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Rare but serious causes of conjunctivitis

What is conjunctivitis and how do you get it?

Conjunctivitis is also known as pink eye, and it is usually quite mild. It is very common, and it can be spread quickly to other people. It sometimes needs medical treatment depending on the cause. Conjunctivitis is an inflammation of the conjunctiva, which is the soft, clear mucosal lining of the eyelids and white part of the surface of the eye.

The four main causes of conjunctivitis are:

  • Viral conjunctivitis
  • Bacterial conjunctivitis
  • Allergic conjunctivitis
  • Irritants (such as swimming pool chlorine)

Having treatment for conjunctivitis will depend on the cause and also the degree of your symptoms.

Symptoms of conjunctivitis include:

  • Redness and swelling of the inside of the eyelids and white of the eye
  • Increased tearing or lachrymation
  • Eye discharge, which can be clear, yellow, white or even green
  • Itchy, irritable and burning eyes
  • Gritty eyes
  • Crusting of the eyelids and lashes
  • General discomfort

Rare but serious causes of conjunctivitis

1. Chlamydial conjunctivitis

This is a severe form of conjunctivitis that is sexually transmitted and is more common in adolescents and young adults under the age of 24. It is serious because there can be severe sequelae, not just to the eye with an infection of chlamydia trachomatis, but it also poses a risk to women of infertility, pelvic inflammatory disease or even ectopic pregnancy. There is also the risk of spreading it to their partner.

An ophthalmologist may suspect chlamydial conjunctivitis from the appearance of the conjunctiva and the patient history. However, a sexually transmitted diseases doctor will have to diagnose the condition from a urine or vaginal swab specimen.

In this situation, the ophthalmologist will work with the sexually transmitted diseases doctor to isolate the chlamydia, then treat it with systemic antibiotics for a week and advise on the management of sexual partners.

2. Neonatal or newborn conjunctivitis

Any newborn with symptoms of conjunctivitis or pink eye should be seen by a paediatric doctor immediately. The cause is likely to be an infection, chlamydia trachomatis, that the baby has caught from his or her mother during childbirth, which manifests as chlamydial conjunctivitis – a serious eye condition.
Other causes of conjunctivitis in newborns are local irritation to the conjunctiva or a blocked tear duct. Another infection that can cause neonatal conjunctivitis is gonococcal conjunctivitis, which will need fixing urgently.
If you think that you or your child might have conjunctivitis, the first step is to see your ophthalmologist or, if it is your newborn baby who is affected, your paediatrician or ophthalmologist.

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