a couple of years. Occasionally, this scarring might even affect visual acuity and result in glaring. Fortunately, this does not happen too often, but, nonetheless, care should be taken to avoid exposure to persons with conjunctivitis.

How about secondary bacterial infection?

Secondary bacterial contamination, which is very rare, can also happen to those with viral conjunctivitis. In this contaminated case, the eyes will have purulent (pus) discharge and bacterial cultures can be done to identify the bacteria and the antibiotic most effective for it. This is viral infection with superimposed bacteria infection.

Can sex transmit conjunctivitis?

Yes, if one of the partners has conjunctivitis. But another type of conjunctivitis, known as Adult Gonorrheal Conjunctivitis, which is not very common, is caused by contamination (by finger-to-eye contamination) from a person with the venereal disease called Gonorrhea, a sexually transmitted illness.  As a rule, only one eye is involved here, but the condition is very severe. Both sexual partners must be treated without delay.

Can conjunctivitis be caused by bacteria also?

Yes, this is called nongonococcal bacterial conjunctivitis, meaning the bacteria causing it is not of the gonorrhea variety. These bacteria are usually staphylococcus aureus, streptococcus pneumoniae and hemophilus influenzae. To prevent further transmission of any type of conjunctivitis, the examining physician must wash his/her hands well, and so with the patient. Touching the infected eye, or the area around it, or the secretion from it, contaminates that hand, and this can spread the disease to other persons. Family members in the same household as the patient should all wash their hands very well, several times a day, and should stay away from the one with conjunctivitis, in order to minimize catching the disease.

Does one catch “sore eyes” from peeping?

Peeping toms have been scared by a myth that they will catch stye (kuliti), not conjunctivitis. However, if a person with viral conjunctivitis had looked through the same hole, the subsequent peeping tom could be inoculated with the virus also and get the disease.

What is seasonal conjunctivitis?

Seasonal conjunctivitis is also known as hay fever conjunctivitis, usually due to allergy to airborne pollens, and the peak season is spring, late summer and early fall. Besides the itchy red eyes, the person also has rhinitis (inflammation of the nasal mucosa—inner lining of the nose) with tendency to sneeze a lot and have clear watery nasal discharge (sipon).  Another form that is due to allergy is called perennial allergic conjunctivitis or atopic conjunctivitis, where the irritants are dust mite dander or animal dander. This is a chronic form, with symptoms round the year, and usually these persons also have eczema, asthma and other allergic conditions.

Can the condition be prevented?

Yes, most definitely, in majority of cases. Careful avoidance of the known modes of transmission discussed above is the best way to prevent catching the disease, even some of those secondary to allergies. Eliminating dust, dust mite and dander at home of office by good housecleaning, abstinence from food or items one is allergic to, good personal hygiene (washing hands often, especially if someone with conjunctivitis is in the same room), care in handling items touched by the patient) and the usual common sense approach to a contagious disease.

What are dust mites?

Dust mites are real, and not just a metaphor. They are scary-looking, live, crawling, beetle-like micro “insect” with fangs and spiky legs. They are the components in dust that cause allergic reactions when inhaled, causing red, itchy eyes, stuffy, runny nose, and nasal discharge. Daily vacuum cleaning and dusting (furniture, etc) is the best way to eliminate dust and dust mites.

What is the treatment for “sore eyes”?

Since the cause of conjunctivitis varies, the prudent action is to consult your physician right away for prompt diagnosis and treatment. This medical evaluation is vital because conjunctivitis could be as trivial as those due to allergies, or as serious and those caused by a venereal disease or other eye condition that could lead to blindness. There is no substitute for early diagnosis and prompt treatment, just like in any other medical conditions. Obviously, even better than this is prevention!

***

Philip S. Chua, MD, FACS, FPCS, Cardiac Surgeon Emeritus in Northwest Indiana and chairman of cardiac surgery from 1997 to 2010 at Cebu Doctors University Hospital, where he holds the title of Physician Emeritus in Surgery, is based in Las Vegas, Nevada. He is a Fellow of the American College of Surgeons, the Philippine College of Surgeons, and the Denton A. Cooley Cardiovascular Surgical Society. He is the chairman of the Filipino United Network – USA,  a 501(c)(3) humanitarian foundation in the United States. Email: scalpelpen@gmail.com

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