Your Comprehensive Guide To Eye Infections
Are you experiencing redness, swelling, pain, discharge or blurred vision in one or both eyes? These symptoms could indicate an eye infection that requires prompt medical attention from an eye doctor specializing in ocular disease and emergencies. This comprehensive guide will help you understand the types of eye infections, their symptoms, when to seek emergency care, and how an eye doctor can diagnose and treat these potentially sight-threatening conditions.
When to Seek Immediate Care for an Eye Infection
While most eye infections do not cause lasting damage, it is important to see an eye doctor to diagnose the type of infection, improve the healing time, prevent transmission to others, and prevent possible complications which in certain cases can cause permanent vision loss if left untreated. With locations in Greenbelt, Rockville, and Cumberland, Washington Eye Institute serves patients from the Washington, D.C. Metro Area for comprehensive and expert emergency eye care.
Requiring Immediate Attention
- Severe eye pain not relieved by over-the-counter medications
- Sudden vision loss or changes
- Extreme light sensitivity
- Significant eye redness and swelling
- Thick, colored discharge or pus
- High fever with eye symptoms
- Foreign body sensation that persists
- Double vision
- Facial swelling around the eyes
- Recent eye injury or surgery with pain or vision changes
- Severe headache with eye symptoms
- Peripheral vision loss
High-Risk Populations and Conditions
- Infants and young children
- Immunocompromised individuals
- Recent eye surgery or trauma
If you’re experiencing any of these symptoms, contact an eye doctor immediately for an emergency exam. Eye doctors have the specialized equipment and expertise to properly diagnose and treat eye infections.
Why you should always see an eye doctor for eye infections
The importance of visiting an eye doctor for eye infections cannot be overstated. Eye infections can have a wide range of causes, from viruses and bacteria to fungi and parasites, and the symptoms can vary greatly. Some eye infections may resolve on their own, but certain symptoms like severe pain, sudden vision loss, or significant swelling warrant an immediate visit to an eye doctor. Eye doctors have the specialized equipment and expertise to properly diagnose the underlying cause and provide the appropriate treatment to prevent complications and protect your vision. Ignoring eye infection symptoms or attempting to self-treat can lead to worsening conditions and potentially sight-threatening consequences. Regular eye exams can also help detect and address eye infections early before they become serious problems.
Prevalence & Impact
Eye infections are surprisingly common, affecting millions each year in the U.S. alone:
- Nearly 1 million ER and doctor’s office visits annually for corneal infections
- 1 in 500 contact lens wearers develop sight-threatening infections yearly
- Pink eye causes 3 million missed school days per year
- 1 in 3 Americans will get shingles, potentially infecting eyes, in their lifetime
- Globally, infections like trachoma blind 1.5-2 million people each year
| Eye Infection | Prevalence |
| Viral Conjunctivitis | Most common type of infectious conjunctivitis in adults |
| Bacterial Conjunctivitis | Accounts for a significant portion of eye infections, especially in children |
| Allergic Conjunctivitis | Affects up to 40% of the population |
| Ocular Herpes | 400,000 Americans have had some form, 50,000 new/recurring cases per year |
| Uveitis | Affects approximately 1 in 4,500 people |
| Periorbital Cellulitis | Most common in the pediatric population |
| Endophthalmitis | Rare but serious condition, often after eye surgery or trauma |
| Acanthamoeba Keratitis | Increasing incidence in recent years |
| Contact Lens-Related Infections | Up to 1 in 500 contact lens users per year affected |
| Chlamydial Eye Infections | Relatively uncommon but can lead to serious complications |
| Corneal Ulcers | Serious condition requiring prompt medical attention |
| Neisseria Gonorrhoeae Infections | Relatively uncommon but potentially vision-threatening |
| Toxoplasmosis | Relatively uncommon but can have serious consequences |
| Postoperative Eye Infections | Relatively uncommon but can have serious consequences |
Contact Lens Related Eye Infections
Contact lens wearers are at a higher risk of developing certain types of eye infections, particularly bacterial and parasitic keratitis. Improper lens hygiene, sleeping in contacts, and exposure to contaminated water sources can all introduce harmful microbes that infect the cornea. These contact lens-related eye infections can progress rapidly, causing severe pain, vision loss, and even blindness if not treated promptly by an eye doctor. Following strict contact lens cleaning and replacement protocols, avoiding risky behaviors like swimming in contacts, and seeking immediate medical attention for any eye irritation or changes in vision are crucial for contact lens wearers to prevent these sight-threatening conditions.
