Email a Friend
Print Article
When 'Pinkeye' Becomes Red Eye
Twice this week I've seen patients with simple viral pink-eye. It's usually caused by the same virus that causes the common cold, hence the expression 'cold in the eye'.
When it came time to counsel and discharge the patients they both asked, "What about the antibiotics?" Each had been referred to my clinic by an outside provider who was not an ophthalmologist, and both had already been prescribed an expensive, broad-spectrum antibiotic eyedrop. Hmmm...should I continue the use of antibiotic eyedrops for viral pink-eye?
The concern is superinfection, a second bacterial infection piggybacked on top of the viral infection.
I do not find the specter of superinfection persuasive and usually do not superprescribe antibiotics. Healthy folks with an uncomplicated common cold usually do not start taking Amoxicillin or Zithromax, right?
Most healthy folks have an intact immune system, that's how they got pink-eye in the first place! The same inflammatory cells mobilized to attack a virus will pounce on a bacteria with even greater ferocity. Compared to viruses, bacteria are huge, clumsy targets.
I also worry about something called medicomentosa. All eyedrops sting when applied to inflamed eyes. The chemistry of antibiotics are especially prone to further irritate the eye, making it appear even more inflamed. Should the patient return to clinic 2 days later with an intensely red eye it could be difficult to determine with confidence its true cause - it might simply be a reaction to the antibiotics eyedrops. It often is!
Contracted a case of viral pink-eye? Wash your hands frequently, avoid contact with others, and use preservative-free artificial tears to keep the eye comfortable. Things should resolve (just like a cold) in 5-7 days.
Related Topics: Antibiotics: Good Choice for Pinkeye?, Back-to-School Health Checkup
Technorati Tags: pinkeye, antibiotic eyedrops
When it came time to counsel and discharge the patients they both asked, "What about the antibiotics?" Each had been referred to my clinic by an outside provider who was not an ophthalmologist, and both had already been prescribed an expensive, broad-spectrum antibiotic eyedrop. Hmmm...should I continue the use of antibiotic eyedrops for viral pink-eye?
The concern is superinfection, a second bacterial infection piggybacked on top of the viral infection.
I do not find the specter of superinfection persuasive and usually do not superprescribe antibiotics. Healthy folks with an uncomplicated common cold usually do not start taking Amoxicillin or Zithromax, right?
Most healthy folks have an intact immune system, that's how they got pink-eye in the first place! The same inflammatory cells mobilized to attack a virus will pounce on a bacteria with even greater ferocity. Compared to viruses, bacteria are huge, clumsy targets.
I also worry about something called medicomentosa. All eyedrops sting when applied to inflamed eyes. The chemistry of antibiotics are especially prone to further irritate the eye, making it appear even more inflamed. Should the patient return to clinic 2 days later with an intensely red eye it could be difficult to determine with confidence its true cause - it might simply be a reaction to the antibiotics eyedrops. It often is!
Contracted a case of viral pink-eye? Wash your hands frequently, avoid contact with others, and use preservative-free artificial tears to keep the eye comfortable. Things should resolve (just like a cold) in 5-7 days.
Related Topics: Antibiotics: Good Choice for Pinkeye?, Back-to-School Health Checkup
Technorati Tags: pinkeye, antibiotic eyedrops
