Self-treatment for Conjunctivitis?

October 30, 2005 4:20 AM

Is conjunctivitis worth getting worked up over?

I have, for the first time, at age 26, developed mild conjunctivitis in my right eye. For someone who typically gets sick once every 2+ years -- even while others around him fall victim to whatever cold or flu happens to be making the rounds -- this seems to be little more than an annoyance. Since moving to Seattle in 2001, I have yet to find myself in a condition that warranted the acquisition and/or consultation of a doctor.

Research conducted via This American Internet indicates that the disease (I rate bacterial conjunctivitis on this chart) tends to run its course in a week whether or not medical consultation is sought. Opinions on whether immediate treatment is necessary run the gamut from "Eh." to "OH NOEZ!!!11"

I can rule out infection due to STDs like gonorrhoea, chlamydia or herpes, as those seem tied to copious amounts of discharge from the eye (absent), and I haven't had contact with any third-party genitalia in quite some time. Similarly, I can all but eliminate allergic conjunctivitis from the realm of possibility because I have no known allergies except cats (absent), and don't wear contact lenses.

So, all of you non-doctors in the audience, I put it to you: Must I actively seek treatment for this inconvenient malady, or is it sufficient to sequester myself in a Miss Havisham-like fashion and to wash my hands with ever-increasing ferocity and volumes of antibacterial soap? (If worse comes to worst, I am both well-insured and burdened by copious amounts of money. But finding a doctor -- particularly at 4:00am on a Sunday -- seems like such a damned chore.)

posted by Danelope to health & fitness (25 comments total)

Well, what about seeing your internist tomorrow? At worst, if your internist is booked up, see someone else in the same practice group.
posted by NucleophilicAttack at 4:24 AM on October 30, 2005

Last time I had conjunctivitis (no known cause), I just left it alone and it cleared up within a few days.
posted by Lotto at 4:44 AM on October 30, 2005

I'm pretty sure conjunctivitis is contagious, so maybe you ought to go see a doctor tomorrow to get it cleared up so you don't inflict someone else with itchy nasty pink eyes.
posted by tastybrains at 5:10 AM on October 30, 2005

If you live with someone (or occasionally share living quarters with someone), they will get pink eye. I'm speaking from experience as a former victim of this. So, you might want to get the situation cleared up for their sake.

I think a good rule of thumb for visiting your doctor would be:
Is your eye swollen?
Do you have quite a bit of discharge?
Are your eyelids stuck together with discharge in the morning?

Those things are all good signs that this is bacterial, not viral, and that you'd be better off with an antibiotic. Of course, if you have a robust immune system and it isn't anything more serious than a routine pink eye infection--it will most likely still clear up over time. It all depends on how uncomfortable you are and how likely you are to pass along the joy to somebody else.

They've also started selling some OTC pink eye relief medicines, none of which I've tried personally. But, if you go the wait-and-see route those might provide some relief.
posted by divka at 5:44 AM on October 30, 2005

Whether you decide you want to go to a doctor or not, I've found using lots of the no-water hand wash (that gel stuff that dries right away) and washing the infected eyelid/lashes with baby shampoo helps to clear up the symptoms faster (doesn't mean you're still not infectious, of course). The baby shampoo thing was recommended by a doctor to a family member that got conjunctivitis a few months ago (she got the antibiotics too) and works really well. IANAD, if you go blind from doing this it's not my fault, standard disclaimer, and so forth.
posted by Melinika at 6:02 AM on October 30, 2005

I got pink eye once. Turns out is wasn't just standard pinkeye. I had three different viral strains in one eye, and it would never have cleared up without steroid drops.

My boyfriend at the time was taking care of me, and he got it. Over a year and a half later, he's never fully beaten it. He also can't wear his contacts anymore due to what his doctor calls "corneal scarring".
posted by ArsncHeart at 6:23 AM on October 30, 2005

I'd go see the eye clinic in your local hospital. As far as eyes go, even something minor can eventually cause enough inflammation to have nasty effects. And don't rub then in the meantime.

The reason I suggest the eye clinic (if you have one) is that you can turn up and wait, and they'll know pretty much instantly exactly what it is. A GP won't.
posted by paperpete at 7:22 AM on October 30, 2005

What we call 'pinkeye' can be various kinds of viruses and infections. A doctor needs to diagnose it to know whether it's viral or bacterial. If it's bacterial (really conjunctivitis, that is) , only medication will clear it up. If it's viral, it will go away in a matter of days. There's no way for you to tell the difference by how your eye looks or feels. In the meantime, if it is a bacterial infection, allowing it to progress can do damage to your eyesight and spread the bacteria to many other people. So it's worthwhile to get treatment, even if others say theirs 'went away'. If it went away, it wasn't conjunctivitis.
posted by Miko at 7:46 AM on October 30, 2005

Your eyes are too valuable to leave to chance. I get eye infections about twice a year (I wear contacts, which contributes to the problem). My doctor gave me a prescription ointment and instructed me to use it any time I feel an eye infection coming on. It seems to clear up much faster when I catch it early.

