红眼病（结膜炎）

概述

红眼病（结膜炎）是眼睑内层和覆盖白眼球部分的透明膜（结膜）发生炎症或感染。结膜中的小血管在发炎时会变得更加明显。这就是导致您眼白出现红色或粉红色的原因。

红眼病通常是由细菌或病毒感染、过敏反应或是婴儿泪道未完全打开引起。

虽然红眼病可能产生刺激，但它很少影响人的视力。治疗可以帮助缓解红眼病的不适。由于红眼病可能具有传染性，因此早期诊断和治疗可以帮助限制其传播。

症状

最常见的红眼病包括：

• 一只或两只眼睛发红
• 一只或两只眼睛发痒
• 一只眼睛或两只眼睛有砂砾感
• 一只眼睛或两只眼睛的分泌物在夜间形成一层结壳，可能使您在早晨难以睁开眼睛
• 流泪

何时就诊

严重的眼部症状会导致眼睛发红。这些症状可能导致眼睛疼痛，感觉有东西卡在眼睛里（异物感），产生视力模糊和光敏感。如果出现这些症状，请寻求紧急护理。

戴隐形眼镜的人一旦出现红眼病就需要停止戴隐形眼镜。如果您的症状在 12 到 24 小时内没有开始好转，请预约眼科医生就诊，以确保您没有因为使用隐形眼镜而引起更严重的眼部感染。

When to see a doctor

There are serious eye conditions that can cause eye redness. These conditions may cause eye pain, a feeling that something is stuck in your eye, blurred vision and light sensitivity. If you experience these symptoms, seek urgent care.

People who wear contact lenses need to stop wearing their contacts as soon as pink eye symptoms begin. If your symptoms don't start to get better within 12 to 24 hours, make an appointment with your eye doctor to make sure you don't have a more serious eye infection related to contact lens use.

病因

红眼病的病因包括：

• 病毒
• 细菌
• 过敏
• 化学药品溅入眼睛
• 眼中有异物
• 新生儿泪道阻塞

病毒性和细菌性结膜炎

大多数红眼病都是由于腺病毒所致，但也可能由单纯性疱疹病毒、水痘-带状疱疹病毒和各种其他病毒引起，包括导致 2019 冠状病毒病（COVID-19）的病毒。

病毒性结膜炎和细菌性结膜炎都可能伴有感冒或呼吸道感染症状，例如咽喉疼痛。佩戴没有清洁干净的隐形眼镜或他人的隐形眼镜可能导致细菌性结膜炎。

这两种类型都有很强的传染性，均可通过直接或间接接触从被感染者眼睛里流出的液体传播。单眼或双眼均可能被感染。

过敏性结膜炎

过敏性结膜炎会影响双眼，是对引起过敏的物质（如花粉）的反应。作为对过敏原的反应，身体会产生一种叫做免疫球蛋白 E（IgE）的抗体。这种抗体在眼睛黏膜和气道中触发一种叫做肥大细胞的特殊细胞，使其释放炎性物质，包括组胺。身体释放的组胺会产生许多过敏体征和症状，包括眼睛发红或红眼病。

如果您有过敏性结膜炎，可能会感觉剧烈瘙痒、流泪和眼睛发炎，以及打喷嚏和流清鼻涕。大部分过敏性结膜炎都可以使用过敏滴眼液控制。

刺激导致的结膜炎

眼中有异物或化学药品溅入眼睛引起的刺激也与结膜炎有关。在冲洗和清洁眼睛以清除其中的化学药品或异物时，有时可能会引起发红和刺激。体征和症状（可能包括泪溢和黏液性分泌物）通常在大约一天内便会自行消除。

如果冲洗不能解决症状，或者如果化学药品具腐蚀性，如碱液，早您需要尽快去看医生或眼科专家。化学药品溅入眼睛会造成永久性眼睛损伤。症状持续不退也可能表明您眼睛里还有异物，或者可能是角膜或眼球覆盖物（巩膜）上有划痕。

Viral and bacterial conjunctivitis

Most cases of pink eye are caused by adenovirus but also can be caused by other viruses, including herpes simplex virus and varicella-zoster virus.

Both viral and bacterial conjunctivitis can occur along with colds or symptoms of a respiratory infection, such as a sore throat. Wearing contact lenses that aren't cleaned properly or aren't your own can cause bacterial conjunctivitis.

Both types are very contagious. They are spread through direct or indirect contact with the liquid that drains from the eye of someone who's infected. One or both eyes may be affected.

Allergic conjunctivitis

Allergic conjunctivitis affects both eyes and is a response to an allergy-causing substance such as pollen. In response to allergens, your body produces an antibody called immunoglobulin E (IgE). IgE triggers special cells in the mucous lining of your eyes and airways to release inflammatory substances, including histamines. Your body's release of histamine can produce a number of allergy symptoms, including red or pink eyes.

If you have allergic conjunctivitis, you may experience intense itching, tearing and inflammation of the eyes — as well as sneezing and watery nasal discharge. Most allergic conjunctivitis can be controlled with allergy eye drops. Allergic conjunctivitis is not contagious.

Conjunctivitis resulting from irritation

Irritation from a chemical splash or foreign object in your eye also is associated with conjunctivitis. Sometimes flushing and cleaning the eye to wash out the chemical or object causes redness and irritation. Symptoms, which may include watery eyes and a mucous discharge, usually clear up on their own within about a day.

If flushing doesn't resolve the symptoms, or if the chemical is a caustic one such as lye, see your health care provider or eye specialist as soon as possible. A chemical splash into the eye can cause permanent eye damage. Ongoing symptoms could indicate that you still have the foreign body in your eye. Or you also could have a scratch on the cornea or the membrane covering the eyeball, called the conjunctiva.

风险因素

导致红眼病的风险因素包括：

• 接触过敏的东西（过敏性结膜炎）
• 接触感染结膜炎病毒或细菌的人
• 使用隐形眼镜，尤其是长期佩戴隐形眼镜

并发症

在儿童和成人中，红眼病均可引起角膜发炎，并影响视力。如果出现眼睛疼痛、眼内感觉有异物（异物感）、视力模糊或对光敏感等状况，及时接受医生的评估和治疗，可以降低并发症发作的风险。

预防

防止红眼病蔓延

保持良好的卫生习惯，以控制红眼病的蔓延。例如：

• 不要用手触摸眼睛。
• 经常洗手。
• 每天使用干净的毛巾。
• 不要共用毛巾。
• 经常更换枕套。
• 丢弃眼部化妆品，比如睫毛膏。
• 请勿共享眼部化妆品或个人眼部护理用品。

请记住，红眼病的传染性并不强于普通感冒。如果您不能请假的话，回到工作、学校或托儿所也没关系，只要坚持保持良好的卫生习惯就行了。

预防新生儿红眼病

新生儿的眼睛对母亲产道中的常见细菌很敏感。这些细菌在母亲体内不会引起症状。极少数情况下，这些细菌可引起婴儿出现严重的结膜炎，称为新生儿眼炎，需要及时治疗以保护视力。这就是为什么出生后不久要将抗生素软膏涂在每个新生儿的眼睛上。该药膏有助于预防眼部感染。

Preventing pink eye in newborns

Newborns' eyes are susceptible to bacteria present in the mother's birth canal. These bacteria often cause no symptoms in the mother. In some cases, these bacteria can cause infants to develop a serious form of conjunctivitis known as ophthalmia neonatorum, which needs immediate treatment to preserve sight. That's why shortly after birth, an antibiotic ointment is applied to every newborn's eyes. The ointment helps prevent eye infection.