Common Eye Infections

It's not Halloween, but you look in the mirror and the face of an alien squints back at you. Your eye is oozing, swollen and red. You may feel like something from another planet, but don't worry: eye infections can be treated. Here's the scoop on the goop.

1. Conjunctivitis

By far, the number one type of eye infection is conjunctivitis, more commonly known as pink eye. Pink eye infections enter through a part of the eye called the conjunctiva, the thin membrane that coats the whites of your eyes. Antibiotic treatment is usually effective in treating this disease. However conjunctivitis spreads easily, so it is important to take some precautions if you have this eye infection, such as washing your hands often, not touching your eyes, and ensuring that you don't share a washcloth or a towel with another person.

For more information on the three types of conjunctivitis, see Pink Eye Blues in this issue.

2. Bacterial Corneal Infections: Staph and Strep

Corneal infections, also known as keratitis, enter your eye through the cornea, the clear globe at the front of the eye. According to Dr. Harold Stein of the Bochner Eye Institute, the cornea usually stands up well to disease. However, occasionally certain bacteria and viruses manage to enter the cornea because it is torn or injured in some way. The deeper the injury, the more severe the infection usually is.

Most bacterial corneal infections are caused by:

  • Staphylococcus, or 'staph.' Staph is found in the normal bacteria in our eyelids, skin, mouth and nose; about 20 to 30% of us are staph carriers.
  • Streptococcus, or 'strep.' This is the same bacteria that causes strep throat and many other infectious problems in our body. The strep bacteria normally resides in the mouth, skin, intestine, and upper respiratory tract.

There are a number of ways to get staph and strep infections once you have a tear or injury in your cornea. You can become infected when your eye comes into contact with a contaminated object (such as contaminated water or a dirty contact lens). Or you may already be a staph or strep carrier, and infect yourself by touching your eye. Or you can get these infections from skin-to-skin contact from another person.

Staph and strep infections can be painful. If you have one, your eyes will be red and your vision may be a bit blurry. You may also have a discharge from your eyes. If left untreated, these infections can lead to scarring, which can cause permanent vision loss and may require a corneal transplant.

If you have a corneal infection, see your eye doctor right away. Minor infections are treated with anti-bacterial eye drops. More difficult cases may require stronger antibiotics or an antifungal treatment to eliminate the infection, and you may also need steroid eye drops to reduce swelling in your eyes.

3. Corneal Ulcers

Corneal ulcers are an offshoot of corneal infections. If a corneal infection is severe, you may get a growing ulcer (a sore) deep inside your cornea, creating a pocket of secretions behind the eye. If this happens, you will experience severe eye pain. Corneal ulcers can also cause permanent vision loss very quickly.

Colour photo of eye doctor holding an ophthalmoscopeThere are a variety of ways to treat corneal ulcers, including the use of powerful antibiotics. If you suspect you might have a corneal ulcer, see your eye doctor immediately for treatment.

4. Blepharitis

There are two types of blepharitis:
  • Anterior: affects the front of the eyelid, where the eyelashes are attached. The two most common causes of anterior blepharitis are staphylococcus and scalp dandruff.
  • Posterior: affects the inner eyelid (the part that touches the eye). It is caused by oil from acne or scalp dandruff found near the eyelid.
Blepharitis symptoms include excessive tearing, the sensation of having a foreign body in the eye, burning, itching, sensitivity to light (photophobia), red and swollen eyelids, red eyes, blurred vision, frothy tears, dry eye, or crusting of the eyelashes when you wake after sleep.

Blepharitis complications can include:
  • A sty: a red, tender swelling near the edge of your eyelid. You can treat a sty by applying a clean, warm compress to your closed eye several times a day (use a small towel or face cloth dipped in clean hot water and wring it out, then apply it to your eye for about ten minutes). If your sty doesn't go away in a few days, see your doctor, who will prescribe a topical antibiotic.
  • Chala
  • zion: a painless firm lump that can follow after the development of a sty. Chalazion can be painful and red if there is also an infection.
  • Problems with your tear film: Abnormal oil secretions can result in excess tearing or dry eye. Tear film problems can make you more at risk for corneal infections.

Treatment for blepharitis involves keeping the eyelids clean and free of crusting by washing the edge of the eyelids with a cotton swab dipped in a mixture of warm water and baby shampoo. You may also be advised to treat any applicable conditions such as acne or dandruff. Talk to your doctor about developing an eye care regimen to deal with blepharitis. If your blepharitis is severe, your eye doctor may also prescribe antibiotics or steroid eyedrops.

6. Other Corneal Infections

There are numerous other bacterial and viral causes of eye infections, although they are far less common than those discussed above. Here are just a few:

Herpes Simplex: If you have a cold sore and a mildly irritated eye, chances are you have a herpes simplex eye infection. You may only have little tearing, slight light sensitivity and a feeling of dust in the eye. If caught early, herpes simplex can be treated with antiviral medication.

Herpes Zoster: If you notice painful blisters on your face or the tip of your nose, you may have a herpes zoster eye infection, the same virus that causes chicken pox. You may feel feverish and generally unwell. You'll know you have a serious eye infection because your eyes will start to water and hurt. See your eye doctor right away when you have these symptoms, so you can be treated with powerful antiviral medication.

Neisseria Gonorrhea: If your eyes swell and produce a large amount of secretions a couple of days after you have been with a new sexual partner, you may have a neisseria gonorrhea infection. Your eyes will become intensely painful and your vision may become blurred. If caught early, neisseria can be treated with aggressive antibiotics. If left untreated, it can cause a corneal ulcer, and may even lead to a ruptured cornea.

Chlamydia: If you develop mild eye irritation a couple of days after you have been with a new sexual partner, you may have an eye infection from chlamydia. Chlamydia causes mild redness, irritation, and sometimes tearing in the eyes. Chlamydia can be readily treated with antibiotics, but if missed, it can scar the cornea.

The Bottom Line

So here's the scoop on the goop: taking just a few simple precautions can help prevent eye infections and may even save your vision.

  • Wash your hands often, and try not to touch or rub your eyes.
  • Avoid sharing towels with another person.
  • If you use contact lenses, take good care of them and follow all instructions for use. See Contact Lens Infections in this issue for more information.
  • Take steps to prevent eye injuries that may scratch your eye. Use safety glasses or goggles when you do home repairs such as drilling, or use power tools when trimming hedges, for example. And make sure children are safe when playing with toys.
  • If you think you might have an eye injury, follow some simple first aid tips to avoid complications, and make sure you have the injury checked at the Emergency department or by your eye doctor immediately.
  • If you have symptoms of an eye infection, see your doctor as soon as possible.
  • If you have severe eye pain and blurred vision, see your eye doctor immediately, as it could be a corneal ulcer, and your vision is at risk.