Eye Infections in babies and young children
Eye infections are particularly concerning in young children, who may be unable to effectively communicate their symptoms or refrain from touching or rubbing their eyes. Common pediatric eye infections include bacterial and viral conjunctivitis (pink eye), which can spread easily in daycares and schools. Children with compromised immune systems or those who have recently undergone eye surgery are also at higher risk for more serious infections. Parents should be watchful for signs of eye redness, discharge, pain, or light sensitivity in their children and promptly consult an eye doctor, as timely treatment is essential to prevent complications like vision loss or permanent eye damage in this vulnerable population.
Recognizing the Signs & Symptoms
Different types of eye infections can cause an array of symptoms. Here are some of the most common infections and their typical signs:
Symptoms:
- Early Symptoms (Days 1-2):
- Redness in one eye.
- Watery discharge.
- Itching or gritty sensation.
- Mild eyelid swelling.
- May accompany cold or flu-like symptoms.
- Progression (Days 3-5):
- Symptoms often spread to the other eye.
- Increased tearing and discomfort.
- Sensitivity to light (photophobia).
- Swollen lymph nodes near the ear.
Causes:
- Caused by viruses, most commonly adenoviruses.
- Often associated with upper respiratory infections or exposure to someone with viral conjunctivitis.
Transmissibility and Recommendations:
- Highly contagious through direct contact with eye secretions or contaminated surfaces.
- Practice good hygiene: frequent handwashing, avoid touching eyes, and don't share personal items.
- Stay home from school or work until symptoms improve, typically for 5-7 days, to prevent spreading the infection.
Treatment:
- No specific antiviral treatment; the condition is usually self-limiting.
- Symptomatic relief with artificial tears, cold compresses.
- Avoid using antibiotics as they are ineffective against viruses.
Length of Treatment:
- Symptoms typically resolve within 1-2 weeks.
- If symptoms persist beyond 7-10 days, consult a healthcare provider to rule out complications.
Urgency of Appointment:
- Schedule an appointment within the next day or two to confirm the diagnosis and receive guidance.
- Seek immediate medical attention if there is significant pain, vision changes, or if symptoms worsen.
Symptoms:
- Early Symptoms (Days 1-2):
- Redness in one or both eyes.
- Thick, yellow or green mucopurulent discharge.
- Eyelids may stick together, especially upon waking.
- Mild discomfort or burning sensation.
- Progression (Days 3-5):
- Increased eyelid swelling.
- Foreign body sensation in the eye.
- Possible involvement of both eyes.
- May occur alongside ear or sinus infection.
Causes:
- Caused by bacteria such as Staphylococcus aureus, Streptococcus pneumoniae, or Haemophilus influenzae.
- Spread through direct contact with infected secretions or contaminated objects.
Transmissibility and Recommendations:
- Contagious, especially among close contacts.
- Maintain good hygiene and avoid sharing personal items.
- Stay home from school or work until 24 hours after starting antibiotics and symptoms improve.
Treatment:
- Often self-limited but may require antibiotic eye drops or ointments.
- Common treatments include polymyxin B-trimethoprim, fluoroquinolones, or aminoglycosides.
- Avoid topical steroids unless prescribed by an eye specialist.
Length of Treatment:
- Improvement typically seen within 3-4 days after starting antibiotics.
- Complete the full course of 5-7 days even if symptoms resolve.
Urgency of Appointment:
- Schedule an appointment promptly, ideally within the next day, to initiate appropriate treatment.
- Immediate attention is needed if there is severe pain, vision changes, or lack of improvement with initial treatment.
Symptoms:
- Early Symptoms (Days 1-2):
- Redness and eye discomfort.
- Light sensitivity.
- Blurred vision.
- Progression (Days 3-5 and beyond):
- Severe pain.
- Excessive tearing.
- Thick, white or yellow discharge.
- Visible corneal ulcer or infiltrate.
