Pink eye
January 15, 2008 6:29 PM   Subscribe

Can pink-eye cause permanent blindness?

I've got a raging infection in my left eye right now. Yesterday I went to see the doctor, and he looked at it and then prescribed me Tobramycin, one drop in each eye ever four hours for a week.

This morning when I woke up, vision in my left eye was really foggy. There was a lot more gunk than usual in it. That sometimes happens to me anyway when I wake up, and I use artificial tears (Visine Tears) to rinse the gunk out. But it didn't totally help.

My left eye hurts enough so that I've been keeping it closed, and using my right eye today. But when I do open my left eye and look at things, it's kind of milky, a bit fogged. I can focus, but it's like I'm looking through a piece of waxed paper, or like my glasses lense is really smeared. I'm beginning to be a bit afraid: has the infection damaged my cornea? If that's why things look foggy, is it permanent, or will it clear up when the infection does?

I've tried several times today to rinse that eye (with Visine Tears) but it hasn't done any good. When I look at it in the mirror, I don't see anything wrong, but I'm not a doctor and I'm not using any medical instruments for a close look.

Wikipedia (that great and wonderful source of medical knowledge) says that pink-eye can be caused by a lot of things, but based on what they do say and how the doctor reacted, it's probable that what I've got is bacterial. Gunk in the eyes, pain when I look up or down, the fact that it's not symmetric, the fact that I don't have any respiratory problems right now, etc. The question is whether the fogginess I'm seeing in that eye might be permanent. I am not really happy about the idea of partial blindness, and I'm a bit afraid here.

Can anyone reassure me?
posted by Steven C. Den Beste to Health & Fitness (26 answers total) 2 users marked this as a favorite
I am not a doctor but I have had pink eye. Here's what I found.

It's not permanent.

Your optical nerve isn't damaged, your cornea is fine. When I had pink eye, I had the same foggy vision for a few days. Why? Because your eye is releasing pus that is obscruing your vision. Visine won't help remove it and, in fact, I would suggest against using that. You want to do all you can to not have the anti-biotic from being washed off your eye.

Wipe the gunk off your eyelid using a cloth or paper towel and then wash your damns hands! I cannot stress this enough. Pink eye is extremely infectious and you can also infect your other eye if you're not careful. Wash your hands, don't touch your eyes, sleep on one side of your face, and keep your eye, and contact with other people minimal. Unless you have an enemy and you want to annoy them. If you do, then go wave your pink eye at them.
posted by Stynxno at 6:38 PM on January 15, 2008

I'm also suffering from pink eye at the moment...not fun! IANAD, but my understanding is that UNTREATED, pinkeye can lead to further problems, like blindness. Venturing a guess, perhaps you're allergic to the antibiotics? I had a similar problem a few months ago during an earlier contraction.

Additionally, throw out your existing Visine bottles and buy new. You can have traces of the bacteria on the dropper and are essentially re-infecting your eye and building up a resistance to the antibiotics you're on. My doctor also recommends washing your eyelashes with baby shampoo until the infection clears up, to remove any bacterial gunk left in the lashes.
posted by messylissa at 6:40 PM on January 15, 2008

Do you have any photophobia?
posted by sulaine at 6:41 PM on January 15, 2008

Pink-eye is a layman's term for conjunctivitis which is usually self-limited. Conjunctivitis can be caused by many different agents though, some being more serious than others. That combined with other factors (patients immune response, etc) determine the outcome.

Basically, yes it can involve your cornea and yes it could affect your vision permanently. You should contact your doctor and tell him about any changes (vision, pain). You also might want to ask if he did a culture to ID the responsible agent.
posted by sero_venientibus_ossa at 6:47 PM on January 15, 2008

Pinkeye can be viral or bacterial--usually staph or strep, but chlamydia can cause it, too (rarely in North America). If it's viral, antibiotics are ineffective. IANAD, but you should see one if you're worried.
posted by weapons-grade pandemonium at 6:52 PM on January 15, 2008

Turf the Visine for good. It's too harsh for infected eyes. Today's extra gunk and pain may be a reaction to the Visine rather than the infection.

For your comfort, and to help the medication do its work, get the morning gunk out of your eyes with a baby shampoo solution, as messylisa has said. Alternatively, you can buy something called LidCare. It's more expensive than shampoo, but it's sterile and the right concentration for your eyes.

