You can talk in the mic. You're going to have
to be used to just staying still, which is hard
for you. So you're going to have to basically
stay right in the mic. Right here. Because you
can see your sound waves. You're on the bottom.
I can't see them. You can't see them? No, I can't.
Where am I looking? Oh. The white one? Yeah,
so that's your sound waves. I'm saying nothing.
You are. It's doing nothing. What are you talking
about? Do you not see those bars of white? But
they're there whether I'm saying something or
not. Oh. Is he not? Oh, okay. Welcome to the
Your Mom on Drugs podcast. I've got myself, Josh
Klaus here. And I'm Jennifer Seltzer. Yes, and
we're a lovely mother and son pair who really
love talking about drugs. Mostly the kind that
you take and usually that you get at your local
pharmacy or prescribed by your doctor. The other
recreational stuff that you want to do, you're
going to have to go to another podcast. I was
fortunate enough to be raised by a mom who was
a pharmacist. My mom has a doctorate in pharmacy.
And I always thought that that was just common
mom knowledge of knowing what drugs to take in
the house for what conditions. But I realized
she was trained quite rigorously at various universities
to know what little pills to put in your mouth
and definitely what pills not to put in your
mouth so that you take them for certain conditions.
So I wanted to share that knowledge with the
world. I thought it was extremely selfish to
keep that to myself. And so we basically each
week or each month, we should say each episode,
really. Um, we take a topic that we think is
interesting, usually a topic that usually afflicts
a lot of people. Um, and we try to say, this
is the best or most, you know, this is the best
way to treat yourself with the current knowledge
that we have. Um, and speaking of knowledge,
I'm going to turn it over to my mom of how we
do our research each episode. Um, so you have
an idea. of how we think about these conditions
and what resources we use if you want to go look
them up for yourself. So mom, how do you research
each episode? Well, I think with my pharmacy
background and specifically I was trained in
the area of drug information. So I learned how
to research drug information. through an evidence
-based format. And what that means is that you're
looking for data that has been assessed through
clinical trials or data that have been collected
over time to help determine the information that's
presented. So I will use... textbooks to get
background information. There are some pharmacy
texts and resources that I'll use to get specific
drug information. And sometimes I'll even do
Medline searches or PubMed searches to look for
specific articles, clinical trials to help support
or refine the information that we're discussing.
So you don't just Google search and just regurgitate
your Google search? I don't really do that. Now,
there are some legitimate websites to go to that
do have good data that we may also use, things
like the Centers for Disease Control or the Food
and Drug Administration. But they have data on
their websites that are evidence -based, so we'll
use those sometimes as well. Yeah, we should
clarify evidence -based because not all evidence
-based research is made equal. Like for example,
randomized control trials are at the top of,
we should describe that pyramid that you showed
me that one time. So if you're reading a study
online, it'll probably mention the type of study
that's being done. And you'll see different words
like prospective study, retrospective study,
observational, et cetera. And each of those studies
might be evidence -based. But the design of that
study is going to be limited by a certain number
of factors that we might get into in another
episode. But would you mind for the listeners
just letting what people know? like maybe the
hierarchy of certain types of trials? Sure. You
know, at the bottom, you're going to, you know,
like public opinion or opinion pieces are going
to be kind of at the bottom of the pyramid. And
you may have case reports down at the bottom
as well, too. And then as you go up, you may
have observational studies, which don't have
a control group. So it's basically just looking
for associations between the different things
that you're looking at. You move up to a randomized
control trial where you actually do have a control
group and you can look at cause and effect in
those types of trials. And then above that, you
have things that are called either meta -analysis,
meta -analyses, or systematic reviews, which
can take a bunch of clinical trials and look
at them together, looking for similar characteristics,
different characteristics, and answering a particular
question based on what available literature is
about that particular topic. usually are about
the top of the pyramid as far as information
and evidence goes. And unlike something like
math where two plus two equals four, science
works a little bit differently where you have
a claim like this drug decreases this amount
of chemical in my body. And that's not going
to be like a definitive answer. You're basically
collecting evidence, almost like you'd be collecting
evidence in a court case to prove guilt or not
guilt. You're also doing the same thing with
science. You're proving effectiveness or non
-effectiveness. And there's a degree of how effective
something might be. And you're trying to collect
enough evidence to show support of your claim,
right? That's correct. Yes. And sometimes you
do and sometimes you don't. Yeah. And it's just
as powerful to know what you don't know versus
what you do know. So you can eliminate variables.
And so when we give recommendations. It's not
a definitive answer. This is just based on evidence
that we've collected or other people have collected.
So we really want people to think about science
that way. It's this really fun, almost like detective
or court case where you're trying to support
or tear down your own claim. And if you have
an opinion that you hold about something and
you find a website that confirms your opinion,
try to go find a website that. disconfirms your
opinion. A lot of science is about falsifying
your claim, meaning that you're trying to actually
prove your claim wrong. You're eliminating variables.
