Signalling the immune system is under stress, conjunctivitis could be a Covid symptom.
Many of us will have woken up with that gritty feeling in one or both of our eyes and gone to check in the mirror only to find an especially bleary-eyed version of ourselves.
Sometimes known as pink-eye, the literal meaning of conjunctivitis is inflammation of the conjunctiva, which is the membrane on the inside of the eyelid. It happens when the blood vessels of the sclera (the white of the eye) become dilated, giving us that red- eyed appearance. The conjunctiva also produces too much of the mucus and tears it’s meant to secrete, resulting in discharge.
Tell-tale signs you may be suffering from pink-eye
GP, Dr Nisa Aslam and advisor to Golden Eye® says: “Depending on whether the conjunctivitis is caused by bacteria or a virus, it will present as sticky pus (bacterial) or watery eyes (viral or allergic). Itching is more likely to be a symptom if it’s caused by an allergy, like hay fever. While the condition may start in only one eye, it’s common for conjunctivitis to spread to both eyes because it’s so contagious. This means it’s also easily spread from person to person, meaning good hygiene is a must to ensure you keep your conjunctivitis to yourself.”
Immune system SOS
According to NICE, acute infective conjunctivitis accounts for around one in 100 GP visits in the UK1. When you consider the population is made up of nearly 67 million people2, that adds up to quite a chunk of doctors’ time. The condition usually strikes when your immune system is low, such as when you have a cold or flu, with a range of viruses (including adenovirus (65–90% of cases), Herpes simplex and Epstein-Barr) and bacteria (including Streptococcus pneumoniae, Staphylococcus aureus and Haemophilus influenzae) potentially being the culprit causing the infection.
Could it be Covid?
Some recent case studies3 have suggested that conjunctivitis may be a symptom of Covid-19. Researchers at the University of Alberta in Canada published one example in the Canadian Journal of Ophthalmology4. They studied the case of a 29-year- old, otherwise healthy, woman who presented for treatment at a local hospital in March 2020. While she had minimal respiratory symptoms, she was suffering from a severe case of conjunctivitis, which was unresponsive to treatment. She had also recently returned from a trip to Asia, which prompted doctors to test her for Covid-19; the test came back positive. As a result, people presenting with conjunctivitis are now treated as potential Covid patients, and eye healthcare practitioners are strongly advised to wear PPE when performing eye examinations.
In another example in the European Journal of Ophthalmology5, an emergency healthcare worker tested positive for the virus, again with conjunctivitis being the only symptom. However, while nose and throat swabs returned positive results for novel coronavirus, the eye swab was negative, so it wasn’t possible to say whether coronavirus can be transmitted through eye fluids.
Soothe the symptoms
“If you do contract conjunctivitis, it’s important to treat it quickly”, advises Dr Nisa Aslam. “Wipe away any crust from each eye using a separate, clean cotton wool pad dipped in cooled boiled water. Mild infections can be treated using Golden Eye® Eye Drops or non-antibiotic Golden Eye® Eye Ointment.
Containing a type of antiseptic called ‘dimidines’, these products help to stop bacteria growing and multiplying so your immune system can get to work.
“If you’re using either product alone, it should be applied four times a day. However, if you choose to use the ointment and eye drops in combination, you can use the drops four times a day and the ointment once a day at bedtime. Golden Eye® Antibiotic Eye Ointment containing chloramphenicol may be used in cases of acute bacterial conjunctivitis – but don’t forget the importance of good hygiene.”
Back to School…
Conjunctivitis or red-eye is common in young children as well as adults. The bad news is, it is highly contagious, and breakouts can sweep through nurseries, preschools, infant schools and playgrounds. Conjunctivitis can be caused by bacteria or viruses responsible for colds and infections, such as those causing ear infections which are also common in children. If a little one shows signs of red-eye, it is important to speak initially to a pharmacist. If the pharmacist considers the red-eye is more than a superficial infection, he or she will refer to the GP, particularly in very young children.
Both Golden Eye® Eye Drops or non-antibiotic Golden Eye® Eye Ointment can be used to treat superficial eye infections in very small children as well as older children and adults and is available from the pharmacy. Antibiotic Golden Eye® Eye Ointment is suitable for use in children of 2 years and over.
3 top tips to maximise your immune defences Whether it’s a cold, flu or you’re feeling run down for some other reason, they are all signs that your immune system is under stress and in need of TLC. And there are plenty of things you can do to nurture yourself.
6 steps to stop conjunctivitis in its tracks from Pharmacist, and Golden Eye advisor, Sultan Dajani:
Golden Eye® Eye Drops contain propamidine isetionate, whilst Golden Eye® Eye Ointment contains dibrompropamidine isetionate. Both of these compounds belong to a group of medicines called antiseptics, part of the aromatic diamidine group of compounds that possess bacteriostatic properties against a wide range of organisms. This means they stop bacteria from growing and multiplying rather than killing them. They control the number of bacteria causing the eye infection, so helping to relieve symptoms. The remaining bacteria die or are killed by your body’s immune system.
Diamidines exert antibacterial action against bacteria such as pyrogenic cocci, antibiotic-resistant staphylococci and some Gram-negative bacilli. Of relevance to eye infections, the activity of the diamidines is retained in the presence of organic matter such as tissue fluids, pus, and serum. Always read the label.
Cheema M et al. (2020) Keratoconjunctivitis as the initial medical presentation of the novel coronavirus disease 2019 (COVID-19). Can J Ophthalmol 55: e125-e129.
Ozturker ZK (2020) Conjunctivitis as sole symptom of COVID-19: A case report and review of literature. Eur J Ophthalmol 31(2): NP161-NP166.