Causes:
- Caused by fungi such as Fusarium, Aspergillus, or Candida species.
- More common after eye injury involving organic material (e.g., plant matter), contact lens wear, or exposure to contaminated water.
Transmissibility and Recommendations:
- Not contagious person-to-person.
- No need to stay home for transmissibility reasons, but avoid activities that may worsen the condition.
Treatment:
- Requires topical and/or oral antifungal medications like natamycin, amphotericin B, or voriconazole.
- Severe cases may need surgical intervention, such as a corneal transplant.
Length of Treatment:
- Prolonged treatment over weeks to months.
- Regular follow-up appointments are essential.
Urgency of Appointment:
- Seek immediate medical attention—this is an ophthalmic emergency.
- Early diagnosis and treatment are critical to prevent vision loss.
Symptoms:
- Early Symptoms (Days 1-3):
- Eye redness and discomfort.
- Sensation of something in the eye.
- Mild tearing.
- Progression (Days 4 and beyond):
- Severe eye pain disproportionate to clinical findings.
- Increased redness and tearing.
- Blurred vision.
- Light sensitivity.
- Ring-shaped corneal ulcer may develop.
Causes:
- Infection by Acanthamoeba, a free-living amoeba.
- Associated with contact lens wear, especially with poor hygiene or exposure to contaminated water (e.g., swimming pools, hot tubs).
Transmissibility and Recommendations:
- Not contagious between people.
- Emphasize strict contact lens hygiene.
- No need to stay home from school or work unless vision is impaired.
Treatment:
- Long-term use of topical anti-parasitic medications like polyhexamethylene biguanide or chlorhexidine.
- Oral medications may be added.
- Severe cases might require corneal transplant.
Length of Treatment:
- Very prolonged treatment, often 3-12 months.
- Close monitoring by an eye specialist is essential.
Urgency of Appointment:
- Immediate medical attention is necessary.
- Delayed treatment can lead to severe vision loss.
Symptoms:
- Early Symptoms (Days 1-2):
- Tingling or burning sensation on the forehead or eyelids.
- Mild discomfort.
- Progression (Days 3-5):
- Pain and redness in the eye.
- Development of skin rash or blisters on the forehead, eyelids, or nose.
- Light sensitivity.
- Decreased vision.
Causes:
- Reactivation of the varicella-zoster virus (chickenpox virus) affecting the ophthalmic branch of the trigeminal nerve.
Transmissibility and Recommendations:
- Contagious to individuals who have not had chickenpox or the vaccine, through direct contact with lesions.
- Avoid close contact with high-risk individuals (e.g., pregnant women, immunocompromised persons).
- Stay home until skin lesions crust over, typically about 7 days.
Treatment:
- Oral antivirals like acyclovir or valacyclovir.
- Topical steroids may be used under close supervision.
- Pain management and, if necessary, antibiotics for secondary infections.
Length of Treatment:
- Antivirals are typically taken for 7-10 days.
- Additional treatments may continue for weeks to months based on severity.
Urgency of Appointment:
- Seek immediate medical care.
- Early antiviral treatment within 72 hours of rash onset improves outcomes.
Symptoms:
- Early Symptoms (Days 1-2):
- Redness and swelling around the eyelids.
- Mild eye discomfort.
- Possible fever or feeling unwell.
- Progression (Days 3 and beyond):
- Increased pain and swelling.
- Eyelid tenderness.
- Fever and chills.
- Reduced eye movements (in orbital cellulitis).
- Vision changes may occur.
Causes:
- Bacterial infection, often from Staphylococcus aureus or Streptococcus species.
- Can result from sinus infections, trauma, or spread from adjacent structures.
Transmissibility and Recommendations:
- Not directly contagious, but underlying infections can be.
- Hospitalization may be required; activity restrictions depend on severity.
Treatment:
- Prompt systemic antibiotics.
- Intravenous antibiotics like vancomycin for severe cases.
- Transition to oral antibiotics once improvement is noted.
Length of Treatment:
- IV antibiotics until significant improvement, then oral antibiotics to complete a 7-10 day course.
- Hospital admission is often needed for close monitoring.
Urgency of Appointment:
- Immediate medical attention is critical.