And that's the fun thing. And we try to circle
the truth that way. So with that being said,
in that little intro about how we do what we
do, we're going to move into talking about the
topic today, which might throw you off. We're
going to be talking about conjunctivitis, which
also is known as Pink eye. Pink eye. And if you've
ever had a pink eye before, you probably know
it's not a fun ordeal. And that it's easily spread.
You probably have some jokes about it. But we
want, it was one of the conditions that's actually
most people are afflicted by. So we wanted to,
our first couple of episodes, we wanted to talk
about things that people are most afflicted by.
Because it is mildly annoying to have your eyesight
taken away from you. I think it's one of those
things that's taken for granted of how well you
can see and how unperturbed you could actually
see. So, mom, do you want to kick off in talking
about what conjunctivitis is? So, to describe
conjunctivitis, let me first tell everyone what
the conjunctiva is. And the conjunctiva is...
part of our eye, obviously. It is actually the
part that covers the surface of the eye as well
as the inner lining of the eyelid. So it's going
to be that white part. It covers what we call
the sclera of the eye. So it's that white part
in your eye. And so what happens when you get
conjunctivitis is it gets infected or it gets
irritated. And interestingly, like Josh said,
we are talking about topics where things affect
a lot of people. And there can be up to 6 million
cases of conjunctivitis each year in the United
States. And it can cost anywhere from $300 million
to $800 million to just treat this particular
condition or, you know, malady. And that's, and
by treating is just, you know, people buying
eye drops or, you know. It could be, it could,
and we'll get into treatment in a minute. It
could be things that you buy and it could be
just things like cold compresses, you know, and
stuff. So just depending on the type of conjunctivitis.
Yeah. So I was, I looked up some interesting
facts about the conjunctiva, just as some people
who wanted a deeper dive, but there's two types.
It's the, the bulbar and the palpebral. conjunctiva,
the palpebral being the stuff that goes under
your eyelids and the bulbar, which is attached
to your eye itself in the sclera, like my mom
said. The palpebral, actually, palpebral, anytime
you see that word, it just means of or relating
to the eyelids. It's Latin for palpebralis. And
then the bulbar is associated with like the bulb
of your eye. Like you think of like a bulb, like
an onion bulb. Your eye is kind of shaped in
a similar shape. And the word conjunctiva also
comes from Latin, conjugere, which is like conjugate,
which means to come together. So it's actually
the coming together of basically two different
types of tissue. And the conjunctiva is really,
even though it's super thin, it's really, really
cool. I mean, it has like these types of cells
that secrete stuff like tears, and it also keeps
your eyes fairly lubricated. It also has like
immune cells in there as well, like B cells and
T cells. And that's going to come into play when
we talk about infection, which conjunctivitis
just means the inflammation of. So when you hear
inflammation, a lot of times that's associated
with the immune system. So I just wanted to say
in this very thin layer of your eyes, actually,
there's so much going on in there with a lot
of different types of cells because you really
do want to protect your eye, but also you want
to keep it functional. by keeping it lubricated,
keeping it moist, so that light can come in and
do what it does and allows you to see certain
things. So it's one of the more sensitive parts
of your eye, which makes it vulnerable to attack.
So we should probably talk about the ways in
which it could get attacked. So, Mom, do you
want to outline the ways that the conjunctiva
can be invaded? Absolutely. So actually, when
you get conjunctivitis, it needs to be determined
what type of conjunctivitis you have. So there
are four different types. You can have bacterial
conjunctivitis. So that's kind of obvious. It's
going to be caused by bacteria. You can have
viral conjunctivitis caused by a virus. You can
have allergic. conjunctivitis due to some sort
of a allergen in the air. And then you can also
have what they call irritative or contact dermatitis.
And it could be due to something that gets in
your eye that causes irritation. Yeah. So there's
like a mechanical, like just like a piece of
dust or some. It could be that smoke, you know,
wind. can do that. So let me break down those
different types. Would that be okay and give
you a little bit more detail about each one?
Absolutely, it'd be okay. Okay. Let's start first
of all with viral conjunctivitis, which happens
to be the most prevalent type of conjunctivitis
of all age groups. It can happen in up to 80
% of all cases. And it's going to be more common
in the summertime. And it usually begins when
you have viral conjunctivitis, it usually begins
with one eye, but it can transmit to the other
eye. And so then you could have it in both eyes.
