Sir Elton John recently revealed on ABC’s Good Morning America that he lost the sight in his right eye after suffering from an eye infection. With poor vision in his left eye too, John said. “It’s been four months now since I haven’t been able to see.”
Reassuringly, the most common eye infections, such as conjunctivitis, are not usually sight-threatening and go away without treatment.
Conjunctivitis is known as pink eye because the conjunctiva (a thin membrane covering the white sclera), turns pink and sore.
Viral conjunctivitis is the most common conjunctivitis. It typically makes your eyes irritated and feel gritty, with watery or mucous discharge. Using a cool, clean compress and gently wiping away eyelid crusting helps keep your eyes comfortable as they heal.
Bacterial conjunctivitis is the next most common. It is more likely to have thicker yellow or green discharge that might crust on the eyelids and lashes. It usually gets better in one or two weeks without treatment, but antibiotic eye drops may speed this up a little, helping a quicker return to work or school.
If your eyes are pink, sore and itchy at certain times of the year, it’s probably allergic conjunctivitis, which commonly accompanies hay fever. Around 40% of people suffer from allergic conjunctivitis at some point and it’s eased by antihistamines in the form of eye drops and tablets.
For all these forms of conjunctivitis, sunglasses, artificial tears and gentle lid hygiene help.
It’s also possible to get conjunctivitis from a sexually transmitted disease such as chlamydia and gonorrhoea, but these are more serious and need medical attention as soon as possible. Bacteria can spread from the genitals to the eyes through hand-eye contact and may cause watery discharge or pus, itchy, red, swollen eyes and sensitivity to light.
The more serious eye conditions causing the kind of sight loss Elton John describes, are, fortunately, rarer. The main infections of concern are orbital cellulitis, endophthalmitis and infectious keratitis.
In orbital cellulitis, the tissues around the eye become infected, inflamed and swollen. More cases occur in children than adults and most follow a nasty sinus infection, which spreads to the orbit (the bony cavity in the skull that contains the eye and its surrounding structures). The skin around the eye will be painful, red and swollen. There may be fever, double vision, headaches, and loss of vision and it requires immediate medical attention.
Endophthalmitis is a serious infection affecting the fluids inside the eye. It most commonly occurs after something has entered the eye, so it can occur after surgery, after an eye injection, after a nasty accident, or following a severe corneal infection. If you have pain after an eye injection, injury or surgery that feels increasingly worse, seek medical attention immediately.
Keratitis happens when the front surface of the eye – the clear, dome-shaped cornea in front of the pupil – becomes inflamed. Noninfectious keratitis might occur after a corneal injury, or from the corneal surface drying out from wearing contact lenses too long.
Infectious keratitis is where bacteria, viruses, fungi and parasites infect the cornea. Contact lens wearers need to be careful with contact lens hygiene and remove the lenses before swimming because these organisms are attracted to the space between the contact lens and the eye.
Water from hot tubs, rivers and lakes may contain these organisms. Usually, these are no threat to eyes with healthy corneas as the cornea forms a natural barrier to infection. But if the corneal surface becomes damaged, possibly from wearing contact lenses too long, there is a higher risk of infection.
Please note that the above is not intended to be an exhaustive list of possible eye infections.
Hand hygiene is essential to avoid getting and spreading an eye infection. Wash your hands well and often, and avoid touching or rubbing your eyes.
Viral, fungal and bacterial infections are highly contagious, so carefully dispose of any wipes used to clean the eyes, and wash your hands before and after cleaning your eyes or putting drops in.
Avoid sharing personal items, such as flannels and towels. And if you have an eye infection, avoid using makeup on your eyes until you’re better.
Artificial tears (without preservatives) and a good routine of gently cleaning your eyes can help get rid of allergens and irritants.
If you wear contact lenses, be vigilant about cleaning and not over-wearing them. If you suspect anything more serious than simple conjunctivitis, seek medical attention. Any unexplained sudden change in your vision, eye pain, or any associated swelling, headaches, double vision or fever needs immediate attention.
If you have experienced sight loss and can relate to the struggles that Sir Elton John describes, don’t suffer alone, there are many low-vision health services and charities that offer support, such as RNIB and the Royal Society for Blind Children.
Charlotte Codina does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
