Eye inflammations

If the eyes are itchy, burning or red, this is usually very unpleasant and irritating for the affected person. Inflammation of the eyes such as conjunctivitis, styes or inflammation of the eyelids are common and can have various causes. 
 
The good news is that most eye infections can be treated successfully and subside accordingly quickly. However, since our eyes are one of the most sensitive areas of our body, even the slightest symptoms of an infection of the eyes can have a significant and negative impact on those affected. 

Symptoms
Causes
Diagnosis
Treatments
Aftercare
FAQs

Most common eye infections

  • Conjunctivitis  
  • Stye
  • Inflammation of the eyelid (also: blepharitis)
  • Corneal inflammation (medical term: keratitis)  
  • Uveitis ( inflammation of the middle layer of the eye)
  • Eye infection
  • Inflammation of the iris (= iritis)
  • Inflammation of the lacrimal sac and lacrimal ducts

Symptoms

Each of these infections has its own symptoms: 

  • Conjunctivitis manifests itself in the form of red eyes, burning eyes, itching, swollen conjunctiva, a feeling of pressure in the eye, high degree of sensitivity to light and/or sticking together of the eyelids due to the presence of certain secretions. 
  • In the case of a stye, those affected complain of pain and tenderness in the inflamed area of the eye. Both the lower and upper eyelid may be affected. This depends on which gland of the eye has become inflamed. Furthermore, a distinction must be made between an internal and external stye – the internal stye (hordeolum internum) is located on the inside of the eyelid and is usually invisible, but leads to a severe redness and swelling of the eyelid. An external stye (hordeolum externum) is, on the other hand, clearly visible on the edge of the lid. 
  • In the case of inflammation of the eyelids, the affected person has red, encrusted, swollen, itchy and/or burning eyelids. Other symptoms of this disease may include the sensation of having a foreign body in the eye, shiny eyelid edges, scaling on the eyelashes, eyelashes falling out or, above all, glued-up eyelashes in the morning. 
  • There are several types of corneal inflammation in medicine. People with corneal inflammation usually suffer from a reddened, watery eye that secretes an aqueous or purulent (pus) substance because conjunctivitis often occurs as part of a cornea disease. If the cornea is intact, the inflammation usually only spreads on the surface of the cornea. In the case of this superficial inflammation, the outer layer of the cornea (known as the epithelium) becomes slightly cloudy. If, however, the underlying layer of the cornea (medical term: stroma) is inflamed – for example due to an injury – this results in more turbidity, which becomes visible as a whitish spot. In the case of inflammation of the innermost layer of the cornea (medical term: endothelium), on the other hand, the cornea can swell. Corneal inflammation often causes severe pain in the patient and also significantly impairs their vision. 
  • Inflammation of the vascular membrane is noticeable due to the reddening of the eyes, increased lacrimal flow, increased glare, blurred vision and pain when pressure is applied to the eye. In addition, many patients report having noticed fluff, flakes or streaks in front of their eyes in connection with uveitis. 
  • An eye infection can be down to a variety of causes. Therefore, a variety of symptoms may be present. However, symptoms such as redness of the conjunctiva, mild to severe burning pain in the eye and/or a watery, mucous-like or purulent discharge usually indicate an infection of the eye. If the eye is very red, there is likely to be a bacterial infection; if, on the other hand, the eye has become rather pink, this points to a viral infection. 
  • Inflammation of the iris manifests itself in the form of eye pain, sensitivity to light and impaired vision. 
  • In the case of inflammation of the lacrimal sac and the lacrimal ducts, pain, swelling and redness are present in the area of the lacrimal sac and the inner corner of the eyelid. 

Causes

The individual types of eye inflammation can also be traced back to a variety of causes: 