It usually, so viral conjunctivitis is usually
associated with a thin watery discharge. And
you can have, sometimes you can have kind of
a pussy discharge, but that is not as common
with viral conjunctivitis. Yeah. So does a thin
watery discharge, does that just mean that, does
it feel like you're just crying a little bit
more? You can, it just, yeah. I mean, it doesn't
necessarily mean that the, that it's pouring
down your face per se, but you know, that it's
just, it's not normal. You know, it's like, you
know, we've got lubrication in our eyes, but
this is going to be excessive. So you're going
to definitely feel like it. You might have to
blot your eyes. You're like, something's not
right here and stuff. And as opposed to like
a pussy discharge, which is kind of, I know that's
a little gross, y 'all, but it's just that kind
of white discharge that you get from something
infecting you. Right. And you can have itching
with viral conjunctivitis, but not always. And
you can have redness sometimes with viral conjunctivitis
as well, too. But that's not necessarily going
to be the diagnostic tool or figuring out what
kind of conjunctivitis you have. It's going to
be looking at kind of the whole pattern. package
or the whole picture to figure out kind of what
conjunctivitis you have. Okay. So that's viral
and it affects the most people, but it seems
to be fairly mild, slightly discomfort. It is.
The interesting thing about bacterial and viral
conjunctivitis are that they are very contagious.
And so you have viral conjunctivitis and it can...
It can cure on its own, but it can take sometimes
up to two weeks. And so you could stay infectious
and contagious during that time period, especially
if you still have a lot of discharge or, you
know, you feel the effects of that in your eye.
And antibiotics will not work for viral conjunctivitis
because there's no bacteria there. So taking
an antibacterial eye drop is not going to be
what's... prescribed for you for viral conjunctivitis.
So if I'm at the pharmacy or the grocery store
and I see something that says antibacterial or
antibiotic, that is just for bacteria. Right.
And you can't just look for those. They are prescription
only. So your physician or healthcare provider
would have to be involved with getting a prescription
for an antibacterial eye drop to treat. bacterial
conjunctivitis. So hopefully they'll be knowledgeable
enough and they won't give you antibacterial
for a viral pink eye. Right, right. There's a
little caveat to that, though. Let me talk a
little bit about bacterial conjunctivitis, and
then I'll come back to that, okay, if that's
okay. Absolutely. Okay. That's a good little
segue. Okay. So that is a good segue into bacterial
conjunctivitis. Actually, bacterial conjunctivitis
is more common in kiddos. And when they get conjunctivitis,
50 % to 75 % of the time it's due to a bacteria.
And remember, it's very contagious. So getting
a handle on it to keep it from spreading to a
bunch of other kids is a good idea. A little
bit about bacterial conjunctivitis. It's going
to occur more commonly in the winter months,
from December to April is when you're going to
see it more commonly. And the way it's easier
to detect... or to tell the difference with bacterial
conjunctivitis versus viral or allergic conjunctivitis
is in that you usually have that. purulent pussy
discharge. And it's the one where you'll wake
up in the morning with your eyes crusted over,
which is not as common in viral conjunctivitis.
And you really don't see that in allergic conjunctivitis
either. Now, you don't see it always 100 % of
bacterial conjunctivitis. So if it's not there,
it doesn't necessarily mean you don't have bacterial
conjunctivitis, but it is a more... diagnostic
tool for that type of conjunctivitis. Usually
it can't, you know, when you get that pussy,
you know, crusty kind of discharge in your eye,
you can have a little visual blurring, but you
shouldn't have vision loss with it. It just,
you know, it's uncomfortable and it's just kind
of a pain. Okay. So there's going to be a little
bit of pain. swelling and that it's just not
going to look very good and it's also yes but
it's it's going to be noticeable right and you're
and you're gonna definitely feel it usually with
bacterial conjunctivitis like viral conjunctivitis
it usually starts in one eye and may then spread
to the other eye as well because it's probably
because it's going to be irritating so you're
probably going to scratch it with your hand And
then you're going to touch the other eye. And
you might touch your other hand, which then you'll
go, yeah, because we just can't help but touch
our face. There you go. We love touching our
faces. We can't. I just did it right now. That's
right. You can't see it on podcast. And the other
thing that's really interesting with bacterial
conjunctivitis is that it's usually not associated
with other conditions like upper respiratory
infections. So you can have a viral conjunctivitis.
conjunctivitis or allergic conjunctivitis and
also have a cold or having an allergic experience.
But usually that's not the case with bacterial
conjunctivitis. And like we mentioned before,
it is going to require a prescription by a healthcare
provider to treat it because it's due to a bacteria.
And we want to get rid of it as fast as possible
because it's so contagious. Gotcha. And so you
can't get an over -the -counter antibacterial?
You cannot. Is there a reason for that? Is it
just because we don't want to give... I just
want for people out there, if you don't complete
your course of antibiotics, there's a chance
of bacteria becoming antibiotic resistant. And
that is not good because you want antibiotics
to treat it. But is there a reason why antibiotics
are only prescribed? Are there side effects associated
with taking them? I think that... You know, there's
not a lot of adverse effects associated with
them. I mean, there can certainly be some burning
and stuff, but I think it's also too... looking
for a for a health care provider to look at your
eye to make sure that there's nothing else going
on as well too especially with bacterial conjunctivitis
because sometimes you can get a cellulitis so
that means the skin around your lid of your eye
whatever can also get infected and so you might
not be the best person to determine that and
so I think somebody with more experience like
a health care provider is going to give you the
right kind of treatment for that. And again,
they're going to look for other things too that
might be going on as well to just make sure that
there's nothing else going on. In fact, I've
got, this might be a good time to kind of break
over to that. I've got a little, I've got a list
of times when we should seek attention from a
healthcare provider when something's going on
with our eye. And so here is that list. So if
you have, Not irritation, but pain in your eyeball,
like pain in your eyeball. In your eyeball. In
your eyeball. You'll feel it in your eyeball.
