FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

MEDICATION FOR PINKEYE DEPENDS ON THE BUG

Question: My friend's baby was sick with a respiratory infection and was on oral antibiotics. A few days later, both of his parents came down with pinkeye. Now I have it, too. My doctor gave me one type of eye drop, while their doctors each gave them different ones. Why were different medicines prescribed?

Answer: Pinkeye is a common name applied to a variety of medical conditions that cause the eye to become irritated and inflamed and, hence, appear "pink." Most of these are infections of the conjunctiva the mucous membrane that lines the inner surface of the eyelid and the exposed surface of the eyeball. These infections usually cause discomfort. Rarely, a "pinkeye" infection can actually threaten vision, as can other non-infectious disorders that cause the eye to become red.

In babies under a month old, the most common cause of pinkeye is an infection that is acquired while passing through the mother's birth canal. This condition carries the cumbersome medical label "ophthalmia neonatorum," and the eye infection is often associated with a respiratory infection from the same infecting organism. Prompt treatment with antibiotics is necessary to avoid serious damage to the baby's eyes as well as damage to other organs. Since most people call babies under a month old a "newborn," and you use the term "baby," I suspect the child has another type of infection.

Respiratory infections can be caused by several different bacteria or viruses. Many of these organisms, particularly H. aegyptius, Strep. pneumoniae, H. influenzae, Staph. aureus, Chlamydia trachomatis and adenovirus also cause infections of the eye. Your friend and you have probably shared one of these organisms. This often happens from getting the infecting germ on the hands, then spreading it into the eyes by rubbing them. You've probably done this, and you may or may not have gotten the original infection from the baby.

Most infections of the conjunctiva clear up with use of eye drops containing medication that kill or at least cripple the offending organism. The choice of eye drop depends on the particular germ causing the infection. We physicians often make an educated guess about which organism causes an infection based upon appearance and nature of discharge as well as the history of the illness and its progression. The alternative to this "educated-guess approach" is to take a culture and then wait two or three days for the results before starting treatment. You were given a different medication than either of the baby's parents because, while the doctors made guesses, they came to different conclusions about the nature of the offending organism.

Question: I play with my dogs every day. Is there a chance that I could give my eye infection to them?

Answer: Dogs and cats get conjunctivitis quite frequently, just like we humans do. Many of the organisms that cause infections in humans can also cause them in our pets. So yes, it is possible for you to give your pinkeye to your dogs. Fortunately though, this doesn't seem to happen all that often. Both veterinarians and physicians, however, are concerned when a cat, particularly a young cat, has conjunctivitis. This is because the infection may be caused by Chlamydia trachomatis; and, if so, it can lead to permanent eye damage without proper treatment.

So, I'd suggest that as long as you have an eye infection, you should wash your hands both before and after handling your dogs, and keep your face away from theirs. If your dogs develop an eye infection, take them to the veterinarian.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.