Avery famous actor cum politician was constantly ridiculed for being drunk all the time owing to pink eye. But the truth is he wasn’t drinking that much. And anyone can have pink eye, even if he’s not drunk or has a disease. (Pink eye photo here)

As we go closer to the equator, pink eye is a common phenomenon that occurs in most of the people. It’s the eye’s defence mechanism against the highly dynamic tropical weather. We, ophthalmologists, call it muddy conjunctiva. The conjunctiva is a loose transparent tissue that covers the white part of the eye called sclera. (Conjunctiva photo here)

A muddy conjunctiva doesn’t require any action, and no, there is no medicine to help bleach it. Just live with it and ignore the criticism that comes with it.
We need to be selfish about certain imperfections in the body, and a muddy conjunctiva is one of them.

When the pink eye becomes a disease, it’s called conjunctivitis. You can self-diagnose it doesn’t go away in 24 hours… And it’s imperative not to be egoistic and get an over-the-counter drug from the pharmacy and visit your ophthalmologist. Doing so can worsen the situation and can even cause loss of vision.

Behind the scene of a pink eye:
Eyes appear bloodshot or pink because the blood vessels of the conjunctiva become prominent due to reactions induced by either a virus, a bacteria, or an allergen like dust or pollen.

Sometimes, it follows a chemical spillage into the eye (cleaning liquids) or if your eyes trap a foreign body (pieces of tar or a but during welding. In newborns, it can occur with a faulty duct. Tear Pink eye usually happens in both eyes and responds well to medication. It can follow the common cold, a virus transmitted to the eyes via the nose to the tear duct to the eye.

That said, how do we know it will heal itself or require medication? No, you can’t many times (barring the 1st 24hrs). It requires an ophthalmic slit lamp examination by an ophthalmologist (photo here) to diagnose and treat.

What will you usually complain about?
You can experience one or all the following: redness, itching, watering, swollen eyelids, grittiness, discharge, sticky crusty eyelids, and sometimes blurriness of vision, and in worse cases, sensitivity to average daylight.

Will looking into an affected person’s eye spread the disease?
Yes and no. The disease spreads by contact. It’s highly contagious. The tears, discharge and crust have either one of the antigens (disease-causing agent) and if you touch any infected surface and your face or eyes, the disease also spreads to you.

So if you are dangerously close to the affected person’s face, looking into their eye, and ready to pop the question with a ring in your hand, chances are you will catch the infection by a droplet transmission directly entering your eyes.

What will the ophthalmologist do?
He will take your history and assess your symptoms. Most diagnoses are done with just history. In addition to reinforcing it, he will do a basic vision check and examine you under a slit lamp and clinch the diagnosis.

Types of pink eye
You will notice a spurt of “Madras eye” in the country during seasons like summer. Madras eye got its name as the disease was discovered 1st in erstwhile Chennai at the Regional Institute of Ophthalmology in Egmore.

Virus – It’s usually adeno viral or Herpes simplex. Many a time, it mimics bacterial conjunctivitis and has to be treated very prudently. If not, it can cause extensive corneal damage (cornea image here). This is self-limiting, so you need to treat the symptoms. This occurs in all seasons.

Bacterial is like viral but occurs during summer. I have seen a spurt of viral conjunctivitis from November 2022 to 2023, And there was considerable debate if this was a new coronavirus strain. But since it responded well to medication, no one bothered to gene map it.

Allergic conjunctivitis is caused by dust or pollen. It’s generated by factors called Histamines released when allergens come in contact with our immune system.

It isn’t nice when a contact lens wearer sleeps without removing them. It causes another condition called keratitis (meaning cornea). It’s a potentially vision-threatening condition and requires immediate attention.

In case of chemical spillage, it’s imperative that you immediately wash the eye with tap water and rush to consult your doctor. And if there is a foreign body, only an ophthalmologist can remove it. So don’t try to extract it using a rupee note (now you know why it’s not in circulation) or rubbing your eyes.

For newborns, it’s usually straightforward diagnosis and treatment.

Ask your ophthalmologist to teach you a tear duct massage to open the baby ducts.

Pink eye is treated with various drugs ranging from cortical steroids to antibiotics to artificial tears. Sometimes antivirals. Steroids need to be reduced sequentially as the disease responds to the medication. A cold compress can ease some discomfort. I sometimes prescribe sterile lid wipes to clean the sticky eyelids.

It also helps to heal faster if you keep off digital devices and rest for at least four days. And please tell your HR or school principal to grant you leave until the doctor deems you non-contagious. Pink Eye loves closed spaces, standard rooms, cinema theatres, air-conditioned train and bus coaches, flights, etc. Pink eye usually resolves in 7 days to 10 days.

Home remedies
Pick a towel, wrap some ice cubes, and gently massage the eyes for relief.

If you can’t find lid wipes, get a clean, soft cloth, dip it in hot water and soak the sticky eyelids to release the matting gently.

Never sleep with contact lenses on. If found infected, discard all of them and meet your doctor. That’s why it always helps to keep a pair of standby spectacles or correct your vision using LASIK.

Does mother’s milk cure pink eye?
I always tell my patients that mother milk best belongs in a baby’s belly and castor oil in a lamp. So spare that friendly neighbourhood mother and stop watching TikTok videos that spread fad-like benefits of castor oil to the eye.

If you want your eyes to be in the pink of health, then avoid getting pink eye.
Constantly sanitise your hands, avoid touching your face, sharing linen, wearing sunglasses or eye visors while welding, etc.

Since the famous actor didn’t have the disease, he used it to his advantage by portraying himself as an angry young man with a heart that melts seeing his mother in agony. Just be narcissistic when it comes to your imperfections. You will see people love you for who you are.