You want to go seek immediate attention. Also,
if you have significant changes in your vision,
so not just a little blurring or just kind of
irritation, but it's like I can't see or something's
gone, some field of vision is gone, definitely
you want to go see somebody right away. You might
have to get a ride because you won't be able
to see. That's right. That's absolutely true.
Don't drive if you can't see. That is very, very
smart. I hope that's obvious. So if you all of
a sudden have extreme sensitivity to light, that's
not normal. So you want to go get that checked
out. And if you feel like there's a foreign body
in your eye, there could be a foreign body in
your eye. That's very different than like a gritty
sensation. And so again, and the reason I'm giving
you this list of things to do if you've got these
symptoms is that. You don't want to lose your
vision. And so these are things that could potentially,
if not dealt with, could cause you some vision
loss. So that's why you want to deal with these
more acutely, you know, than an allergic conjunctivitis,
which you can handle on your own. A couple of
other things are if you've had trauma to your
eye, then absolutely you want to go see somebody.
If you've got hit in the face in your eye, you
definitely want to go see somebody about that
because there could be other things that you
can't see going on that you want somebody to
take care of or evaluate. Also, too, if you noticed
you've got blood, that you see actual blood in
your eye or Pussy discharge, like you having
a bacterial conjunctivitis. You want to see somebody
about that. Like when you look in the mirror
and you might see a little, like a burst, like
blood vessels. Right. Because that can mean there's
high pressure in your eye and somebody needs
to look at that right away. If you do have, like
I talked about, that sometimes you can have.
swelling of the tissue around your eye, of the
lid or the tissue around your eye, underneath
your eye. That could mean that you've gotten
the infection that's in your conjunctiva could
have spread to the tissue around it. And that,
again, is a reason that you would need antibiotics.
And then finally, contact lens wearers. If you've
got something going on with your eye, you do
need to see your ophthalmologist or your optometrist
or a healthcare provider because with contact
lenses, The contact lens wearers might have a
weird bug growing in their eye just because they've
got something in their eye all the time. Also,
too, with the contact lens, you could have what
they call a corneal abrasion. So your contact
lens might have scratched your cornea. And so
that needs to be looked at as well, too. And
that's more of an acute issue. So those are some
of those reasons that you might want to see somebody
right away, including if you've got pus coming
out of your eyes for bacterial. conjunctivitis.
And you definitely don't want that to get worse.
Right. Absolutely. All right. So we've talked
about viral pink eye. We've talked about bacterial
pink eye. I think you mentioned also that you
can have an allergic reaction and also a dermatitis.
Or irritative. Irritative or contact conjunctivitis
as well, too. Yeah, and that's just from something
like wind or smoke because smoke isn't just smoke.
There's little particles in there. Right. Another
thing that can cause irritative conjunctivitis,
which I found very interesting, was that if you're
exposed to intense light, what they call snow
blind, that that can cause an irritative conjunctivitis.
Of course, living in South Texas, we don't see
a lot of snow for long periods other than 2020
winter. Or 20, yeah. But anyway, 21 winter. Excuse
me. Everyone up north is like, you babies. I
know, we are poor little babies. The other thing
that can be an irritant to your eye is chlorine
from a swimming pool. And so all of us may have
experienced a little redness in our eyes after
we've been swimming and it's because of that
chlorine. And then like Josh mentioned too, the
fourth category is allergic conjunctivitis, which
can happen in 15 to 40 % of the population. And
it can actually become frequently recurring or
chronic depending on your history of allergies.
It can be seasonal or it can be, so that means
it may just happen in the seasons. Or it could
be perennial, which means it could happen all
year round. Yeah. And we should mention what
an allergy is, like just mechanically. Like an
allergy in your body is essentially when a substance
that isn't a part of you, like your cells or
the things that you create, and it enters your
body and your body detects it as a foreign threat
and it mounts an immune response. to that foreign
body, which is usually a good thing. But a lot
of the side effects that happens with an immune
response are things like inflammation. And inflammation
is an increased amount of blood flow to an area.
And if you think about like a water balloon,
when you're filling a water balloon with water,
it expands the size of the balloon. And if that's
in a tight area, that's an increased pressure.
And that increased pressure we call swelling.
