Pink eye, or conjunctivitis, is an inflammation of the transparent membrane that lines the inner surface of the eyelid and covers the white part of the eyeball. This common eye condition causes redness, irritation, and discharge. During pregnancy, it is important to approach any illness with caution, as some medications can potentially impact the developing fetus. This guide outlines safe, evidence-based management strategies for pregnant individuals, focusing on non-medicated relief and appropriate prescription treatments.
Identifying the Cause of Conjunctivitis
Determining the exact cause of conjunctivitis is the first step toward safe and effective treatment, as management differs based on whether the cause is viral, bacterial, or allergic. Viral conjunctivitis is the most common form, often accompanying a cold or respiratory infection. It typically presents with a clear, watery discharge and may begin in one eye before spreading to the other; this type is highly contagious and generally does not require antibiotic treatment. Bacterial conjunctivitis is less common but more likely to require medication, distinguished by a thick, yellow or greenish discharge that causes the eyelids to stick together, especially upon waking. Allergic conjunctivitis is characterized by intense, immediate itchiness and typically affects both eyes simultaneously, often alongside other allergy symptoms like sneezing or a runny nose.
Non-Medicated Relief and Safety Precautions
Conservative, non-medicated measures are safe during pregnancy and often provide sufficient relief, particularly for viral or mild allergic cases. Applying a clean, cool compress several times a day helps soothe irritation and reduce swelling. For bacterial cases that cause matting, a warm compress can help loosen the crusted discharge, making it easier to gently clean the eyelids.
Practicing meticulous hand hygiene is the most important safety precaution, as both viral and bacterial forms are highly contagious. Hands should be washed frequently with soap and water, especially after touching the eyes or face, to prevent spreading the infection. Avoid touching or rubbing the eyes, and never share towels, washcloths, pillowcases, or eye makeup. Contact lens wearers should immediately switch to glasses until the infection has completely cleared to prevent complications.
Safe Prescription Treatments During Pregnancy
When non-medicated efforts are insufficient, prescription treatments may be necessary. Topical eye drops are generally preferred over oral medications because systemic absorption into the mother’s bloodstream and potential exposure to the fetus is minimal. However, any medication use must be discussed with an obstetrician or eye care specialist.
For bacterial conjunctivitis, topical antibiotics are used to speed up recovery and reduce transmission risk. Erythromycin ophthalmic ointment is considered a first-line treatment and is classified as Pregnancy Category B, meaning studies have shown no evidence of risk to the fetus. Tobramycin eye drops are another Category B option, used due to their low systemic absorption following ocular administration.
Treatment for allergic conjunctivitis focuses on avoiding the allergen and managing the inflammatory response. Safe topical options include mast cell stabilizers like sodium cromoglicate, which is considered safe because very little crosses the placenta. If topical antihistamines are needed, oral antihistamines like cetirizine or loratadine are generally preferred due to their established safety profile in pregnancy.
Viral conjunctivitis has no specific medical treatment; management remains supportive, focusing on symptom relief while the body clears the infection, which typically takes one to two weeks. Antibiotic drops will not help viral infections and should not be used unnecessarily. Certain high-risk medications, such as systemic tetracyclines or high-dose topical steroids, should be strictly avoided during pregnancy unless absolutely necessary and prescribed by a specialist.