1. Red Eye or Acute Conjunctivitis?
Conjunctiva is a layer of transparent membrane covering the eyes. When it is inflamed or infected, it is known as conjunctivitis. Conjunctivitis is one of the most common eye diseases and it is usually infective in nature, either by virus or bacteria. Other causes include allergy, contact lens, air pollutant, or chemical agents.

2. What is the incubation period?
Usually one to twelve days, depending on different inciting agents. That means when one is exposed to the inciting agent, he/she may not develop the disease until as long as twelve days later.

3. How does one get conjunctivitis?
Conjunctivitis usually spreads through direct or indirect contact. The infective agent is present in the tears and discharge, which may then contaminate the sufferers' belongings like handkerchief, basin, towel, eyedrops or toys. Other people may get the disease if he/she comes into contact with these objects.

4. What are the signs and symptoms?
Early: itchiness, scratching or foreign body sensation, congested and red eyes, discharge from eyes.
Late: tearing, chemosis, severe red eyes and hemorrhage, lid swelling
Both eyes can be affected at the same time or one eye may follow the other.

The disease process varies with different inciting agents. It may last from a few days to a few weeks. By the time there is no more redness and discharge, the disease ends. Conjunctivitis is usually a self-limiting disease without significant long-term consequences.

5. Nursing care and self care
- Seek proper medical advice, apply medication as instructed and take adequate rest
- Avoid strong light which may be uncomfortable to the eyes
- To prevent the disease from spreading
- Avoid sharing or towels, basin with family members.
- To sterilize the towel, basin, bed cover, pillow cover and other contaminated self-belongings. Method: Put these things into - boiling water for 15-20 minutes to ensure complete eradication of the infective agents.
- Used tissue paper should be properly disposed of into litterbin or flushed down the toilet.
- Keep the hands clean, not to rub the eyes with fingers, and not to share eyedrops or cosmetics with others.
- Always wash the hands before using eyedrops.
- Patients should avoid using some public facilities, like swimming pool, before they have recovered.

Q/A

Q: I want to ask how to prevent and treat epidemic red eyes (F/30)

A: I believe you are talking about epidemic conjunctivitis. This is a highly infectious disease caused by a virus called adenovirus. This is not a common disease but when it happens, a group of people may be affected at the same time.

Sufferers will have red eyes, tearing and discharge, enlarged neck lymph nodes. As this is caused by a virus, there is no particular anti-microbial agent. The immune system will tackle the virus. Yet, topical antibiotics may be prescribed to prevent secondary bacterial infection. The disease usually lasts one to three weeks and there is usually no long-term consequence. Occasionally, there may be some faint marks on the cornea, which take months to resolve.

Prevention is better than cure. Good self-hygiene and hand washing are essential, particularly when one of the family members get infected. The towels and handkerchiefs should not be shared and should be well sterilized before usage.

Q: Is repeated episodes of "eye hemorrhage" and early sign of severe systemic disease? (F/62)

A: The appropriate medical term is sub-conjunctival hemorrhage. Healthy people may have this condition when the tiny blood vessel in the conjunctiva get injured as in severe coughing and heavy exertion. Not uncommonly, there is no cause identified.

This condition is usually mild and self-limiting. It will not affect your vision and it will resolve in one to two weeks time. Yet, if one gets repeated episodes of sub-conjunctival hemorrhage, it would be safer for he to be seen by an internist for blood pressure checking and circulatory system assessment.

Q: I am suffering frequent red eyes and a lot of eye discharge in the morning for a long time. This problem waxes and wanes and I have not been seen by eye doctors, is this all right? (M/36)

A: From your description, you have whitish secretion in the morning. These are formed by sebum from the sebaceous glands of the eyelids. It is not infectious and do not get worse. Some healthy people do have a lot of these if their sebaceous gland is very active. Of course, there would be even more discharge if one gets conjunctivitis.

If we are talking about red eyes, there are many possible causes and conjunctivitis is the most common cause. You can refer to the previous page for further information.

Finally, I think it would be appropriate for you to seek proper eye care.

Special thanks to Dr. Lam Nai-man for contributing this article.

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