PINK EYE
Pink Eye (Conjunctivitis)
Pink eye is a common eye infection that causes inflammation of the tissues lining the eyelid (conjunctiva). It’s caused by allergens, irritants, bacteria and viruses, such as coronaviruses that cause the common cold or COVID-19. Treatment depends on the specific cause and includes eye drops, ointments, pills, water flushes and comfort care.
What is pink eye (conjunctivitis)?
Pink eye is an inflammation (redness) of the conjunctiva, the clear tissue that lines the inside surface of your eyelid and outer coating of your eye. This tissue helps keep your eyelid and eyeball moist. You can get pink eye from viruses, bacteria, allergens and other causes.
The medical name for pink eye is conjunctivitis. You can get pink eye in one or both eyes.
What does pink eye look like?
In an eye with pink eye, the white part looks light pink to reddish and your eyelids are puffy or droopy. You might see fluid (discharge) coming from the infected eye or crusting on your eyelashes and eyelids.
What’s the difference between pink eye and a stye?
Both pink eye and a stye share some common symptoms, including redness, sensitivity to light and crusting along your eyelids. But these two conditions are different and have different causes.
A stye is a red, painful bump that forms either on or inside your eyelid near the edge of your eyelashes. Pink eye is an inflammation of the lining of the inside surface of your eyelid and outer coating of your eye. Pink eye doesn’t cause bumps in your eyelid or around your eye.
Styes are caused by an infection in the oil glands on your eyelid. Pink eye is caused by viruses, bacteria, allergens and other causes different than what causes styes.
How common is pink eye?
Pink eye is one of the most common eye infections in children and adults. There are about 6 million cases of pink eye in the U.S. each year.
Symptoms and Causes
What are the symptoms of pink eye?
Symptoms of pink eye include:
- Redness in the white of your eye or inner eyelid.
- Increased tearing.
- Thick yellow discharge that crusts over your eyelashes, especially after sleep.
- Green or white discharge from your eye.
- Gritty feeling in one or both eyes.
- Itchy eyes (especially in pink eye caused by allergies).
- Burning eyes (especially in pink eye caused by chemicals and irritants).
- Blurred vision.
- Increased sensitivity to light.
- Swollen eyelids.
How do you know it’s pink eye?
Only your healthcare provider can diagnose you for sure, but there are a few symptoms to look for that are characteristic of pink eye. You probably have pink eye if the white of your eye is light pink to reddish all over and it:
- Is constantly tearing.
- Has a green, yellow or white discharge.
- Itches.
What causes pink eye?
The pink or reddish color of pink eye happens when the blood vessels in the membrane covering your eye (the conjunctiva) gets inflamed, making them more visible. Causes of inflammation include:
- Viruses. Viruses are the most common cause of pink eye. Coronaviruses, such as the common cold or COVID-19, are among the viruses that can cause pink eye.
- Bacteria. Common types of bacteria that cause bacterial conjunctivitis include Staphylococcus aureus, Haemophilus influenzae, Streptococcus pneumonia and Pseudomonas aeruginosa.
- Allergens. This includes molds, pollen or other substances that cause allergies.
- Irritating substances. This includes shampoos, cosmetics, contact lenses, dirt, smoke and pool chlorine.
- Sexually transmitted infections (STIs). A virus (herpes simplex) or bacteria (gonorrhea or chlamydia) can cause STIs. STIs can cause pink eye in both adults and newborns.
- A foreign object in your eye.
- Blocked or incompletely opened tear ducts in babies.
- Autoimmune conditions. Diseases that cause your own immune system to overreact are a rare cause of pink eye.
Is pink eye contagious?
Pink eye that happens due to bacteria or viruses is highly contagious (very easily spread from person to person). This is because you can spread pink eye before you know you have it. We also all touch our faces and eyes much more than we think.
Pink eye caused by allergies isn’t contagious.
How long am I contagious with pink eye?
If you get pink eye from bacteria, you’re contagious while you have symptoms or until about 24 to 48 hours after starting antibiotic treatment.
If you get pink eye from a virus, you’re contagious for as long as you have symptoms (usually several days). You can also spread pink eye before you notice any symptoms.
How is pink eye spread?
Pink eye spreads:
- During close contact (touching, shaking hands) with another person. Viruses and bacteria move from someone else’s hand to yours, then you touch your eye.
- By touching surfaces contaminated with bacteria or viruses then touching your eyes before washing your hands.
- By using old eye makeup or sharing makeup that’s contaminated with bacteria or viruses.
- Through sexual contact. Pink eye caused by STIs spreads when you touch infected semen or vaginal fluid vaginal fluid and then touch your eyes without first washing your hands.
Symptoms and Causes
How is pink eye diagnosed?
Your ophthalmologist or pediatrician will examine your eyes or your child’s eyes. Your provider can usually diagnose pink eye based on symptoms and health history. You may do an acuity test (eye chart test) to check your vision.
Tell your healthcare provider if you have:
- Had a viral or bacterial infection recently.
- Allergies.
- Gotten anything irritating (like chemicals or foreign objects) in your eye recently.
- Been exposed to a sexually transmitted infection.
- A family history of autoimmune disease or other reason to think you have an autoimmune disease.
What tests will be done to diagnose pink eye?
While not common, if your provider thinks bacteria is causing pink eye or if the infection is severe, they may want to do testing. They’ll use a soft-tipped stick (swab) to collect secretions from around your eye, then send the sample to a lab. The lab will run tests to find out what’s causing your pink eye.
How can you tell if pink eye is bacterial or viral?