Use separate gauze on each eye: first wipe the inner edges of your lids, then -- with a fresh piece of gauze -- wipe your eyelid. Do the same with the other eye, using up a total of 4 pieces of gauze. If you gunk up again at night, repeat the routine.

Keep applying the topical antibiotic every 4 hours. It should go in after de-gunking: don't de-gunk after applying the topical. Use a fresh pillow case each night, or at least lay a clean towel on top of it.

If things are better or no worse tomorrow, it's probably bacterial. If it starts getting worse, then another visit to the doctor may be a good idea, especially if a culture wasn't taken.

If you repeatedly get eye infections, certainly talk with your doctor. He may advise that you clean your eyes every morning with LidCare or something similar on a daily basis to make the next infection less likely.
posted by maudlin at 7:07 PM on January 15, 2008

This is the first infection of this kind I've had in my life, as far as I remember. I have a vague memory from when I was really little of my parents putting some sort of ointment in my eyes; maybe it happened then, too. But it's certainly been more than 45 years. It's not a chronic thing.

As to doing a lab test, I think I agree with him that there was no point. If it's viral, the antibiotics won't do any good, but nothing else will either and it'll either kill me or my immune system will clear it up. If it's bacterial, then presumably the eyedrops will help. They only cost $16, and a lab test would cost a lot more than that, and take too long. By the time the result came back, it would already be moot.

I'm not allergic to antibiotics. I'm certainly not allergic to this one, because I'm also using it in my right eye and haven't had any comparable reaction there.
posted by Steven C. Den Beste at 7:29 PM on January 15, 2008

Keep using the antibiotics. I got pinkeye a lot as a kid and it would get worse as soon as I started drops and then get better in a day or so.
posted by martinX's bellbottoms at 7:40 PM on January 15, 2008

I'm gonna assume that "gunk" is a white/yellow translucent discharge a.k.a. pus, similar to yellow snot from your nose. If so, this is a good sign. It's just the remains of white-blood cells that were fighting the infection. Given that you're also receiving antibiotics, the infection should clear up very quickly.

Give it another day, and in the meantime practice good hygiene as others have suggested. In addition to what's been said so far, you should change pillow cases daily and wash them in very hot water (separately if the color runs).
posted by randomstriker at 9:14 PM on January 15, 2008

I don't know, Steven, this is your eye, and even though having to wear a patch over it might give you a permanent lock on the role of Odin in the annual Sons of Norway re-enactment of the Elder Edda, I think you should get back to that doctor sooner rather than later, if not go to the emergency room right now.

You mention glasses, not whether you wear contacts, but just last summer there was a recall of an AMO contact solution associated with an amoebic infection (Acanthamoeba keratitis, or AK) which did "commonly" lead to cases of corneal scarring and occasionally blindness, and in 2006, a contact lens associated fungal infection (Fusarium keratitis) also led to a recall and even more serious eye problems. Tobramycin has no activity against amoebas or fungi.

You could wait and see what happens, but that includes a lot of possibilities, and most of them are bad. Please go somewhere and get this taken care of as soon as possible.
posted by jamjam at 10:18 PM on January 15, 2008

Last time I self-medicated for pink eye, I made a compress of green tea bags soaked in warm water and honey and repeated all day long for a couple of days. It's a little sticky, but I got over the bad eye juju faster than I've ever gotten over it before.

(My doctor did check out my eye and tell me I'd be okay if I did this, by the way)
posted by katillathehun at 10:24 PM on January 15, 2008

I don't wear contacts. (It isn't possible to make contacts for my correction: 3.5 diopters of vertical shift.)
posted by Steven C. Den Beste at 10:43 PM on January 15, 2008

I'm very prone to getting Pink Eye. I've had it at least ten times. In fact, I just got over a case last week. The effects are most definitely not permanent, just a pain in the butt.
posted by cmgonzalez at 11:09 PM on January 15, 2008

You will not go blind, but in extreme pinkeye cases it does feel like that for a day or two. Here's the advice I got from the nurse-practitioner at the CVS MinuteClinic: Before applying your prescription eyedrops, dab each eye with damp (saline or distilled water) cotton balls. Use a separate cotton ball for each eye to avoid cross-infection. Wash hands thoroughly afterwards.
posted by brownpau at 6:47 AM on January 16, 2008

Go see an ophthalmologist goddamnit.

As a PCP, a rule of thumb to live and fail by is "all red eyes are not pink-eye". Only a slit lamp exam will say for sure. If this is iritis, or herpetic injury, or a bunch of other things, it could get worse and cause permanent damage.

