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Your Complete Guide to Eye Infections

Find answers to all your questions about eye infections, from identifying symptoms and understanding stats to treatment options and prevention. Learn when it's time to treat an eye infection as an emergency.

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Your Complete Guide to Eye Infections Optometrist
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When is an Eye Infection an Eye Emergency?

According to the American Academy of Ophthalmology, 85% of eye infections are bacterial, viral, or fungal, and each requires specific treatment. It's not advisable to self-treat as you could worsen the condition.

Eye infections can vary in severity, and while some may resolve on their own or with home care, certain symptoms should prompt you to seek immediate medical attention from an eye doctor or visit an emergency room.

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Do I need to go to an emergency room or eye doctor for an eye infection?

It is always advisable to schedule an emergency eye exam with either an optometrist or ophthalmologist if you have an eye infection. In certain situations where the only available care is urgent care or an emergency room, you may be advised to go there, however in general eye doctors have the equipment and training to best diagnose and treat eye infections of all types. 


While each situation is different, we have listed some potentially serious symptoms that require immediate medical attention. This list is not a replacement for an eye doctor, and if you are unsure it is always advisable to call an eye doctor to get specific guidance.

Symptoms that require an emergency eye exam

These symptoms suggest a potentially serious condition that requires immediate evaluation by an eye doctor:

Severe eye pain: Intense and persistent eye pain that is not relieved with over-the-counter pain relievers should be evaluated promptly.

Sudden vision changes: Any sudden loss of vision, whether partial or complete, warrants immediate attention.

Eye trauma: If you have sustained an eye injury, such as a foreign object embedded in the eye or a chemical exposure, seek immediate medical care.

Severe light sensitivity (photophobia): Experiencing extreme sensitivity to light, to the point where it is unbearable, may indicate a serious eye infection or condition.

Severe Redness and swelling: If your eye is extremely red, swollen, and painful, it could be a sign of a severe infection or inflammation.

Blurred or distorted vision: Vision that becomes suddenly blurred or distorted, especially if accompanied by other symptoms, is cause for concern.

Discharge or pus:  Thick, yellow or green discharge from the eye, is generally a sign of a bacterial, viral, allergic, or gonococcal conjunctivitis. However when these symptoms are accompanied by pain and redness, that may indicate an infection that requires immediate attention and should be seen by an optometrist.

Fever: If you have a fever in addition to eye symptoms, it could suggest a systemic infection that needs prompt medical evaluation.

Foreign body sensation: If you feel like there's something stuck in your eye, don't try to remove it yourself; instead, seek professional care. Learn more about foreign body sensation.

Double vision: Double vision that appears suddenly or is persistent should be investigated by a healthcare professional. Learn more about double vision.

Eye swelling with facial swelling: Swelling around the eyes, particularly if it spreads to the face, could be indicative of a serious infection or allergic reaction.

Eye pain with a history of recent eye surgery or injury: If you've recently had eye surgery or sustained an eye injury and experience severe pain with or without accompanying infection symptoms, contact an optometrist for an emergency eye exam.

Severe headache: A severe headache associated with eye pain, eye infections, or vision changes can indicate a potentially serious condition, such as glaucoma.

Loss of peripheral vision or tunnel vision: A sudden loss of peripheral vision can be a sign of conditions like retinal detachment or acute angle-closure glaucoma.

Eye symptoms in an infant or young child: If a child has eye redness, discharge, or other concerning symptoms, it's important to seek pediatric eye care promptly.

Infectious endophthalmitis is an emergency condition that requires urgent referral to an ophthalmologist and may be associated with cataract surgery, intravitreal injections, trauma, or systemic infections.