And swelling can sometimes lead to pain. Now,
if you think about how amazing that is, you eat
foreign substances every day. We call it breakfast,
lunch, and dinner. And your body doesn't mount
an immune response to them. It's gotten used
to you eating these things. But sometimes for
people who have allergies to things like peanuts
or maybe even seafood, you're aware that certain
things that are normal for other people aren't
normal for you. And so in Texas, for example,
we have these trees called cedar trees, specifically
ash junipers. That whenever they pollinate, whether
basically they're releasing their fertilizer
to basically reproduce with other trees, that
pollen is actually quite, a lot of people are
quite allergic to that. Most of the time it's
breathed in through their lungs, which causes
some fatigue and malaise. But other things can
also enter your eye in a similar way and cause
the same effect. So it's all about the portal
of entry sometimes with allergens. But I just
wanted to talk about allergies because a lot
of times it's so hard to diagnose what's an allergy
versus what's a virus and what's a bacteria because
your body responds and it only has a set number
of strategies to fight multiple things. So what
can feel like an allergy might actually be a
virus and what is a virus might actually be a
bacteria. which is why it's really good to not
always assume that something's an allergy or
a virus or bacteria. It's really good to confirm
what that is. But if you've had allergies in
the past, like we've said on this podcast before,
when you hear hooves, it's probably a horse,
not a zebra. But if you're experiencing something
for the first time, it'd be a good idea to start
asking these basic questions so you kind of get
at the root of your condition. With that being
said, love for you to talk about how allergic
conjunctivitis can affect people. Sure, that's
a great segue. So again, it's common if you have
allergies and you develop allergic conjunctivitis,
you could have what they call allergic rhinitis
along with it, which means that runny nose, sneezing,
watery eyes, your eyes can itch. So that's kind
of all that part of that allergic conjunctivitis
kind of condition. And again, allergic conjunctivitis
is most likely going to occur in spring and summer
months, but you could also get it any other time.
So if you are allergic to cedar in South Texas,
you could get allergic conjunctivitis at that
time as well. Um, so again, again, let us, let's,
let's just recap. So there are four different
kinds of conjunctivitis. There is that viral,
which is the most common that we see bacterial,
which is the most common that can be seen in
kiddos, um, uh, allergic conjunctivitis and then
irritative conjunctivitis. And let me, yeah.
And also with the, uh, Vax, uh, the virus usually
happens in the summertime. And the bacterial
usually happens in the wintertime. Right. The
viral in the summertime and the bacterial in
the winter. So if you are experiencing these
symptoms, and especially if you have kids, most
of the time, if it's in the summer, the high
likelihood of viral versus in the winter. So
something to look for too. And also to remember,
if you have a more pussy kind of a discharge,
it may more likely be a bacterial conjunctivitis.
So you're going to probably need some antibiotics.
Again, let me just refresh or just review kind
of the symptoms that you can see with conjunctivitis.
You can have a pink color in the whites of your
eyes. Again, remember that membrane is covering
the whites of your eyes. So if you get, like
Josh said, that inflammation, that you can have
that redness. And so you're going to notice that
in your eyes. You can have increased tear production.
You can have itching and blurred vision. And
you can have irritation. So it feels kind of
irritated in your eye. And then you can have
crusting of your eyelids upon awakening, but
that's usually just with bacterial conjunctivitis.
So you don't always have all of these symptoms
with all the different kinds of conjunctivitis,
but these are the types of symptoms that you
can have with conjunctivitis. Wonderful. And
well, not wonderful if you're experiencing these
things, but it's good to know. And I'm sure listeners
out there are like, okay. Now I know everything
about the conjunctiva, probably more than I even
wanted to know. But I hope that for those of
you who like knowledge, you like knowing more
than you should know. For the people going through
this condition, they're probably screaming, how
do I treat this thing? I just want to feel better.
Well, luckily we've got our mom on drugs and
she is going to be going over some of the treatment
options for when you or a loved one is experiencing
pink eye or conjunctivitis. So mom, what can
we do to avail ourselves from this? This eye
of pain. Well, so first of all, there are some
general things that can be done. Make sure that
you wash your hands often and you don't touch
and rub your eyes. It was like we talked about
if it's in one eye and you don't want it to go
to the other eye, you got to keep your hands
off and stuff and make sure that you keep your
hands clean during this time. I'll definitely
say easier said than done. Absolutely. But, you
know, and again, with kiddos, especially, that's
going to be really hard. Another thing is that
you want to avoid close contact with other people
until your symptoms improve. For bacterial conjunctivitis,
you're going to avoid contact with people for
at least 24 hours after you've started antibiotic
therapy or antimicrobial therapy. until the pus
discharge from your eye is reduced. So you got
to wait at least 24 hours and sometimes it'll
be 48 hours before you can go back and interact
with people again when you start feeling better
with that. Remember with allergic conjunctivitis,
I'm sorry, please excuse me, with viral conjunctivitis,
antimicrobials are not going to work and you
can have symptoms for up to two weeks. So you're
going to need to kind of stay away or just assess
yourself until your symptoms start getting better
before you start interacting with other people.
