Conjunctivitis treatment, pink eye condition by Ray Sahelian, M.D.
April 17 2015

Conjunctivitis - sometimes called pink eye - is an inflammation of the blood vessels in the conjunctiva, the membrane that covers the sclera and inside of the eyelids. Conjunctivitis may be caused by bacteria or viruses, making it quite contagious. For most kids with pink eye, also known as acute infective conjunctivitis, the condition will usually resolve on its own, without antibiotic treatment.

Natural treatment
Most cases of pink eye are due to a minor infection that clears by itself, it vision is impaired or there is pus or no quick improvement, a doctor's visit is required to determine the cause which could also include allergies, a foreign body in the eye, uveitis, or from contact lens use. In some cases more serious systemic conditions can cause the look of a pink eye. If only one eye is pink that means it is an infection. If both eyes are pink one should consider the possibility of an allergy or a systemic condition.

Is there an alternative treatment for pink eye?
   Colloidal silver drops are used by some people but I personally do not have experience with this treatment.

One simple remedy for this eye disorder is to use is a warm or cold water compress. Put a warm compress over the eyes to soothe them and prevent the sticky discharge from drying on the lashes, and a cold one to shrink the swelling and reduce the itchiness. Do this for a few minutes three or four times a day.

Conjunctivitis: Are Antibiotics Necessary?
A randomised controlled trial of management strategies for acute infective conjunctivitis in general practice.
BMJ. 2006. Primary Medical Care, University of Southampton, Aldermoor Health Centre, Southampton.
To assess different management strategies for acute infective conjunctivitis. 307 adults and children with acute infective conjunctivitis. One of three antibiotic prescribing strategies--immediate antibiotics (chloramphenicol eye drops), no antibiotics (controls), or delayed antibiotics (n=109); a patient information leaflet or not; and an eye swab or not. Severity of symptoms on days 1-3 after consultation, duration of symptoms, and belief in the effectiveness of antibiotics for eye infections. Prescribing strategies did not affect the severity of symptoms but duration of moderate symptoms was less with antibiotics: no antibiotics (controls) 4.8 days, immediate antibiotics 3.3 days, delayed antibiotics 3.9 days. Compared with no initial offer of antibiotics, antibiotic use was higher in the immediate antibiotic group: controls 30%, immediate antibiotics 99%, delayed antibiotics 53%, as was belief in the effectiveness of antibiotics: controls 47%, immediate antibiotics 67%, delayed antibiotics 55%, and intention to reattend for eye infections: controls 40%, immediate antibiotics 68%, delayed antibiotics 41%. A patient information leaflet or eye swab had no effect on the main outcomes. Delayed prescribing of antibiotics is probably the most appropriate strategy for managing acute conjunctivitis in primary care. It reduces antibiotic use, shows no evidence of medicalisation, provides similar duration and severity of symptoms to immediate prescribing, and reduces reattendance for eye infections.

Treatment of allergic conjunctivitis: results of a 1-month, single-masked randomized study;
Figus M, Fogagnolo P, Lazzeri S, Capizzi F, Canovetti A, Iester M, Ferreras A; European Journal of Ophthalmology (2010). Allergieso antazolineo chlorphenamineo cromoglicic acido diclofenaco epinastineo fluorometholoneo ketotifeno levocabastineo naphazolineo olopatadine
To compare the effects of topical antiallergic eyedrops in relieving the signs and symptoms of patients with allergic conjunctival pathology. Methods. In this multicenter, single-masked, randomized study, 240 patients with signs and symptoms of allergic conjunctivitis were randomized to receive 1 of the following 8 treatments twice daily: cromolyn sodium/chlorpheniramine maleate, diclofenac, epinastine, fluorometholone, ketotifen, levocabastine, naphazoline/antazoline, and olopatadine. Clinical signs and symptoms were evaluated by a masked operator using a 10-point scale at the moment of enrollment and at weeks 1, 2, and 4. The percentage of patients achieving at least a small (at least 50% reduction of the total scale score) or a good (at least 75%) improvement of signs and symptoms was calculated at each visit. Tolerability was also evaluated as the duration of discomfort after instillation. Results. All drugs gave some improvement in symptoms in more than 85% of cases. Epinastine and olopatadine obtained at least a good relief of symptoms in 37% and 33% of cases at week 1. At the end of the study, good improvement of symptoms was obtained in at least 70% of patients by epinastine, ketotifen, fluorometholone, and olopatadine, whereas a 75% improvement for signs was obtained only by fluorometholone and ketotifen. Naphazoline/antazoline induced higher discomfort compared to the other study treatments. The efficacy of epinastine, ketotifen, and olopatadine in the treatment of allergic conjunctivitis was comparable to fluorometholone. Naphazoline / antazoline had lower tolerability than the other study treatments.