Watch Out for Three Types of Conjunctivitis in the Eye 

The holiday season is a time for celebration and gathering with loved ones, but it also often coincides with the circulation of viruses. To minimize spreading viruses during the holidays, stay home if sick, wash hands often, cover coughs/sneezes, improve ventilation and consider wearing masks in crowded indoor spaces.

Dr. Carlo Pelino is a primary care and retinal disease eye doctor at The Eye Institute (TEI) and chief TEI’s Chestnut Hill satellite. Here he discusses the three main types of conjunctivitis, sometimes known as pink eye.   

Q: What is pink eye?  

A: Not all pink eye is a virus, but when we talk about conjunctivitis, the white part of the eye becomes red. And, it could either be allergic, which would be a presentation of a red eye and itching. It could be viral, which would give you more of a pink eye versus a redness in color. That would include more tearing and foreign body sensation inside of the eye. The third type of conjunctivitis, which presents more of a meaty red eye, is considered bacterial conjunctivitis. And those symptoms are usually, a mucopurulent discharge, usually yellow or green with a foreign body sensation. Something is inside the eye, irritating it. But what's even more important, there's a subset of conjunctivitis that we would like you to be aware of, and those are the sexually transmitted infections.  

Q: What are sexually transmitted infections?  

A: The first one that is in that subset of sexually transmitted infections is chlamydia. That is a bacteria that can infect the eye, give a pink or red color to the white part of your eye. For that, we would have to do some systemic testing, some generalized testing through your doctor and treat that with eye medications or oral medications. 

The second is also a sexually transmitted infection, and that is known as gonorrhea. Gonorrhea is more of a meaty red eye that can mimic the bacterial conjunctivitis we talked about earlier. And the gonorrhea is going to give a discharge coming out of the eye that's usually green or yellow in color, and it just keeps on oozing out.

We would have to once again, get you to your primary care doctor, and get tested to see if it is gonorrhea. In some instances, gonorrhea is treated intravenously with medications, usually an antibiotic. We would also prescribe an antibiotic for the eye. 

So far, we’ve talked about the subset of sexually transmitted infections of chlamydia, and then we also talked about gonorrhea. Those two are bacterial in nature. There are two more that we want to talk about, and those are viral in that subset. 

The first one is human papillomavirus (HPV). The human papillomavirus can give you a pink eye, but it's usually a pink eye that's associated with something that's growing on the white part of the eye, known as a papilloma. So human papilloma virus gives you a wart-like appearance on the white part of the eye. 

That wart-like appearance causes the eye to turn a pinkish color with some discharge, some tearing, foreign body sensation and so forth. And, that would have to be looked at by your general practitioner in conjunction with our eye care providers to make sure that that condition is under control.  

The fourth virus that we'll look at today is the herpes simplex virus (HSV). This particular virus can cause a red eye. The white part of the eye can turn a pinkish color or even a darker red color with this virus. And, what we have to be aware, it can also affect the cornea or the front part of the eye with an ulcer. So, it would cause some tearing to occur, a foreign body sensation like something was in the eye, maybe some mild pain initially with that redness. You would have to be examined and we would determine that you had herpes simplex virus and we would treat it appropriately with an antiviral medicine to the eye. 

Q: Can you summarize what we’ve discussed?  

A: The three main types of conjunctivitis are allergic, viral and bacteria. And in the subset of conjunctivitis, you have the sexually transmitted infections. What we talked about with those are basically the human papillomavirus, the human herpes simplex virus, gonorrhea, which is a bacteria and chlamydia, which is a bacteria as well. 

One other important thing to remember is that if left untreated, some of these conditions can cause some scar tissue to occur in the eye with a possible reduction of permanent visual loss. If you think that you have one of these conditions that we mentioned, please don't panic. Feel free to give us a call, we will examine you and we will get the appropriate diagnosis and treatment. 

Call The Eye Institute (TEI) at 215.276.6111 to schedule your appointment today.