Eye Infection Stats You Should Know

Eye Infection Stats You Should Know

  • According to the Centers for Disease Control and Prevention (CDC), there are almost million outpatient and emergency department visits for keratitis (corneal infections) each year in the United States.
  • Up to 1 in 500 contact lens users per year are affected by serious eye infections that could result in blindness.
  • Conjunctivitis, commonly known as pink eye, accounts for an estimated 3 million school days lost each year, as per the American Academy of Ophthalmology.
  • 1 in 3 Americans are estimated to have shingles, a viral infection that can affect the eyes. In fact an estimated 200,000 cases of shingles cases per year in America impact nerves in the head which can lead to an infection in the eye and eyelids. 
  • The World Health Organization estimates that globally, 1.5–2.0 million people become blind due to scarring resulting from eye infections like trachoma each year.
Signs & Symptoms of Eye Infections

Signs & Symptoms of Eye Infections

Bacterial Conjunctivitis (Bacterial Eye Infection):

  • Common Symptoms
    • Redness and pink eye
    • Watery discharge
    • Gritty or itchy sensation
    • Swollen eyelids
    • Mild discomfort
  • Common Signs
    • Redness of the whites of the eyes
    • Crusty or sticky eye discharge, especially in the morning
    • Swelling or puffiness around the eyes
    • Sensation of a foreign body in the eye
  • History
    • Recent exposure to someone with pink eye
    • Close contact with individuals in crowded or shared spaces
    • Often affects both eyes
    • Can be associated with upper respiratory infections

Viral Conjunctivitis (Viral Eye Infection or Pink Eye):

  • Common Symptoms
    • Redness and pink eye
    • Watery discharge
    • Itchy or burning sensation
    • Swollen eyelids
    • Mild discomfort
  • Common Signs
    • Redness of the whites of the eyes
    • Crusty or sticky eye discharge, especially in the morning
    • Swelling or puffiness around the eyes
    • Sensation of a foreign body in the eye
  • History
    • Exposure to someone with pink eye or viral illness
    • Common in schools or other crowded settings
    • Often starts in one eye and spreads to the other
    • Can accompany other viral symptoms like a runny nose or sore throat

Allergic Conjunctivitis (Eye Allergies):

  • Common Symptoms
    • Redness
    • Watery eyes
    • Itching and burning
    • Swollen eyelids
    • Mild discomfort
  • Common Signs
    • Redness of the whites of the eyes
    • Swelling or puffiness around the eyes
    • Clear, watery eye discharge
    • Allergic shiners (dark circles under the eyes)
  • History
    • Exposure to allergens like pollen, pet dander, or dust mites
    • Seasonal patterns of symptoms
    • Family history of allergies
    • Often affects both eyes

Fungal Eye Infections:

  • Common Symptoms
    • Severe redness
    • Eye pain
    • Light sensitivity
    • Decreased vision
    • Discharge (can be thick)
  • Common Signs
    • Redness of the whites of the eyes
    • Swollen eyelids
    • Corneal ulcers (rare but serious)
    • Decreased corneal clarity
    • Eye discharge may contain fungal elements
  • History
    • Outdoor activities in humid or wooded areas
    • Use of contaminated contact lenses or lens solutions
    • History of eye trauma or injury
    • Previous fungal infections (e.g., athlete's foot)

Stye (Hordeolum):

  • Common Symptoms
    • Painful red lump on the eyelid
    • Swelling and tenderness
    • May produce a pus-filled head
    • Sensation of a foreign body
  • Common Signs
    • Red, swollen, or puffy eyelid
    • Visible bump on the eyelid (external stye)
    • Pain or discomfort when blinking
    • Crustiness around the eyelid
  • History
    • Previous styes or chalazia
    • Eyelash follicle inflammation
    • Poor eyelid hygiene
    • Use of eye makeup or cosmetics

Keratitis (Corneal Infection):

  • Common Symptoms
    • Eye pain
    • Redness
    • Sensitivity to light
    • Blurred vision
    • Excessive tearing
  • Common Signs
    • Inflammation of the cornea (keratitis)
    • Cloudy or opaque appearance of the cornea
    • Presence of corneal ulcers or infiltrates
    • White blood cells in the cornea (hypopyon)
  • History
    • Recent eye injury or trauma
    • Use of contaminated contact lenses or lens solutions
    • Exposure to waterborne pathogens (Acanthamoeba keratitis)
    • History of herpes simplex virus (HSV) infections

Contact Lens-Related Infections:

  • Common Symptoms
    • Redness and discomfort
    • Blurred vision
    • Excessive tearing
    • Sensitivity to light
    • Eye pain
  • Common Signs
    • Redness of the whites of the eyes
    • Corneal inflammation or ulcers
    • Pus or discharge from the eyes
    • Discomfort while wearing contact lenses
  • History
    • Non-compliance with contact lens hygiene and care
    • Extended wear of contact lenses
    • Swimming or showering while wearing contacts
    • Use of expired contact lens solutions

Chlamydial Eye Infection:

  • Common Symptoms
    • Redness and discomfort
    • Watery eyes
    • Itching
    • Swollen eyelids
    • Mild discharge
  • Common Signs
    • Redness of the whites of the eyes
    • Swollen or puffy eyelids
    • Mild, watery eye discharge
    • May affect one or both eyes
  • History
    • Recent sexual contact with an infected partner
    • Exposure to infected genital secretions
    • Newborns can acquire it during birth (neonatal conjunctivitis)
    • Unprotected sexual activity

Herpes Simplex Virus (Ocular Herpes):

  • Common Symptoms
    • Eye pain
    • Redness
    • Sensitivity to light
    • Blurred vision
    • Tearing
  • Common Signs
    • Redness of the whites of the eyes
    • Corneal inflammation or ulcers
    • Recurrent outbreaks with clusters of small, painful sores
    • Often affects one eye
  • History
    • Previous oral or genital herpes outbreaks
    • Stress or illness triggering outbreaks
    • May have recurring episodes of ocular herpes

Parasitic Eye Infections (Acanthamoeba Keratitis):

  • Common Symptoms
    • Severe eye pain
    • Redness
    • Light sensitivity
    • Blurred or decreased vision
    • Excessive tearing
  • Common Signs
    • Inflammation and redness of the cornea
    • Corneal ulcers with a ring-shaped pattern
    • White blood cells in the cornea (hypopyon)
    • Severe discomfort and pain
  • History
    • Exposure to water sources (e.g., tap water, swimming, or hot tubs)
    • Inadequate contact lens hygiene or use of contaminated solutions
    • Use of poorly fitting or extended-wear contact lenses
    • Activities involving soil or dust exposure

Viral Keratitis:

  • Common Symptoms
    • Eye pain
    • Redness
    • Sensitivity to light
    • Blurred vision
    • Excessive tearing
  • Common Signs
    • Redness of the whites of the eyes
    • Corneal inflammation or ulcers
    • Presence of dendritic (branch-like) lesions on the cornea
    • Discomfort while blinking
  • History
    • Previous episodes of herpes simplex virus (HSV) infections
    • Stress or illness triggering outbreaks
    • Recurrent episodes of viral keratitis

Toxoplasmosis:

  • Common Symptoms
    • Eye pain
    • Redness
    • Light sensitivity
    • Blurred vision
    • Floaters or spots in vision
  • Common Signs
    • Inflammation and redness of the retina
    • Retinal scarring (active or healed)
    • Reduced visual acuity
    • May affect one or both eyes
  • History
    • Exposure to Toxoplasma gondii, often through contact with cat feces
    • Immunocompromised individuals are at higher risk
    • May have a history of toxoplasmosis infection in other organs

Complications after Eye Surgery (Postoperative Infections):

  • Common Symptoms
    • Eye pain
    • Redness
    • Swelling
    • Blurred vision
    • Excessive tearing
  • Common Signs
    • Inflammation in the surgical area
    • Surgical wound-related issues
    • Presence of pus or discharge
    • Reduced visual acuity
  • History
    • Recent eye surgery, such as cataract surgery or LASIK
    • Non-compliance with postoperative care instructions
    • Risk factors for surgical site infections (e.g., diabetes)

Autoimmune Diseases Affecting the Eye (Uveitis):

  • Common Symptoms
    • Eye pain
    • Redness
    • Light sensitivity
    • Blurred vision
    • Floaters or spots in vision
  • Common Signs
    • Inflammation of the uvea (middle layer of the eye)
    • Redness and swelling in the eye
    • Reduced visual acuity
    • May affect one or both eyes
  • History
    • Underlying autoimmune conditions like rheumatoid arthritis or lupus
    • Episodes of uveitis related to autoimmune diseases
    • Chronic or recurrent inflammation in the eye
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Example of the progression of a typical eye infection

Example of the progression of a typical eye infection

Day 1-2: Onset of Symptoms

Redness: The whites of the eye (sclera) may become red or pink, often starting in one eye and possibly spreading to the other.