  • Conjunctivitis is one of the most common diseases of the eye. It is caused by bacteria, viruses, parasites, allergies or external stimuli. Corrosive substances, injuries or foreign bodies in the eye, smoke, UV light, dust or draughts as well as a disease of the lacrimal duct can also cause conjunctivitis. 
  • A stye is a purulent inflammation of the glands on the eyelid caused by a bacterial infection, whereby the function of the glands is impaired, which allows the pathogens to multiply more quickly. This abscess has the shape of a small grain from which its (Latin) name comes: hordeolum from “hordeum” which means “barley” in Latin. Poor hygiene is the main cause of the development of a barley grain, but it can also be caused by a weakened immune system or diabetes. 
  • Inflammation of the rim of the eyelid is caused by clogging of the sebaceous glands – for example as a result of irritation, infection or overproduction of fat – on the inside of the eyelids. The special glands on the inside of the lashes remove fats, which are distributed on the eye with every blink, thus ensuring that the eyelids can glide easily over the eye. Increased fat production causes these glands to stick together. In medical terminology, this is referred to as a non-infectious inflammation of the rim of the eyelid (medical term: seborrhoea). Inflammation of the eyelid edges can also be caused by draughts, dust or smoke. 
  • Inflammation of the cornea usually originates from a bacterial infection, whereby diseases such as diabetes or a weakened immune system may still favour bacterial inflammation of the cornea. In addition to bacteria, however, viruses or fungi (rarely) can also be potential triggers. The pathogens often enter the eye with foreign bodies (contact lenses) or contaminated fluids (swimming pool water, contact lens cleaning solution). Corneal inflammation can also be triggered by a non-infectious cause, for example by mechanical stimuli (injuries, contact lenses, eyelashes), alcohol addiction, excessively long screen times and an inadequate tear film. 
  • Some vascular diseases are caused by specific infectious pathogens (bacteria, viruses or parasites). Some uveitis-related diseases occur in the context of systemic diseases (systemic diseases are all diseases that affect an entire or even several organ systems, such as the skin, the central nervous system, the skeleton and the musculature). 
  • An eye infection is caused by viruses (mainly), bacteria, parasites or fungi; an allergy can also cause an eye infection. 
  • Iritis can rarely be traced back to an identifiable cause (known as idiopathic iritis). Many other patients with iritis have a specific genetic trait. This is a certain protein that can be found on the surface of almost all body cells in these patients. 
  • An inflammation of the lacrimal sacs is usually caused by a blockage of the lacrimal ducts. This makes it easier for infectious pathogens to spread and cause inflammation. 

Diagnosis

Inflammation in the eye or around the eye area can usually be seen with the naked eye. Nevertheless, the ophthalmologist first gains a more accurate picture of the medical history. To this end, the patient is asked various questions:  whether eye diseases have been previously diagnosed, whether they have allergies, whether they wear contact lenses or whether they have just got over a flu-like infection. 

The eyes will then be examined more closely, with the ophthalmologist concentrating particularly on the space between the eyelids and the eyeball. They also check whether there is swelling or a sensitivity to pressure. The skin on the face can also provide information – for example, if the inflammation is caused by herpes viruses. If necessary, the ophthalmologist will even carry out an eye test to assess the patient’s eyesight and thus rule out the possibility that the symptoms can be traced back to defective vision or an incorrectly adjusted visual aid. 

Last but not least, the specialist looks at the patient’s eyes using a slit lamp. Thanks to the enlarged image, the individual eye structures can be better identified, meaning the precise area where the inflammation of the eye originated can be determined. In particular, the conjunctiva, the cornea and the eyelids are precisely illuminated before an accurate diagnosis can be made based on the data collected. 

Treatments

It is important that eye inflammation is always treated according to its causes. 

If there is conjunctivitis, it must first be clarified whether it was caused by bacteria or allergens. If bacteria are the cause, treatment is carried out with an antibiotic. If allergens are responsible, they should be avoided in future or the symptoms should be alleviated with anti-allergic agents. However, if conjunctivitis was caused by viruses, treatment options are limited; as a rule, however, antivirals can be administered.  

A similar procedure is used in the case of dacryocystitis (inflammation of the lacrimal sac) or corneal inflammation: If bacteria are the cause, antibiotic eye drops are prescribed; if viruses are the cause, antivirals are administered. However, if the corneal inflammation is due to dry eyes, moisturising eye drops can alleviate the symptoms. 

In the event of inflammation of the vascular membrane, medication is occasionally required to prevent subsequent damage in the form of adhesions to the iris and lens. These medications are usually administered as eye drops that dilate the pupils. Anti-inflammatory ointments with cortisone may also be used. 

In the case of inflammation of the eyelids, the patient must first refrain from using cosmetics or contact lenses and also understand the importance of practising excellent eye hygiene: Damp compresses can help to dissolve the matter clogging the glands. Massaging the eyelid can also provide relief. However, if these methods do not work, the affected eye will need to be treated with antibiotics or antivirals. 

Eye ointments or drops usually cause the inflammatory symptoms to subside quickly as they contain active ingredients that reduce swelling and inflammation. Of course, all medications should only be taken or used after a thorough consultation with an ophthalmologist. 

Aftercare

In order to ensure that the eyes are back to normal and that the inflammation in question has healed, it is advisable to arrange a follow-up appointment with an ophthalmologist during which it can be determined whether the drug treatment has worked or whether further anti-inflammatory measures are necessary. 

FAQs

How can you try to prevent conjunctivitis?

Since conjunctivitis can be caused by external stimuli such as smoke, wind or UV radiation, these kinds of stimuli should be avoided, especially if you know that you are susceptible to conjunctivitis. It can also be helpful to protect yourself from these triggers, for example by wearing sunglasses. 

However, it is not really possible to prevent viral or bacterial conjunctivitis in a targeted manner. 

How long does a bacterial eye infection last?

Bacterial conjunctivitis usually lasts about one to two weeks and may regress on its own or heal after taking antibiotics. 

How long does it take for a stye to go away?

As a rule, a stye will go as quickly as it came: After about a week, the pus usually drains off on its own and the inflammation subsides.