- Orbital cellulitis is a medical emergency due to the risk of serious complications.
Symptoms:
- Early Symptoms (First 24-48 hours):
- Severe eye pain.
- Decreased or blurred vision.
- Redness of the eye.
- Mild swelling of the eyelids.
- Progression:
- Increased pain and vision loss.
- Photophobia.
- Floaters.
- Possible headache.
Causes:
- Infection inside the eye due to bacteria or fungi.
- Risk factors include recent eye surgery, trauma, systemic infections, or intravenous drug use.
Transmissibility and Recommendations:
- Not contagious to others.
- Avoid activities that may strain the eyes.
- Hospitalization is often required.
Treatment:
- Urgent intravitreal antibiotics administered by an ophthalmologist.
- Possible systemic antibiotics.
- Vitrectomy surgery may be necessary.
Length of Treatment:
- Intensive treatment over several days to weeks.
- Close monitoring for response to therapy.
Urgency of Appointment:
- This is an ocular emergency—seek immediate medical care.
- Delay can result in permanent vision loss.
Symptoms:
- Early Symptoms (First 1-2 days):
- Eye redness.
- Mild discomfort.
- Sensation of something in the eye.
- Progression (Days 3-5):
- Severe eye pain.
- Blurred vision.
- Increased redness and discharge.
- Photophobia.
- Visible corneal opacity or ulcer.
Causes:
- Infection of the cornea by bacteria, viruses, fungi, or parasites.
- Risk factors include contact lens wear, corneal abrasions, eye trauma, and immunosuppression.
Transmissibility and Recommendations:
- Not generally contagious.
- Practice good hygiene with contact lenses.
- Avoid wearing contact lenses during treatment.
Treatment:
- Immediate empiric topical antibiotic therapy.
- Adjusted based on culture results from corneal scrapings.
- Intensive application of antibiotic eye drops.
Length of Treatment:
- Intensive therapy often administered hourly initially.
- Treatment tapered over days to weeks depending on response.
Urgency of Appointment:
- Immediate ophthalmologic consultation is necessary.
- Delay can lead to vision loss or corneal scarring.
Symptoms:
- Early Symptoms (First 1-2 days):
- Eye redness.
- Mild irritation or discomfort.
- Tearing.
- Progression (Days 3-5):
- Severe pain.
- Mucopurulent discharge.
- Blurred vision.
- Sensitivity to light.
- Corneal ulcer or infiltrate visible.
Causes:
- Caused by bacteria like Pseudomonas aeruginosa, especially in contact lens wearers.
- Risk factors include improper contact lens use, eye trauma, and prior eye surgery.
Transmissibility and Recommendations:
- Not contagious.
- Stop contact lens wear immediately.
- Practice strict hygiene.
Treatment:
- High-concentration, broad-spectrum topical antibiotics.
- Fortified antibiotics like vancomycin or tobramycin may be used.
- Treatment adjusted based on culture results.
Length of Treatment:
- Intensive application of antibiotics, often hourly.
- Duration spans several weeks, depending on severity.
Urgency of Appointment:
- Urgent ophthalmologic care is required.
- Early treatment is crucial to prevent complications.
Symptoms:
- Early Symptoms:
- Itchy eyes.
- Redness.
- Watery discharge.
- Swollen eyelids.
- Progression:
- Persistent itching.
- Discomfort.
Causes:
- Allergic reaction to pollen, dust mites, pet dander, or other allergens.
- Not caused by infection.
Transmissibility and Recommendations:
- Not contagious.
- No need to stay home unless symptoms are severe.
Treatment:
- Avoid allergens.
- Use antihistamine eye drops or oral antihistamines.
- Cold compresses can provide relief.
Length of Treatment:
- Symptoms resolve with allergen avoidance and treatment.
- May persist during allergen exposure periods.
Urgency of Appointment:
- Schedule an appointment if over-the-counter treatments are ineffective.
- Seek immediate care if vision is affected.
Symptoms:
- Early Symptoms:
- Localized tenderness on the eyelid.
- Mild swelling.
- Progression:
- Development of a red, painful lump.
- Possible discharge if the stye drains.
Causes:
- Bacterial infection of an eyelash follicle, usually by Staphylococcus aureus.
