What is bacterial conjunctivitis?
Conjunctivitis is an inflammation of part of the eye (the conjunctiva, the transparent membrane which overlies the eyelid and covers the sclera, the white part of the eyeball). Conjunctivitis can result from irritating agents, infection with a virus, or bacteria. Known commonly as pink eye, bacterial conjunctivitis results from infection of the eye with bacteria spread through contact with another person who is infected. You can contract bacterial conjunctivitis by touching surfaces of objects that have bacteria on them, or from other parts of your own body, particularly from infected ears or sinuses. Common types of bacterial species that cause conjunctivitis include Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, and Pseudomonas aeruginosa. Such an infection can develop when you are pregnant, just as it can occur outside of pregnancy. There also is a type of bacterial conjunctivitis called Chlamydial conjunctivitis, resulting from an organism called Chlamydia trachomatis which is transmitted sexually, but this is fairly uncommon.
How common is bacterial conjunctivitis during pregnancy?
Bacterial conjunctivitis happens in roughly 135 per 10,000 people each year in developed countries. Adults account for approximately 36 percent of cases. The condition also hits women as frequently during pregnancy as it does outside of pregnancy, so there is a fairly good chance that you could contract bacterial conjunctivitis while pregnant.
How is bacterial conjunctivitis diagnosed?
Bacterial conjunctivitis is diagnosed based on your history of symptoms and examination of your eyes. Typically, with bacterial conjunctivitis, you will have discharge from one or both eyes. The discharge is typically yellow, off-white, or similar color and is usually thick. This can cause your eyelids to stick shut, particularly when you first wake up in the morning, plus your eyes will be very red. Sometimes your doctor will take samples of the pus for laboratory testing.
Does bacterial conjunctivitis cause problems during pregnancy?
Typically, with bacterial conjunctivitis, you will have thick discharge from one or both eyes. This can be very uncomfortable and cause your eyelids to stick shut, particularly when you wake up in the morning. The condition is very contagious and the irritation and stickiness may interfere with your vision temporarily. In some cases, a complication called keratoconjunctivitis can develop, with more severe and long-term consequences for your vision. These are the same problems you would have if you weren’t pregnant.
Does bacterial conjunctivitis during pregnancy cause problems for the baby?
The most common forms of bacterial conjunctivitis generally get better with treatment and do not impact the baby. However, there are sexually transmitted infections (STIs), particularly organisms C. trachomatis and Neisseria gonorrhoeae that can sometimes cause conjunctivitis in the mother, and also neonatal conjunctivitis in the newborn.
What to consider about taking medications when you are pregnant:
The risks to yourself and your baby if you do not treat the bacterial conjunctivitis
The risks and benefits of each medication you use when you are pregnant
The risks and benefits of each medication you use when you are breastfeeding
What should I know about using medication to treat bacterial conjunctivitis during pregnancy?
Generally, treatment with antibiotics is required in the form of eye drops or ointment. You will be instructed to continue the treatment for about one to two weeks, depending on the type of bacterial conjunctival infection and its severity. Such topical medications are not risky for the baby.
In rare cases of STIs, namely C. trachomatis and N. gonorrhoeae, topical antibiotics (ointment or drops) may not be enough and you may need to take antibiotics internally, but antibiotic regimens are available that have low risk to the baby.
There is evidence both for and against the benefits of adding a category of medications called corticosteroids, but generally, these are not harmful to the baby.
Who should NOT stop taking medication for bacterial conjunctivitis in pregnancy?
If your eye doctor determines that you require antibiotic drops or ointment to treat bacterial conjunctivitis, then it is vital that you continue the treatment for the prescribed amount of time. Thus, nobody should stop the medication.
What should I know about choosing a medication for bacterial conjunctivitis in pregnancy?
You may find Pregistrys expert reports about the individual medications to treat bacterial conjunctivitis here. Additional information can also be found in the sources listed at the end of this report.
What should I know about taking a medication for bacterial conjunctivitis when I am breastfeeding?
As noted above, the mainstay treatment for bacterial conjunctivitis consists of topical antibiotic medication in the form of drops or ointments. There is very little absorption from the eyes into the mothers bloodstream from these. Thus, there is no conflict with breastfeeding. However, keep in mind that bacterial conjunctivitis is extremely contagious. Thus you should get the condition under control before you handle your infant so closely. Consult with your eye doctor regarding when you can breastfeed. In some cases, it may be wise to pump for the first couple of days after your bacterial conjunctivitis develops and then switch back to breastfeeding after your antibiotic treatment is underway.
What alternative therapies exist besides medications to treat bacterial conjunctivitis during pregnancy?
There is an agent called Povidone-iodine that may possibly offer benefit as an alternative to ointment or eyedrop antibiotics. The benefits, if real, would be mostly in poor countries where ophthalmic antibiotics are not readily available.
What can I do for myself and my baby when I have bacterial conjunctivitis during pregnancy?
It is very important to follow the instructions of your eye care physician.
Resources for bacterial conjunctivitis during pregnancy:
For more information about bacterial conjunctivitis during pregnancy, contact http://www.womenshealth.gov/ (800-994-9662 [TDD: 888-220-5446]) or read the following articles:
Mayo Clinic: Pink eye (conjunctivitis)
BabyMed: Pink Eye in Pregnancy