My advice would be to go to the doctor, get a prescription, use it, then keep it in the fridge to have on hand in case of future flare-ups.
posted by bonheur at 8:59 AM on October 30, 2005

There is a lot of misinformation in this thread. A short summary from UpToDate:

Clinical experience suggests that in both adults and children most infectious conjunctivitis is viral (there's also allergic conjunctivitis). Bacterial conjuncitivits is much more pus-containing; viral is more watery. Both will usually resolve on their own, but treating bacterial with antibiotics may shorten the course and prevent transmission to others.

Definitely:
*Wash your hands very frequently.
*Try not to touch your eye.
*Wash your pillowcases daily if possible, to prevent spreading it to your other eye.
*Don't wear your contacts if you use contacts.

I'm not giving medical advice here; if you feel like you should go to a doctor, go to a doctor. Even if it's only for the piece of mind.

Actually, the Wikipedia article is pretty good.

Do you have quite a bit of discharge?
Are your eyelids stuck together with discharge in the morning?
These are *not* good questions to differentiate viral from bacterial conjunctivits.

If it went away, it wasn't conjunctivitis.
Miko, that statement is 100% false, and most of your post is incorrect as well.

Also, most conjunctivitis is not treated with steroids, ArsncHeart's case is probably special.
posted by gramcracker at 10:12 AM on October 30, 2005

Do the risk:benefit math. You stand to lose the $ you pay the doctor, plus any prescription. Benefit - you protect your eyes - both of them, since it may spread, and your partner's, as well as anybody else you come in contact with. Go get treated.
posted by theora55 at 10:31 AM on October 30, 2005

I had conjunctivitis a few weeks ago and for the most part I just let it go. I work from home and live alone so minimizing contact with other people was easy and I didn't really see the use in seeing the doctor. I did get some eye drops from Wal-Mart. Similason Homeopathic Pink Eye Relief. I don't know if it helped or not because it had been nearly a week when I got it but it was gone within two days of buying this stuff.

On the other hand, if it's severe, I'm pretty sure it can damage your vision if you don't do something about it.
posted by panoptican at 10:33 AM on October 30, 2005

In response to gramcracker: Although it certainly doesn't match up with visiting a physician for a true diagnosis, discharge and stuck-together eyes can be an indicator of the type of conjunctivitis you're dealing with.

Here is a reference describing heavy discharge and its relation to a bacterial vs. viral infection. Perhaps I should have made more of a distinct between discharge and other clear drainage from the eyes--but to clarify, read this for the desciption of a bacterial-type drainage:
link

Again, I'd agree with anyone that if you feel like a trip to the doctor is in order--go ASAP. Especially if things are getting worse instead of better...
posted by divka at 10:48 AM on October 30, 2005

Thanks to everyone for your advice thus far. Some clarifications:

1. The reason I hesitate to visit a doctor is because I don't currently have a doctor, and this condition does not seem to merit the effort of finding one, scheduling an appointment, taking time off work, going there on the bus, filling out paperwork, waiting, and seeing the internist only to be told that I have an infection that is either untreatable (viral) or (as my research indicates) will go away of its own accord.

2. I live alone, and social interaction always takes place outside of my small studio apartment. As such, my risk of transmitting to others is minimal.

3. I already wash my hands quite often which, when coupled with a juggernaut immune system, explains why I am sick so rarely. I've begun using old t-shirts as pillowcases and will be swapping them out nightly.

4. There is no apparent discharge from the eye. It feels a bit more teary than usual, but is not sticky or crusty or glued closed in the morning. In addition, my vision is not blurry, and my eye does not hurt, burn, itch or feel as if there is foreign material lodged within.

5. Whatever redness might have been present when I posted this question at 4:25am is now gone. The affected eye is more or less indistinguishable from the control case, save for a exceedingly minor swelling and tenderness in the upper eyelid. (The swelling seems to be consistent throughout, and not localized as one might expect from a stye.)

As of now, my plan is to keep an eye out observe the condition for the next 24 hours and, if the symptoms get worse, I will attempt to locate a doctor. If anyone has recommendations for a worthwhile internist or eye clinic in Seattle (preferably one that accepts Premera Blue Cross), I would appreciate any suggestions. Thanks again!
posted by Danelope at 11:12 AM on October 30, 2005

Danelope--you really should get a doctor, just to get a checkup once a year and get some labs drawn.
posted by gramcracker at 11:24 AM on October 30, 2005

You're dealing with your eyesight.
Do you really want to take the risk of going blind/having seriously impaired eyesight, vs. the inconvenience of having to find a place to go show it to someone who knows?
posted by deep_cover at 12:23 PM on October 30, 2005

Also, Danelope--if you can get a good doctor/clinic recommendation from someone here, you can always call in and ask to speak with a nurse for a quick phone consulation. At many clinics, a nurse will give you some general advice about how serious things are over the phone without any charge.

