inflammation =/= "infection"

We medical professionals sometimes take for granted that patients know the differences between viruses and bacteria, and between inflammation and infection. I have come to realise that in actuality very few people who are not in the medical profession understand these differences. Here's a quick rundown (mostly related to eye care since that's what is relevant to this blog): 1) INFECTIONS: caused by a virus or a bacteria or fungus, etc GROWING in, on or near your eye, usually contagious (but not always as in the case of say bacterial ulcerative keratitis), and usually needs to be treated with anitbiotics or antivirals or antifungals, etc. Some common eye infections are epidemic keratoconjunctivitis, microbial keratitis (actually not that "common" but frequently mentioned in the literature), herpes simplex keratitis, bacterial conjunctivitis, etc. There are, of course, a few other rare eye infections that are caused by multicellular organisms like toxoplasmosis or by amoeba as in acanthamoeba keratitis. To "kill" infections we need drugs that KILL these organisms. Infections are out-of-control growths of FOREIGN ANIMALS (technically viruses and fungi are not "animals" but still) that need to be KILLED. INFLAMMATIONS: these are totally different. They are NOT caused by some living microbe GROWING in/on your eye, and therefore do not need medications that KILL bacteria, viruses, fungus, etc. They are reactions that your body has to some insult/irritation/allergy. These are your own body's response and in the case of eyes include swelling ,pain, redness, light sensitivity, etc. Infections can CAUSE inflammation, but an inflammation is not the same as an infection. Therefore inflammation is not treated with drugs designed to KILL MICROBES unless there is an infection. In the absence of infection, inflammation is treated with anti-inflammatories like STEROIDS, not antibiotics to kill bacteria, for example. Some common eye inflammations (not infections!) are pingueculitis, episcleritis, iritis, punctate keratitis, infiltrative keratitis, etc. I realize to a patient these "all sound the same", but they are not, nor are they the same as "infections". The big hang up, of course, has to do with "pink eye". Every patient who comes in with a red, painful, watery, irritated or light sensitive eye assumes it's "infected" and they have been conditioned by most of the medical community to think that they need antibiotics. Some of them are infected, but I find that most of them are not. Most of them are INFLAMED. I Rx way more steroids for inflammation than I do antibiotics and antivirals for infection. "Pink eye" is one of the top reasons for people to go to the doctor, miss work/school, etc and consequently antibiotic eye drops are some of the top selling medications. But a bunch of these "pink eye" cases are, in my estimation, misdiagnosed and mismanaged. One cannot assume that a red eye is an infected one and that antibiotics are warranted. I just stated that I am Rx'ing more STEROIDS than antibiotics, so in my estimation more red eyes are inflamed than infected. Way more. I've said this before but it bears repeating: if you have an eye problem, go to an eye doctor. You know what you're going to get if you go to the primary care doc with an eye problem: antibiotics. But is it an infection? Its probably not. Its probably inflamed.