conjunctivitis

Skills | Eye Pain and Discharge

Eye Pain and Discharge

Eye pain can represent an ocular emergency or just an inflammatory state.  The disease and illness states of the eye are varied and many.  I will address in this article some common eye complaints.

Conjunctivitis, also called pink eye, is an irritation of the conjunctivae (the pink lining of the eye).  This irritation can stem from allergies, viral infections, or bacterial infections.  Here is a table to help distinguish the difference and make a diagnosis:

 

Allergic Viral Bacterial
Symptoms start in both eyes Symptoms usually start in one eye Symptoms almost always start in one eye
Discharge (drainage) is greenish to yellowish Discharge is greenish to yellowish, and sometimes whitish Discharge is whitish and thick
The sclera (white of the eyes) is mildly red The sclera is moderately to mostly red The sclera is moderately to mostly red
Mild discharge amount Moderate to severe discharge amount Moderate to severe discharge amount

The best treatment for all types of conjunctivitis is warm compresses to the eyes 4 to 6 times daily, using a different compress or side of the compress for each eye.  Specific treatment for allergic conjunctivitis includes daily allergy medication, oral garlic oil, oral mullein leaf oil, or once daily oral clove oil.  Specific treatment for viral conjunctivitis includes L-Lysine 1 gram orally three times daily until symptoms resolve and then for two days beyond that.  Specific treatment for bacterial conjunctivitis includes some type of ophthalmic (for the eye) antibiotic drop such as sulfacetamide, gentamycin, or ciprofloxacin, 1 drop into the affected eye every 4 hours while awake until resolved and then for two days beyond that.

Corneal abrasions are when the outer tissue of the cornea has been abraded (scuffed or scratched) by a foreign object.  This can be caused by insects flying into the eyes, sawdust – really anything that gets into the eye.  The symptoms of a corneal abrasion include an almost universal occurrence in a single eye (versus both eyes), weeping of the affected eye, redness of the sclera, sensitivity to light, and sometimes swelling.  Corneal abrasions are treated with warm compresses (as in conjunctivitis) and ophthalmic antibacterial drops or salve.

subconjunctival hemorrhage     hyphema

Subconjunctival hemorrhage (SH) and hyphema are both benign conditions where part of the eye has leaked blood into itself.  SH is painless and can occur after a hard sneeze, a coughing fit, vomiting, and other causes that put strain and pressure on the eyes.  Hyphema can occur after a direct hit to the eye.  A hyphema is usually painful as it puts pressure on the eye itself, and can partially or totally block vision.  Both conditions will resolve on their own with time.  However, with hyphema it is important to note that sometimes the pressure over the eye can increase so much that permanent vision loss, or loss of the eye, can follow.  In the field, there will be no real treatment for the escalation of intra-eye pressure.  You could try distilling a tincture from the plant pilocarpus jaborandi.  This is where we get the medicine Pilocarpine which is used for glaucoma patients (they suffer from increased intra-eye pressure and the medication helps to relieve that pressure).  Pressing the whole plant to release the liquid contents into a beaker or container with 100mL of any liquor or food-grade alcohol would yield the right ratio.  Giving the patient 5mL every 8 hours might help relieve the pressure.