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Pharmacy Care provides information about self-care, that is how to treat minor medical conditions with products available at the pharmacy. Find out how your pharmacist can help you to manage minor conditions yourself.
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Redness and inflammation of the eye has been reported as being the most common ophthalmic problem in Australia. A major cause of eye problems is conjunctivitis, which is an inflammation of the ‘conjunctiva’ (the wet surfaces of the white of the eye and the inner eyelids).
There are three main types of conjunctivitis: allergic, bacterial and viral. They can be difficult to tell apart, and each is treated differently. Irritant conjunctivitis can also occur due to dryness and/or foreign matter in the eye. Always seek medical advice if you have red or painful eyes, loss of vision, irregular shaped pupils or there is unusual discharge.
Allergic conjunctivitis
Allergic conjunctivitis is usually caused by triggers, such as pollen, dust mites, pet dander (hair and dead skin cells), cosmetics or preservatives in eye drops. Symptoms include:
itchy, burning, sore, red eyes with puffy eyelids
dark pouches below eyes
watery eyes
sensitivity to light
other symptoms of allergy, such as sneezing and a blocked or runny nose
Bacterial conjunctivitis
Bacterial conjunctivitis is caused by bacteria and is very contagious, commonly infecting other family members. Symptoms include:
red, burning, sore or gritty eyes with puffy eyelids
eyelids may be stuck together when you wake up, or there may be yellow discharge coming from your eyes.
may present with swelling of the eyelid
symptoms start suddenly and may affect one eye before the other
there are usually no other symptoms associated with bacterial conjunctivitis
Viral conjunctivitis
Viral conjunctivitis is caused by a virus and can be contagious. Sometimes it is accompanied by cold or flu symptoms. Symptoms include:
eyes are red, sore and gritty, and can be watery
itchy and swollen eyes
crusty eyelids
See Your Pharmacist or Medical Professional
if your eyes are painful, sensitive to light, you see colour around lights, or your sight is affected
if only one eye is affected
if you have strangely shaped pupils or cloudy eyes
if you have significant swelling of the eyes
if your eyes have a discharge, such as pus
if you have other symptoms, such as headache, vomiting or a rash
if your eyes do not respond to treatment, or improve in two days
if you have had the problem before
if you think the problem was caused by something stuck in your eye
if you have a cold sore, herpes or shingles
if the person with the eye problem is a baby, young child, or elderly
if you are pregnant or breastfeeding; some medicines may not be suitable
if you have other medical conditions or use other medicines
if you have allergies to any medicines
if you wear contact lenses
Treatment Tips
do not wear contact lenses if you have an eye infection, such as conjunctivitis
do not wear contact lenses with some eye drops; check with your pharmacist
throw eye drop bottles away one month after opening; mark the date you open them on the bottle (check product details as some eye drops can only be used for shorter periods)
if you are using more than one type of eye drops, leave 10 minutes between applications
some eye drops can cause temporary stinging, if this continues talk to your pharmacist
protect your eyes from wind and sun by wearing sunglasses.
simple analgesics such as paracetamol may assist in relieving the pain associated with viral conjunctivitis
Tips for applying eye drops
always wash your hands first
pull your lower eyelid down gently with your index finger to form a pocket; tilt your head back slightly and look up
hold the bottle between your thumb and index finger and squeeze gently to release one drop into your eye pouch
do not touch your eye with the dropper tip
do not blink, as this draws eye drops into the tear duct and out of the eye
close your eye and press gently over the corner, near your nose, to stop the drops draining through your tear duct
wait 10 minutes before adding other eye products
apply only one drop at a time into the affected eye(s) unless the first drop was incorrectly administered
use eye drops before eye ointment
Tips for applying eye ointment
hold the tube between your thumb and index finger and rest your hand against the base of your nose, to position the tube tip
apply a small blob of ointment into your lower eyelid pocket
do not touch the eye with the tube tip
Treatment Options
Allergic conjunctivitis
avoid triggers (e.g. pollen, animal dander) where possible
apply a cold flannel or lubricating eye drops to soothe eyes
Antihistamines (to treat and prevent symptoms)
allergic conjunctivitis can be treated with antihistamine tablets or eye drops.
when you have an allergic reaction your body releases histamine, which leads to ‘allergic’ symptoms
you can prevent the allergic reaction by taking antihistamines when you are around triggers, such as pollen or pet dander
Oral antihistamines (tablets and syrups)
when you have an allergic reaction your body releases histamine, which leads to hayfever. Antihistamines block this reaction. There are two types:
newer, less sedating antihistamines, which do not typically cause drowsiness
older sedating antihistamines that cause drowsiness
antihistamines are good for treating hayfever symptoms as they occur, especially if you have a lot of different symptoms. You can also take them in advance if you know you are going to be exposed to allergens or triggers
cetirizine and loratadine are available as syrups for children; check correct doses for different age groups
newer antihistamines may rarely cause drowsiness; do not drive or operate machinery if you are affected. Cetirizine is more likely to cause drowsiness than other less sedating antihistamines
not available without a prescription for children under two years old
these medicines can cause drowsiness, sometimes the next day; it is important you do not drive or operate machinery
do not drink alcohol with medicines that make you drowsy
sedating antihistamines are not suitable for everyone; check with your pharmacist.
if you have other medical conditions, such as glaucoma, epilepsy or prostate problems, or you take antidepressants, check with your pharmacist before taking these medicines
[PHARMACY ONLY]
e.g. pheniramine + naphazoline (Visine Allergy with Antihistamine, Naphcon-A), naphazoline and antazoline (Antistine-Privine, Albalon-A)
some eye drops contain an antihistamine (such as pheniramine, antazoline) to stop itching, and a decongestant (such as naphazoline) to take away redness
some eye drops cause temporary stinging
limit use of combination eye drops to no more than five to seven days to avoid a ‘rebound’ redness from overuse
these prevent allergic reactions in the eyes and need to be used four to six times per day, depending on the ingredient, for the entire time you are exposed to triggers, such as during spring
Bacterial conjunctivitis
bathe eyelids with warm water or saline, and use warm face cloths
do not share face cloths, towels or eye drops
dispose of tissues carefully
do not use decongestant eye drops as they can mask redness and infection
children should be excluded from school until the infection subsides
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