For ladies or for whoever uses makeup, you don't
want to share your makeup or your cosmetics with
other people. And any of those cosmetics that
you were using on your eye before you got or
while you got conjunctivitis, you're going to
need to throw away because they could possibly
be contaminated. You don't want to use eye medicine
prescribed for someone else. So you want to make
sure if you're going to need eye medicine that
you get your own. Gotcha, because they could
have, it could, for example, if you have bacterial
and it's just for viral, then it's not going
to really work, right? Right, absolutely. So
you want to get the right eye medicine for you.
Absolutely. You don't want to share. towels and
sheets with someone else when you've got conjunctivitis,
because again, it could spread, it could, you
know, get all over the towels and the sheets.
And if you've got conjunctivitis in one eye,
but not in the other, make sure you use a separate
towel for each eye. And then you don't want to
swim while you have conjunctivitis. And you don't
want to wear your contact lenses until your conjunctivitis
improves. Okay, so those are just some general
concepts for all the different types of conjunctivitis.
For allergic conjunctivitis, again, remember,
there's not going to be an antibiotic that we
can take to make it feel better. You can use
cold compresses. What that means is like a cold
rag. And you could place it over your eyes to
just get some relief from maybe if there's a
little swelling there or just uncomfortableness,
irritation. You could place that there. And then
you can also use topical decongestants. So there
are drops that are decongestants that can shrink
those vessels in your eyes and kind of like take
the red out. Okay. And then there's antihistamines
because it's an allergic type of a reaction,
which Josh talked about, you know, the different
types of allergies. the different type of mechanisms
that our body has to fight allergies. Those types
of cells can be prevalent. Mast cells, eosinophils
are some of them. And so you can take an antihistamine
to kind of reduce those numbers to get rid of
those, you know, itchiness kind of feelings in
your eye. Yeah. And just to reiterate, mast cells
and eosinophils are types of cells that release
histamines into the area of interest. which cause
inflammation. Histamines are essentially markers
that these cells will release to say, hey, blood
vessels, go there. And then that's where it increases
a lot of blood. So it's almost like playing fetch
with your circulatory system. And your circulatory
system will go in that direction. So anti, meaning
against or lessening, and histamine, so an antihistamine
or an antihistamine will decrease the number
of histamines being created in that moment. And
that's what's causing the discomfort. Okay. A
couple of other things that can be used in allergic
conjunctivitis are topical non -steroidal anti
-inflammatory drugs. So kind of like your Voltaren
for your eye. It's not Voltaren. You don't put
Voltaren in your eye, but it's the same kind
of drug. There's an eye drop. So it's going to
help reduce inflammation, not by reducing histamine
per se, but prostaglandin is another thing that
can cause inflammation. And that's going to reduce
that in your eye as well. And you said non -steroidal
anti -inflammatory drugs. And you'll usually
on the bottle, you'll see something like an NSAID.
And you might see that on things like Tylenol
or ibuprofen. Sorry, not Tylenol. Tylenol is
not an NSAID. Aspirin is, but not Tylenol. Gotcha.
So we have things like aspirin, but you can also
get some similar things like that in drop form.
So you'll see the drop and it'll say an NSAID
on it. And that's for allergic, correct? That
is for allergic. And I believe if I'm not mistaken,
that's a prescription drug. So you would need
a little bit of help with, you know, getting
a prescription for that. And then the other thing
that can be used to treat allergic conjunctivitis,
and again, this would require a prescription
as well, is something called a mast cell stabilizer.
So again, those... those components that get
released in an allergic reaction like mast cells,
eosinophils, mast cell stabilizers will kind
of help those kind of stop being activated. Again,
it's a prescription drug. It's just another kind
of medication. Chromalin, netochromol, and lidoxamide
are the types of drugs that are in that drug
class and stuff. And that's for allergic conjunctivitis.
Yeah, so it'll basically tell your mast cells
to kind of chill out a little bit. Absolutely.
You're working way too hard. You need to take
a nap. Right. And usually that's not going to
be the first line of therapy. Usually that's
going to be probably for people who just, you
know, have that more chronic, you know, annoying
allergic rhinitis that happens a lot. And rhinitis
is different than conjunctivitis because rhine
relates to the nose, right? That's correct. Like
when you hear rhinoceros, that literally translates
to the king of the nose. Like saurus means king
of, and then rhino means nose. Like Tyrannosaurus
is king of the lizards. So rhinoceros is the
same thing. So I just want to point that out.
Anytime you see rhino, that usually just means
nose, not a rhinoceros like the creature. There
you go. There you go. That's great. We'll remember
no's for the rest of our lives now. For viral
conjunctivitis, again, like we've mentioned earlier,
usually it will go away on its own in a couple
of weeks. And again, remember, it's very contagious.