Transmissibility and Recommendations:
- Not highly contagious, but good hygiene is recommended.
- No need to stay home unless discomfort interferes with activities.
Treatment:
- Warm compresses applied several times daily.
- Most styes resolve on their own.
- Antibiotics may be prescribed if infection spreads.
Length of Treatment:
- Typically resolves within 1-2 weeks.
Urgency of Appointment:
- See a healthcare provider if the stye does not improve in a few days or if it worsens.
- Immediate care if swelling affects vision.
Symptoms:
- Early Symptoms:
- Redness.
- Watery or mucous discharge.
- Gritty sensation.
- Progression:
- Swelling of eyelids.
- Possible involvement of both eyes.
Causes:
- Infection by Chlamydia trachomatis.
- Spread through contact with genital secretions.
Transmissibility and Recommendations:
- Contagious through direct contact.
- Sexual partners should be evaluated.
- Avoid close contact until treated.
Treatment:
- Oral antibiotics like azithromycin or doxycycline.
- Topical antibiotics may be added.
Length of Treatment:
- Typically 1-3 weeks of antibiotic therapy.
Urgency of Appointment:
- Prompt medical evaluation is necessary.
- Important to treat to prevent complications.
Symptoms:
- Early Symptoms:
- Eye pain.
- Redness.
- Tearing.
- Progression:
- Blurred vision.
- Sensitivity to light.
- Dendritic ulcers visible on cornea.
Causes:
- Usually caused by herpes simplex virus (HSV).
Transmissibility and Recommendations:
- Potentially contagious through direct contact with lesions.
- Avoid touching eyes and maintain hygiene.
Treatment:
- Antiviral medications like acyclovir eye ointment.
- Oral antivirals may be prescribed.
Length of Treatment:
- Treatment continues for 2-3 weeks or until the ulcer heals.
Urgency of Appointment:
- Immediate ophthalmologic consultation is required.
- Early treatment improves outcomes.
Symptoms:
- Early Symptoms:
- Mild eye discomfort.
- Blurred vision.
- Progression:
- Eye pain.
- Redness.
- Floaters.
- Vision loss.
Causes:
- Infection by Toxoplasma gondii parasite.
- Acquired through exposure to contaminated food or cat feces.
Transmissibility and Recommendations:
- Not contagious person-to-person.
- Pregnant women and immunocompromised individuals should take precautions.
Treatment:
- Combination of anti-parasitic medications like pyrimethamine, sulfadiazine, and folinic acid.
Length of Treatment:
- Treatment may last for 4-6 weeks or longer.
Urgency of Appointment:
- Prompt medical evaluation is important.
- Early treatment can prevent permanent damage.
Symptoms:
- Early Symptoms:
- Eye redness.
- Mild discomfort.
- Progression:
- Severe pain.
- Light sensitivity.
- Blurred vision.
- Floaters.
Causes:
- Inflammation of the uveal tract.
- Associated with autoimmune diseases like rheumatoid arthritis.
Transmissibility and Recommendations:
- Not contagious.
- Activity restrictions depend on symptoms.
Treatment:
- Steroid eye drops.
- Immunosuppressive medications.
- Treatment of underlying autoimmune condition.
Length of Treatment:
- Varies; may require long-term management.
Urgency of Appointment:
- Urgent evaluation by an eye specialist is necessary.
- Early treatment reduces risk of complications.
In all cases of eye infections, general recommendations include:
- Frequent handwashing
- Avoiding touching/rubbing eyes
- Not sharing towels, pillows, cosmetics, etc.
- Replacing contaminated eye makeup
- Postponing contact lens wear until resolved
- Discarding disposable lenses/lens cases used during infection
- Follow-up with eye doctor to ensure proper healing
If symptoms are severe, rapidly worsening, or fail to improve with initial treatment, prompt re-evaluation by an eye care professional is warranted to prevent vision-threatening complications. Eye infections can be serious and should be managed under the guidance of an eye doctor.
With locations in Greenbelt, Rockville, and Cumberland, Washington Eye Institute serves patients from the Washington, D.C. Metro Area for comprehensive and expert emergency eye care.