I do this fairly often when I'm on the fence about making an appointment and I find it is helpful for me :)
posted by divka at 12:30 PM on October 30, 2005

most of your post is incorrect as well

Ok, I wrote it off the cuff and I was wrong about the use of the term 'conjunctivitis'. But I've been through too much eye stuff to say this shouldn't be taken seriously. And I stand behind the rest of my post. It's true that 'pinkeye' is a completely generic term meaning 'my eye looks pink.' It's true that it can be caused by a large number of different problems. It's true that laypeople can't reliably make good diagnoses of eye problems from apparent symptoms. And it's true that any issue with the eye (that doesn't resolve quickly) is worth a doctor visit. I think going the 24 hours is a good idea. Even then, you may find it was nothing -- I once had an outrageous pinkeye thing for about 10 days. I went to the doc on the 2nd day, and he said it was your basic cold virus and I had to wait it out. It cost $80. But better safe than sorry where sight is concerned.
posted by Miko at 1:17 PM on October 30, 2005

When I had insurance but no primary doctor, I called a clinic covered under my insurance and spoke to a nurse practictioner. She asked me several questions about my symptoms and had a prescription for antibiotic gel left for me at the clinic's pharmacy. I didn't request it be done this way; I was actually calling for an appointment. She said it wasn't necessary, but told me if my eye got worse or didn't improve at least a little in 36 - 48 hours, I had to come in. Everything worked out fine and I never had to see a doctor.
posted by peep at 2:04 PM on October 30, 2005

As far as what you should do, I make no recommendation. I personally wouldn't go to a doctor for conjunctivitis unless I had copious purulent discharge, a lot of pain, or trouble with my vision. On the other hand, I have the advantage of being a doctor and feeling like I have a good idea of what to look out for. As far as what you should do, I make no recommendation.
posted by ikkyu2 at 2:57 PM on October 30, 2005

For somethihng like pinkeye, if your plan covers it, you could go to an urgent care clinic. No appointment needed, and no commitment to a doctor.

This is what I do when I have something minor that needs immediate attention: UTI, ear infection, etc. It always takes too long to get in to see my regular doctor, and for something so common and minor, I know what I need anyway.
posted by monopas at 3:31 PM on October 30, 2005

I'll fifth, sixth, and seventh getting it taken care of immediately.

The reason I suggest the eye clinic (if you have one) is that you can turn up and wait, and they'll know pretty much instantly exactly what it is. A GP won't.

This was very true for me... although another time, I lucked out when I went to the ER at a Kaiser hospital and got an ER doctor that had been an opthamologist in a past life, and immediately identified that I had iritis -- which is similar to conjunctivitis in the early-stage symptoms, but can indicate a bacterial infection that left unchecked can be fatal.
posted by SpecialK at 1:58 AM on October 31, 2005

I suffered from some bad pink eye recently. I had antibiotic drops left over from a previous bought, so I just took those. I didn't have a doctor either.

My situation worsened, and the infection spread to my eyelid and my tear duct. I tried to go to work but they took one look at me and sent me home, so I sucked it up and went to DOCS, a local clinic.

The doctor there had me panicked a little. He made me an eye doctor appointment in the morning, and told me that once the infection starts spreading it can get into your cornea and cause blindness. He gave me some new, stronger drops, and the eye doctor also prescribed some oral antibiotics.

It took me almost a week to fully recover. I looked like a boxer after a fight and had a constant trail of tears down my shirt -- I was starting to worry that my eye would always look a little deformed. I wished I had seen a doctor immediately rather than trying to self-medicate, and I will never ever screw with my eyes again.

Like the others, I'm not telling you what to do, just what I would do -- which is deal with the hassle and get to a doctor asap.
posted by mandlebrotz at 7:05 AM on October 31, 2005

I'd say you should go to the doctor BECAUSE you don't have a regular one. At your age regular checkups and physicals are less important but I think you should use this as a cautionary tale: you now have a condition you may or may not want to see a doctor for and find yourself with a taller slope to climb if you decide to see one.

What will it be like if/when you have something more serious?

Take this as a sign from the heavens that you should have somewhere you can go if you have a problem without taking time to do research and use AskMe. Go get a GP or find a local clinic. Visit them now that the quality and speed of care is less critical and find out if they're someplace you'd go back to.
posted by phearlez at 9:05 AM on October 31, 2005

A few years ago, I thought I *just* had pinkeye or conjunctivitis, but it turned out to be iritis, an infection of the iris. I had to see an ophthalmologist for a diagnosis, after seeing a primary care physician. You really need to see a doctor.
posted by cass at 1:53 PM on October 31, 2005