Call your doc and tell him you are having visual deficits and increased pain and demand a same-day consult with whatever ophtho is on call in your community.
posted by docpops at 11:14 AM on January 16, 2008

(Human) Breast milk is a folk remedy for pink eye.
posted by frecklefaerie at 1:29 PM on January 16, 2008 [1 favorite]

I've had pink eye. My mother's had pink eye. Wash it with baby shampoo. The other people that told you this are not kidding. It really works to clean up the gunk and the yucky feeling in your eye fast.
posted by Melinika at 8:03 PM on January 16, 2008

Just an update, for anyone keeping up with this. Today I went back to the local doctor and told him about the cloudy vision and the continuing pain. While I was walking over there, when I looked up at the overcast sky I noticed that the cloudiness has a texture, and it moves the way floaters do. So I had been worried that something had happened to the cornea, but after that I thought maybe something had gotten into the vitreous humour.

The doctor used a flourescent dye to check the cornea and said there was nothing wrong. He referred me to an opthalmologist (sp?) and they got me an immediate appointment.
The Opth etc. used a machine and said, that's not conjunctivitis, that's uveitis. Apparently it's sometimes a side effect of an immune storm, but often there's no discernible cause. In any case, it doesn't seem to have anything to do with an infection.

He dilated my eyes to get a better look inside. The right one (which is apparently quite healthy) dilated nicely, but the left one (still red and gross looking) didn't, and that's another demonstration that uveitis is involved. Apparently there's some gunk in there sticking the iris to where it is and preventing it from moving.

So I've got two kinds of eye drops to use. He told me to stop using the tobramycin. Instead, I've got Cyclogyl to be used three times a day to keep the iris trying to dilate, so it can get unstuck, and Pred Forte to be used four times a day. That one's a corticosteroid to get the swelling down and reduce the immune overreaction.

Whatever he did to dilate the eyes also made most of the pain stop. He said that's quite common.

I'm supposed to keep using both drops until next Wednesday, when I have an appointment to return.
posted by Steven C. Den Beste at 5:03 PM on January 17, 2008

Oh yeah. I had that once. Two doctors mis-diagnosed it.

I saw my GP, she said it was eye strain. Took some polysporin eye drops anyway. Eventually went to emerg. First doctor looked at it forever, said it was an infection. But he was an intern. So when he got double-checked by what I guess was a real doctor, she said I had a real problem. They sent me up two stories to an ophthalmologist and *poof* a real diagnosis.

As he was writing the prescription, he asked if I had back pain. I actually have a lot of lower back problems, yeah. Apparently they're related.

Anyway, it should get better. Good luck!
posted by GuyZero at 6:36 PM on January 18, 2008

Did your vision get cloudy? And if so, how long did that take to clear?
posted by Steven C. Den Beste at 6:56 PM on January 18, 2008

That was probably 6 years ago and it's never come back since (knock on wood!).

It took a day or so to get mostly better and then several days to get totally better.
All I remember now is wicked, horrible light sensitivity. Which was the source of the pain. I don't remember cloudyness, but I do remember working very hard to keep that eye shut, so it's hard to say. But it should get better with the steroid pretty quickly. YMMV.
posted by GuyZero at 7:25 PM on January 18, 2008

If it had gotten cloudy, you'd have known it. So it sounds like it didn't. Thanks anyway.
posted by Steven C. Den Beste at 9:34 PM on January 18, 2008

As of today, the dilator has done what it's supposed to do. My iris is fully dilated, and the pupil is nice and round. Yay!
posted by Steven C. Den Beste at 1:09 PM on January 19, 2008

Is the cloudiness gone?
posted by jamjam at 3:52 PM on January 20, 2008

Unfortunately, no. If anything, it's worse now. I have an appointment on Wednesday, and that's one of the things I'm going to ask about.

But I'm not too worried about it. "Cloudy vision" is one of the main diagnostics for uveitis, and all reports are that prognosis is good with the right treatment, so that suggests that people who get cloudy vision get better.
posted by Steven C. Den Beste at 6:02 PM on January 20, 2008

Just got back from the eye doctor.

The iris is now fine. I don't have to use the dilator any more. The inflammation is nicely reduced, but I have to continue using the steroid in gradually declining amounts for the next month to avoid a relapse. My vision is much less cloudy now, and basically everything seems to be progressing about as well as it can be.

So it's good news.
posted by Steven C. Den Beste at 12:16 PM on January 23, 2008

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