But things that you can do to help alleviate
some of the symptoms are, again, you can use
cold compresses or cold rags on your eyes. And
you can use anti -allergy medicine. So you can
either take oral tablets for it just to help
reduce some of those itchy or, you know, kind
of redness. symptoms and, or you can use eye
drops as well. That's an anti -allergy and a
histamine type thing. And you can also use artificial
tears just to get some relief. If you feel it's
kind of gritty and just kind of bothersome and
stuff. Yeah. I love artificial tears. And actually
one thing I learned about artificial tears, a
lot of people, I used to do this when I hold
them above my eye, I wish you could see this,
but I would usually hold them like an inch or
two above my eye. And that would be so nerve
wracking for me because that drop was, you know,
you'd flinch because you don't like anything
landing on your eye. So I found this fun little
trick for anybody out there. You actually tilt
your head back and put the bottle in the corner
of your eye. And then kind of tilt your head
so that when you basically squirt, it's right
next to your eye too. So you don't put it above.
You actually put it right in there. So when it
squirts in, it basically just kind of pours into
your eyes. You don't have that dropping thing
anymore. You don't have to worry about that drop
falling on your eye. So I find that technique
much better. If you're ever looking to put drops
in your eyes, definitely YouTube something like
that. I'm sure I'm not the first person to discover
this, but it's a much better way of putting drops
in your eyes. But do remember that when you're
putting any kind of eye drop in your eye, do
not let the applicator, the tip of the bottle,
ever touch your eye. Because remember, you're
putting it in there because something's going
on with your eye. And especially if you have
a bacterial conjunctivitis, you don't want the
bacteria to get on the tip of your bottle because
then you could contaminate the whole solution.
And if somebody else uses that, then you'll give
them the thing that you're curing. That's a good
advice. I didn't think about that. So don't touch
the actual plastic part to your eye. Right. Slightly
above. Right. Absolutely. Okay. That's good advice.
And so then, okay, so then the last type of conjunctivitis
that we're going to talk about as far as treating
is bacterial. Again, we talked about the fact
that you're going to need a healthcare provider
involved because you do need an antibiotic for
that. Usually it's going to be a broad spectrum
antibiotic. Things like, usually it's a combination
of polymyxin, bacitracin, or trimethoprim, polymyxin.
There are some other individual agents. Azithromycin,
I think, is a one -dose medication for it. I
think more likely you're going to get the combination
trimethoprim, polymyxin, or the polymyxin -bacitracin
combinations. They're the more commonly prescribed
agents. If you wear contact lenses, you might
need what we call a fluoroquinolone, so something
like ciprofloxacin or levofloxacin. Or gadifloxacin
are some of the eye drops that are available
to treat that because sometimes contact lens
wearers, as I said, can have other organisms
in their eyes that are a little bit more difficult
to treat. So there might be, again, another reason
for a healthcare provider to look at it to just
make the best choice as far as which medication
to prescribe. In the literature that when I read,
let me add this one last comment, and then I
think Josh has something else to say. I did read
as well that sometimes for school systems, because
sometimes viral and bacterial conjunctivitis
are not. always well delineated from one another.
Sometimes it's recommended that whether you have
viral or bacterial, that a 48 -hour dose of antibiotics
is recommended before the kiddo can come back
to school. So again, that's unfortunate because
again, the antibiotic is not going to help. with
a viral conjunctivitis, but you're also trying
to reduce the contagion and allowing kids to
come back to school. I'm not sure I really agree
with that, but I have seen that in the literature.
So again, it would be hard for a kiddo to stay
home from school for two weeks if they have viral
conjunctivitis. So again, that would just be
a case -by -case basis with the parent working
with the teacher to figure out what to do for
their kiddo in that circumstance. Yeah, I was
going to say. along that vein. That's a silly
policy. I see what they're trying to do. They're
just trying to cast a wide net and hopefully
catch the most cases as possible. But for the
kid who doesn't have bacterial conjunctivitis,
that's not going to be helpful at all. So I was
going to say, when you go to your healthcare
provider for bacterial conjunctivitis or whatever
type of conjunctivitis, Remember, these people
are people just like you are, and they have long
days and you might be the last patient they see,
and they might be tired and they want to go home
and they might not do the due diligence need
to be done. Sometimes people prescribe antibiotics
just because it's, it's easier to prescribe something
than to do a test to see if you need to do something.
So I would really push your healthcare provider
to say. actually prove and actually provide evidence
that there is bacteria in there. You can do easy
tests to show that bacteria are actually living
in your eye, especially ones that cause disease.
And if they're not present, then there's no point
of giving you an antibiotic because giving you
antibiotics when you don't need them is actually
not a good idea because You can actually, like
I said before, you can promote antibiotic resistance
in your body because antibiotics are not specific
to types of bacteria. It's just to all types
of bacteria. So if you do have another bacteria
in your body that will become resistant to an
antibiotic, that's not good. So we really need
to limit our use of antibiotics to when we actually
need to do it. And that actually, unfortunately,
might fall upon you, the patient, to really...
Ask your doctor or health care provider to do
their due diligence and test because, you know,
we're all lazy. We sometimes want to take the
easy way out. And that even means for people
that you're trusting with your health care knowledge.
