This post is inspired by a very amusing incident as I purchased milk from my vendor yesterday. The boss’s son was berating his assistant, who was slacking off. His assistant offered a lame excuse that his ‘eyes had come’ (colloquial for conjunctivitis in India). The wise man, all of 23 years of age, told his employee that he would be fine if he wore dark glasses. He had another piece of sage advice to the onlookers: don’t look at this man directly in his eyes; otherwise, you, too, will contract the disease. He then directed his employee to the nearby chemist shop to pick up cheap drops that would do wonders for his eyes.

It amused me, but these are the most common pervasive myths prevalent in the general population. Lack of proper health education results in unnecessary spread of the disease and wrong treatment, causing prolonged suffering. In rare instances, it may even result in people losing their eyesight.

So I thought that I would address some of the issues and myths surrounding the most common condition that afflicts the eyes:

What is Conjunctivitis?

The conjunctiva is a very thin membrane that lines the white of the eye and extends under the eyelids. It keeps the eyes moist by forming a thin film of tears and protects the underlying eyeball from damage due to dust, foreign bodies, or allergens.
When this lining gets inflamed, its blood supply increases. This causes redness of the eye and increased tears production. There is also irritation and pain in the eye because of the inflammation. This results in the classic ‘pink eye.’
The inflammation can be because of infections, allergies, chemicals, trauma to the eye, or if foreign bodies enter the eye.
Infections are most commonly due to viruses. Bacterial infections can occur, and compared to adults, are commoner in children.
Pink eyes can also occur because other sinister diseases affect the true eyeball and its components.

Most cases of conjunctivitis are due to viral infections!

Conjunctivitis occurs when infected secretions from a person suffering from conjunctivitis enter another person’s eyes.
Not all people whose eyes are contaminated with other patients’ secretions develop conjunctivitis. The viral load, how likely that strain is to infect humans, and the body’s defense mechanisms decide whether we come down with conjunctivitis.

Dark Glasses do not prevent the spread of the infection!

Doctors advise their patients to wear dark glasses not to prevent the spread of infection but to ease the concomitant sensitivity to light. Due to the presence of infection, the eye becomes sensitive to light (photosensitivity), and the muscles in the eye go into spasm, causing pain to the patient when exposed to bright light. Dark glasses cut off the light that enters the eye. This is very soothing to the eye, and the patient becomes comfortable.

Do not self-medicate or use drops on the advice of your local chemist!

It is common practice to hoard drops used in the last conjunctivitis season, using either the same or the labeled bottle to get a new one! This epitomizes:

Penny wise and pound foolish

Another cheap option people resort to is asking the local chemist for the appropriate prescription. The person manning the counter is usually not a qualified pharmacist and simply sells you the most prescribed drops without diagnosing what you are actually suffering from.
Conjunctivitis is not the only cause of red eyes. You must see your doctor before instituting therapy. Your pediatrician, family physician, or ophthalmologist are your best bets. They will ascertain the cause of your child’s pink eye. They will rule out other sinister underlying eye conditions that can also present with ‘pink eye’.

Many physicians make the mistake of prescribing steroid drops for simple viral conjunctivitis. Steroids worsen the condition and increase the duration of viral shedding to many weeks. As long as the patient sheds the virus, she remains a potential source of infection for others.
Most cases of viral conjunctivitis do not require antibiotic eye drops. Your doctor will usually prescribe moistening eye drops that will give the maximum symptomatic relief.

So ideally, the person dishing out advice to his employee should have told him to stay off work for a few days, see his family physician, wear dark glasses to protect himself, and ask others to ‘look after him’ rather than not look ‘at’ him. But the employee really had the last laugh since he told his employer that he did not have enough money to buy medicines or dark glasses, so would he cough up the required amount? 😂

General advice to treat your child’s infection and to prevent the spread to others

• Keep the area around your eyes clean. Warm up some water in a clean bowl. Drop small balls of cotton in the water and gently wipe the secretions that accumulate around the eyes as often as necessary.
• Wash your hands frequently with soap and water. Do not use the same eye drops or eye drop dispenser for infected and non-infected eyes, and do not share the same eye drops with someone else.
• Wash your hands after applying eye drops to your or someone else’s eyes.
• Wash your face, hand towels, and pillowcases daily with detergent and water (preferably hot).
• Wear dark glasses, especially when exposed to bright light.
• Protect the bedding and pillow where you sleep with disposable or easily washable towels to prevent the spread of infection.
• Take care that you do not shake hands or touch any common areas with soiled hands.
• Do not use the same eye drops or eye drop dispenser for infected and non-infected eyes, and do not share the same eye drops with someone else.
• Stop wearing contact lenses if you use them.
• Do not use swimming pools as it may spread infection and worsen your child’s symptoms.
• Make cleanliness and sanitation part of your routine life. Reading up and implementing sanitation measures when sick (especially children) is difficult.

This post has been written by Drs. Rajesh Nathani and Ankita Bhandari.