Irritation: Patients may experience mild irritation or a gritty sensation in the affected eye.

Watery Discharge: A clear or watery discharge from the eye may be present.

Day 2-3: Worsening of Symptoms

Increased Redness: The redness of the eye may become more pronounced.

Swelling: There may be slight swelling of the eyelids.

Eye Discharge: The clear discharge may become thicker and more noticeable, especially upon waking in the morning.

Itchiness: Some individuals may experience mild itching.

Day 4-5: Peak of Symptoms

Severe Redness: The eye may appear intensely red or bloodshot.

Swelling: Swelling of the eyelids may increase.

Eye Discharge: The discharge may become thicker, yellow, or greenish in color.

Increased Irritation: Patients may experience increased eye irritation and discomfort.

Sensitivity to Light: Some individuals may become more sensitive to light (photophobia).

Day 6-7: Gradual Improvement

Redness: Redness of the eye may start to diminish.

Swelling: Eyelid swelling begins to subside.

Discharge: The discharge may become less noticeable.

Improved Comfort: Eye discomfort and irritation gradually improve.

Sensitivity to Light: Sensitivity to light typically decreases.

Day 8-10: Recovery

Resolution: Most symptoms continue to improve, and the eye infection begins to resolve.

Minor Residual Symptoms: Some individuals may still experience mild redness or occasional discomfort.

Conditions That Can Cause Eye Infections

Bacterial conjunctivitis: Bacterial conjunctivitis occurs when various bacteria, such as Staphylococcus or Streptococcus species, enter the eye, leading to infection. It is typically not life-threatening but can be highly contagious, requiring prompt medical attention to prevent spreading and to determine the appropriate antibiotic treatment. Bacterial conjunctivitis (pink eye) is more likely to occur in those who wear contacts, emphasizing the importance of proper contact lens care.

Viral conjunctivitis (pink eye): Viral conjunctivitis is the most common cause of infectious conjunctivitis. This infection is more common in adults than in children. Around 65–90% of cases are caused by adenovirus. Occasionally, herpes simplex or zoster virus is responsible. While it often resolves on its own, it may require medical attention to manage symptoms and prevent complications such as corneal involvement. Learn more about the different types of pink eye.

Contact lens-related infections: Improper contact lens hygiene or extended wear can lead to microbial contamination and serious eye infections, such as keratitis. These infections require prompt medical treatment and can be considered emergencies if left untreated.

Viral keratitis: Viral keratitis is typically caused by herpes simplex virus or varicella-zoster virus. It can lead to corneal inflammation and ulcers and should be promptly treated to prevent complications.

Shingles: Shingles is a viral infection caused by the same virus that is responsible for chickenpox. While it's more common among older adults, particularly those over 50, it can also affect younger individuals, especially those with weakened immune systems. This condition can be quite severe and may lead to complications like vision loss if not treated promptly. Stress, a weakened immune system, and certain medications are factors that can trigger a shingles outbreak. Therefore, those at risk should be vigilant about eye symptoms like redness, irritation, or blisters and seek immediate medical attention.

Cellulitis: Cellulitis is a bacterial infection that can affect the skin around the eyes or the tissues behind the eye. While it can occur at any age, children with skin conditions like eczema are particularly susceptible. Diabetic patients and those with compromised immune systems also face higher risks. Cellulitis around the eyes needs immediate treatment as it can quickly spread to other areas and potentially cause serious complications like vision loss or even life-threatening conditions if it spreads to the brain.

Staphylococcus aureus infection: Staphylococcus aureus can lead to various eye infections, and it usually enters the eye through direct contact or contamination of contact lenses. While not always an emergency, it can cause serious conditions like keratitis, which require prompt medical treatment.

Streptococcus pneumoniae infection: Streptococcus pneumoniae can cause conjunctivitis and more severe eye infections, spreading through respiratory droplets. It may not be an immediate emergency but necessitates medical attention to prevent complications.