Causes & Risk Factors
Eye infections develop when viruses, bacteria, fungi or parasites invade the eye and surrounding areas. However, certain factors make some people more prone to infection:
- Contact lens wear, especially improper hygiene/care
- Recent eye injury or surgery
- Weakened immune system from disease or medications
- Exposure to contaminated water sources
- Crowded living situations with shared personal items
- Sexually transmitted infections like chlamydia and gonorrhea
- Eyelid inflammation (blepharitis) or dry eyes
- Viral illnesses like cold sores or shingles
Importance of Prompt Diagnosis
Timely diagnosis and treatment by an eye doctor is crucial to prevent complications and vision loss from eye infections. An eye doctor will:
- Take a detailed medical history
- Examine the eyes with a slit lamp microscope
- Evaluate the cornea, tear film, eyelids and more
- Test visual acuity and eye pressure
- Culture discharge samples to identify infectious agents
- Perform corneal scrapings or biopsies if needed
- Use special dyes or imaging to check for eye damage
Treatment Options for Optimal Outcomes
Treatment depends on the specific type of eye infection diagnosed, but may include:
- Prescription antibiotic, antiviral or antifungal drops
- Oral medications to fight infection
- Frequent artificial tears to flush microbes
- Steroid drops to quell inflammation
- Removing contact lenses until healed
- Surgical procedures to repair corneal ulcers or perforations
Close monitoring by an eye doctor is essential to ensure the infection improves as expected. In resistant or severe cases, treatment may require multiple medications or prolonged therapy.
Potential Complications if Untreated
Eye infections can progress rapidly, leading to sight-threatening complications:
- Corneal ulcers and scarring
- Chronic or recurrent infections
- Perforated cornea requiring transplant
- Inflammation inside the eye (uveitis or endophthalmitis)
- Irreversible vision loss or blindness
This underscores the importance of seeking prompt care from an eye doctor at the first signs of infection. With proper treatment, most people recover fully.
Prevention Strategies
To reduce your risk of developing an eye infection:
- Wash hands thoroughly and frequently
- Never share towels, makeup or eye drops
- Clean and replace contact lenses as directed
- Avoid sleeping in contacts
- Discard eye makeup if you develop an infection
- Don’t swim in contacts; wear goggles in pools/hot tubs
- Use sunglasses and protective eyewear when needed
- Get regular eye exams to maintain eye health
When to Refer Patients for Care
If you’re a health professional, consider referral to an eye doctor if a patient has:
- Eye symptoms not improving after 24 hours of treatment
- Copious discharge or eyelids matted shut
- Corneal involvement like ulcers or lesions
- Severe pain, redness or swelling
- Vision changes, double vision, or visual field defects
- Recent eye surgery or trauma with infection signs
- Suspected orbital cellulitis or shingles
- Newborn with conjunctivitis (potential blindness)
Partnering with an eye doctor ensures patients receive appropriate care for eye infections and emergencies. Early referral when indicated can prevent adverse outcomes. At Washington Eye Institute, Dr. Misbah Shafiq, O.D., Dr. Michael Summerfield, MD, Dr. Joseph Mekhail, MD, Dr. Sarah Chang, MD, Dr. Sunil Bellur, MD, Dr. Rajini Seevaratnam, O.D., Dr. Diana Chu, O.D., and Dr. Debra Weltman, O.D., bring years of experience in treating urgent eye conditions. Our dedicated team is committed to providing fast, expert care to safeguard your vision during emergencies.
If you suspect an eye infection, don't delay, our eye doctors are your best ally in overcoming ocular infections.
At Washington Eye Institute, we specialize in delivering high-quality emergency eye care services across our three convenient locations. Our state-of-the-art clinics are equipped to handle a wide range of urgent eye conditions, and our experienced team of eye doctors is committed to providing immediate, personalized care. Patients from Greenbelt, Rockville, Cumberland, and surrounding areas trust us with their eye emergencies, whether it's sudden vision loss, an eye injury, or another urgent issue. Washington Eye Institute is here to protect your vision when you need expert care the most.
When you schedule a comprehensive or emergency eye exam with us you can rest assured of the highest standard of care with the latest advancements in technology. Our technology advantage provides our eye doctors access to a more accurate diagnosis and effective treatment plan for any form of eye infection or eye emergency.