So I always think an informed patient is a good
patient because you're really working in tandem
with your health care provider to provide the
best treatment for yourself. So be informed and
ask for the appropriate treatment. I would agree
with that. And again, there are some antibiotics
that are more specific for certain bugs than
others. And so some of them are not all broad
spectrum. And even though it says a broad spectrum
or a broad antibiotic, it doesn't cover absolutely
every bacteria. But there are going to be certain
specific bacteria that cause conjunctivitis.
And those antibiotics are going to target those.
So I'd say I think that's pretty much what we've
got to say as far as conjunctivitis. Again, remember
there's four different kinds. We do have some
common treatments for all of them, such as artificial
tears or cold compresses. you know, antihistamines
and decongestants for allergic conjunctivitis.
And for irritative conjunctivitis, it's pretty
much avoiding the substance that's causing the
irritation, you know, and stuff. So you could
still use cold compresses or maybe some artificial
tears to help release some of those symptoms.
But just getting away from whatever that substance
is that's causing the problem will help usually
get rid of that as well, too. Yeah, I think that's
really good advice. I think one of the... One
of the misconceptions out there about pink eye
is that you can only get it from using the bathroom
or using the bathroom that somebody else is at.
I don't know how that rumor or myth started.
You can obviously get it from anywhere. Maybe
there's a lot of bacteria in the bathroom, but
there's a lot of bacteria everywhere. But it
really is just about being in a place where something
could get in your eye and infect it or irritate
it. Um, so for those people out there, they're
overly cautious. Um, don't immediately go to
the doctor if, or the healthcare provider, if
you get it, try a cold compress, try an antihistamine,
um, first. And if that goes away over a couple
of days, remember your body has existed for a
very long time. Um, so, um, It's good about fighting
infections. It's why we still are around as a
human race. But also sometimes problems will
persist. And if they persist, and especially
if you see things like pus, and you'll just know
when something's wrong. You feel it, the pain
especially. The list that my mom said, it's like,
definitely go to the doctor. May I share an anecdote
with you about this particular subject? Absolutely.
I'd love to hear it. So, you know, I'm older,
and so I'm not expecting to struggle with pink
eye anymore. You know, I'm associating that with...
being younger. I don't know why, you know, that's
like not even following my own rules. But so
last winter, I went shopping to go look for wallflowers
at a particular store that sells these wonderful
little things that you can plug in the wall and
make your house smell better. And so, you know,
you touch them and smell the candles to figure
out what your favorite scent is. And so I bought
my little half dozen of them and went home. And
two days later, I woke up with a rusty eye and
I'm like What in the world? And so, I mean, again,
I hadn't been out that much. And so I'm thinking,
again, I have no proof of this, but I'm thinking
because I touched all those wallflowers or the
candles and did not come home and immediately
wash my hands, somebody must have already had
bacterial conjunctivitis. And so sure enough,
I ended up, so I waited a couple of days and
I'm like, I've got to deal with this because
I ended up not only with having the redness in
my white of my eye, but I also started. a crusty
eyelid, but I also had the lid of my eye and
under my eye was also red. So I was developing
a cellulitis as well too. So I was getting skin.
So I ended up having to get antibiotics and stuff.
So it was like, oh my gosh. So here I'm a testimonial
that taking antibiotics for bacterial conjunctivitis
really works. And within two or three days, it
was, it was much better. That's great. And if
you don't take antibiotics, it could last longer
or lead into more chronic problems. Bacteria,
they love to stick around. They love to survive.
And just the story that my mom was mentioning,
she loves Bath and Body Works. I get her something
for her birthday or Christmas every year. I've
been doing it for the past 30 something years.
So we hope Bath and Body Works will sponsor this
podcast so that they can send us free stuff.
Also so that we don't have to go into the store
and touch all the things that everyone else touches
so that we get pink eye. Did I ever get pink
eyes as a kid? I don't remember. You would remember
more than me. I don't remember if it was you
or your brother. I may have it written down someplace,
but one of you got it one time. So if it wasn't
frequent, but one of you all got it one time.
It might have been you, but it might have been
your brother. Maybe it was both of you, you know,
so I'm not sure. All right. Yeah, I know. Kids
get into the strangest things. Well, we really
appreciate y 'all. listening to this episode
on Pink Eye. We hope you learned something. I
know that my mom and I did and looking up this
literature and helping y 'all out. If you ever
have any additional questions or any comments
about maybe an episode you'd like to see in the
future or about this episode, you can follow
us on Twitter, your mom on drugs podcast. We
also have an Instagram and we usually try to
post our links and sources that we use. After
each episode, you guys can follow up and look
at the literature yourself if you're geeks like
us, because the world needs more geek. As the
famous book said, the geek shone hair at the
earth. Am I shaking her head? No, that's not
it. But I changed it to that. So again, thank
you so much for listening. We hope that you have
a wonderful day and we'll see you next time.
We'll see you next time. All right. Bye. Bye.