Fungal eye infections: Fungal eye infections result from exposure to fungal spores or contaminated contact lenses. They are considered serious eye infections that require immediate medical treatment to prevent vision loss.

Parasitic eye infections: Parasitic eye infections, such as Acanthamoeba keratitis, are rare but serious. They require immediate medical intervention to prevent vision loss.

Chlamydia trachomatis infection: Chlamydia can cause conjunctivitis in newborns and adults. It is sexually transmitted or transmitted through contact with contaminated fingers or objects. While it requires medical treatment, it may not be considered an immediate eye emergency.

Corneal ulcers: Corneal ulcers can result from various causes, including bacterial or fungal infections, trauma, or contact lens wear. They are serious and require prompt medical attention to prevent complications and vision loss.

Neisseria gonorrhoeae infection (gonococcal conjunctivitis): Gonococcal conjunctivitis is a severe eye infection caused by Neisseria gonorrhoeae and requires immediate medical attention.

Toxoplasmosis: Toxoplasmosis can cause eye infections, especially in immunocompromised individuals. It requires medical treatment but may not be an immediate emergency.

Complications after eye surgery: Complications following eye surgery, such as infections or inflammation, should be promptly addressed by a healthcare professional to prevent further complications.

Covid 19: Conjunctivitis is the most common ocular manifestations reported in adults with Covid 19, based on a meta analysis of 20 studies it was estimated that eye infections impact 1% of hospitalized COVID 19 cases. (https://journals.sagepub.com/doi/10.1177/25158414211003368)

Eye Infection Stats You Should Know
Signs & Symptoms of Eye Infections

Treatment Options for Eye Infections

The treatment for eye infections largely depends on the cause of the infection. Here's a quick guide to various treatment approaches:

Antibiotics

For bacterial infections, antibiotic eye drops or ointments are commonly prescribed. It's crucial to complete the full course of medication, even if symptoms improve.

Antiviral Medications

Viral infections like herpes zoster ophthalmicus (eye shingles) may require antiviral medications. Early treatment is essential for effective management.

Antifungal Treatments

Fungal eye infections are typically treated with antifungal eye drops or oral medications. The treatment period can be extended, depending on the severity.

Allergy Medications

For allergen-induced infections, antihistamine eye drops can relieve symptoms. Steroid eye drops may also be used in some cases but require professional supervision.

Warm or Cold Compress

For mild cases, a warm or cold compress can alleviate symptoms like swelling and irritation. However, this is usually a supplementary treatment and not a replacement for medical interventions.

Surgery

In extreme cases, particularly with infections like cellulitis, surgical intervention may be necessary to drain abscesses or relieve pressure.

Lubricating Eye Drops

In some instances, artificial tears can help in keeping the eye moist and relieving irritation, supporting the healing process.

How Can I Prevent Eye Infections?

 Here are some key practices to help you avoid these infections:

  • Wash your hands frequently with soap and water, especially before touching your eyes or face.
  • Never share eye makeup, towels, or other personal items that come in contact with the eyes.
  • Always clean and store your lenses as per the manufacturer's instructions. Don't wear your contact lenses for longer than instructed by your eye doctor, and if you feel discomfort from them, give your eyes a break and switch to glasses. Don't sleep in your contacts or wear them for longer than in unless they are approved for overnight wear.
  • If you're involved in activities that expose you to chemicals, dust, or harmful UV rays, wear appropriate protective eyewear.
  • Use caution in communal areas like swimming pools; wear goggles if necessary.
  • Keep your allergies in check with appropriate medication to prevent allergen-induced eye issues.
  • Regular visits to your eye doctor can catch issues before they become severe.
  • Certain vaccines can prevent infections like shingles.
  • Consuming a diet rich in vitamins and minerals can boost your immunity, reducing the risk of eye infections.
  • Try not to rub your eyes, especially when they're irritated, to prevent worsening the condition or spreading an infection.

By adhering to these guidelines, you can significantly lower your risk of developing an eye infection. Remember, if you're part of a group that's at higher risk for specific types of eye infections—like those susceptible to shingles or cellulitis—special precautions may be necessary.

What should I do if I have an eye infection?

The best advice for an eye infection or suspected eye infection is to call an optometrist near you and schedule an emergency eye exam.

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