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Wednesday, May 23, 2012

Pinkeye, the Original Pink Slime … and the Impostors

Original Article

pinkeyeby James Hubbard, M.D., M.P.H.
Well before the controversy over feeding our kids a kind of beef nicknamed “pink slime” in school cafeterias, there was pinkeye. It’s just as gross-looking and even more icky than the new version. Just ask anyone who’s had it.
A reader asked for some posts on common eye problems and their remedies, so guess what I thought of first. And just like some people claim about ground beef and pink slime, there’s the real pinkeye, and there are the impostors.
Pinkeye and its imitators all involve the thin, clear lining of tissue, call the conjunctiva, that covers the white of the eye. They all involve pink eyes too. The color indicates the conjunctiva is inflamed. So what causes this inflammation? Ah, there’s the rub. :-) And I hope to … clear that up—because the remedy depends on the answer.

If you’re like me, you don’t want to play guessing games with your food. Don’t guess when it comes to your eyes either. Many times serious eye problems are hard to tell from the less-serious. Get to a doctor. But if there’s no way you can you, here are some tips to figure out the cause.
The Real Pinkeye: Viral or Bacterial Conjunctivitis
The real pinkeye is caused by bacteria and viruses. Hints that that’s what you’re dealing with:
  • One or both eyes develop more crust, gook, or matting than usual. They may be stuck together with this stuff when you awake.
  • You’ve been around someone with similar symptoms.  (Infectious pink eye is very contagious.)
Infectious-pinkeye remedies:
  1. If you’re wearing a contact lens in an infected eye, take the lens out. Throw away the disposable kind; disinfect the others. Don’t put any back in until all the redness has gone away.
  2. Clean your eyes. Wet a clean cloth with clean water, gently moisten the crust in your eye/eyes, and clean it out. Don’t use the cloth again. Be sure to not use it in an eye that’s not infected.
  3. Start antibiotic eye drops or ointment. We never like to use antibiotics on viruses (they don’t work, and nonjudicious use can lead to bacterial resistance), but most non-eye-specialist doctors like me have a hard time telling viral pinkeye from bacterial pinkeye, so I’m betting you will too. Use the drops or ointment as directed.
If you don’t have eye drops or ointment, though, the reality is, the majority of pinkeye infections are viral and will simply run their course in one to three weeks. But there you are playing games with your eyes.
An alternative is to use the over-the-counter, non-ophthalmic neosporin or triple-antibiotic ointment. As with everything else written here, get your doctor’s opinion or do this at your own risk. The labels say not to use in the eye. My understanding is that they have the same ingredients as the eye kind, but they’re not guaranteed to be sterile. I’d probably not use them on myself if I were going to be able to see a health-care provider within under a week. That’s just me.
Hint pink slime contains bacteria: It turns green?
Remedy for pink-slime bacteria:
Treat it with ammonium hydroxide (done before delivery).
Pinkeye Imitator #1: Allergic Conjunctivitis
Hints allergies may be causing your pink eyes:

  • Allergies usually affect both eyes at the same time.
  • The eyes look the same as they do with the infectious type, but there’s no gunk.
  • Sometimes you have sneezing, runny nose, etc., but not always.
  • You may recognize the symptoms if you’ve had this before.
Allergic-conjunctivitis remedies:

  • If you know what you’re allergic to, avoid it if possible. Stay out of the wind, or wear goggles.
  • Wash your eyes out with clean water frequently.
  • Over-the-counter eye drops might help. If you have an oral antihistamine like Claritin or Benadryl, give it a try. The generic versions are fine.
Hint you’re allergic to pink slime: your throat swells?
Remedy for pink-slime allergy:
epinephrine.

Pinkeye Imitator #2: Chemical Conjunctivitis
This is just what it sounds like—caused by chemical irritation. Alkaline chemicals such as lye and other cleaning agents wreak the most havoc, but strong acids can cause damage also. Wear safety goggles when using such products.
Chemical-conjunctivitis remedy: Wash your eye out with clean water. Irrigate with a continuous stream for at least fifteen minutes.
Hints there are chemicals in your pink slime: ammonium hydroxide, duh.
Remedy for chemicals in pink slime:
don’t eat it?

Pinkeye Imitator #3: Irritation Caused by a Foreign Body in the Eye
Unless the foreign body has chemical in or on it, the irritation is a reaction to the foreign body. This is the one most likely to happen in a disaster situation.
Foreign-body treatment:

  • Never rub the eye. You may scratch your cornea. A scratch feels about the same as a foreign body, but it’s not coming out.
  • Irrigate with water for a few minutes.
  • See my next post.
Foreign body in pink slime: Eyes? Just kidding.
For Any Pink Eye: Warning Signs You Need to See a Doctor Right Away

  • Vision loss. Not just a film over your eyes that you can wash away.
  • Pain. Not just irritation or burning, but severe pain.
These are two urgent reasons you’d better hightail it to a doctor. But, as I said in the beginning, you really need to go, no matter what. Don’t take chances with your eyes.
Photo by Douglas Porter.