Although the symptoms of pink eye can be the same regardless of cause, your healthcare provider uses a few signs to help determine if pink eye is bacterial or viral:
- Age: Viruses cause most cases of pink eye in adults. Bacteria and viruses each cause about the same number of pink eye infections in children.
- Ear infection: If your child has bacterial conjunctivitis, it’s common for them to also have an ear infection at the same time.
- Amount of discharge: A lot of discharge from your eye is usually a sign of a bacterial infection.
- Color or tint of the whites of eye: Salmon (light pink) color may be a sign of a viral infection. A reddish color is more likely to be a bacterial conjunctivitis.
- If it’s in one or both eyes: If you have pink eye that’s in both eyes, a virus is probably causing it.
Management and Treatment
How is pink eye treated?
Treatment of pink eye depends on whether it’s caused by bacteria, a virus, an allergen or something else.
Treatment for pink eye caused by bacteria
If bacteria are causing your pink eye, your provider will give you a prescription for antibiotics (eye drops, ointments or pills). If it’s tricky to put ointment in your eye or your child’s eye, don’t worry. If the ointment gets as far as the eyelashes, it will most likely melt into the eye.
Treatment for pink eye caused by bacteria
Pink eye caused by a virus doesn’t need treatment unless it’s caused by herpes simplex virus, varicella-zoster virus (chickenpox/shingles) or a sexually transmitted infection. These are serious infections that require antiviral medications. If not treated, they could scar your eye or cause vision loss.
Antibiotics can’t treat pink eye caused by a virus.
Treatment for pink eye caused by irritating substances
If something gets into your eyes and irritates them, rinse your eyes with a gentle stream of warm water for five minutes. Avoid further exposure to the irritating substances.
Your eyes should begin to improve within four hours after rinsing them. If they don’t, call your healthcare provider. If the substance in your eyes is a strong acid or alkaline chemical (such as drain cleaner), rinse your eyes with water and call your healthcare provider immediately.
Treatment for pink eye caused by allergies
Allergic conjunctivitis is treated with prescription or over-the-counter eye drops. These contain either antihistamines to control allergic reactions or anti-inflammatory drugs such as steroids or decongestants.
You can relieve your symptoms temporarily by applying a cold compress to your closed eyes. You can prevent this kind of pink eye by avoiding the allergens that cause your symptoms or taking over-the-counter allergy medicines.
Treatment for pink eye caused by sexually transmitted infections (STIs)
Pink eye caused by STIs are uncommon but can be serious. Like other causes of pink eye, bacterial pink eye is treated with antibiotics and viral pink eye is treated with antiviral medications.
Newborn babies can develop a serious type of pink eye that can cause vision loss. If you’re pregnant and living with an STI, your baby can pick up the bacteria during delivery. It’s standard practice in U.S. hospitals is to apply an antibiotic ointment to every newborn’s eyes to help prevent infection.
Treatment for pink eye caused by autoimmune disease
If you have pink eye caused by an autoimmune disease, treating the underlying illness will also treat your pink eye. Ask your healthcare provider how to manage your symptoms until your eye feels better.
Does pink eye go away on its own?
Mild cases of pink eye usually go away on their own within a few days to a few weeks. Most causes of viral conjunctivitis don’t need treatment. Antibiotics for bacterial conjunctivitis reduce the length of your symptoms and the amount of time you’re contagious.
What gets rid of pink eye fast?
You can only get rid of pink eye faster if it’s caused by bacteria. Antibiotic eye drops can shorten the amount of time you have bacterial pink eye. They won’t work on other types of pink eye.
Prevention
How can I prevent spreading a pink eye infection?
If you or your child has bacterial or viral pink eye, your healthcare provider may recommend staying home from work, school or daycare until you’re no longer contagious. Check with your healthcare provider to find out how long that may be. You’re usually less likely to spread the infection if you’ve been on antibiotics for 24 hours or no longer have symptoms.
Following good general hygiene and eye care practices can also help prevent the spread of pink eye.
- Don’t touch or rub the infected eye(s).
- Wash your hands often with soap and water.
- Wash any discharge from your eyes twice a day using a fresh cotton ball. Throw away the cotton ball and wash your hands with soap and warm water afterward.
- Wash your hands after applying eye drops or ointment to your eye or someone else’s eye.
- Don’t share personal items such as makeup, contact lenses, towels or cups.
Outlook / Prognosis
What can I expect if I have pink eye?
Though highly contagious, pink eye is usually not a serious condition. Most cases of mild to moderate pink eye clear on their own without treatment. Treatment is often needed if pink eye is severe. It can shorten the amount of time you feel symptoms and can spread the condition to others.
How long does pink eye last?
If you have bacterial conjunctivitis, it should improve within a week. Take any medicine as instructed by your healthcare provider, even if your symptoms go away. Viral conjunctivitis usually lasts from four to seven days. It can take up to 14 days to fully resolve.
When can I return to daycare, school or work if I have pink eye?
You or your child can usually go back to daycare, school or work as soon as your symptoms go away. This might be as soon as 24 hours after antibiotic treatment for a bacterial infection and between two and seven days after viral infection.
Your eyes shouldn’t have any:
- Yellowish discharge.
- Crusting on your eyelashes or in the corners of your eyes.
- Pink color.
Be sure to check with your healthcare provider about when it’s safe to return. If an allergy or something else that’s not contagious caused your pink eye, you don’t need to stay home.
Living With
What can I do to help relieve symptoms of pink eye?
Since many cases of pink eye are mild, you’re usually able to relieve symptoms at home until it gets better. Using nonprescription “artificial tears” eye drops may help relieve itching and burning from irritating substances.
Note: Other types of eye drops may irritate the eyes, so don’t use them. Avoid eye drops marketed to treat redness. Don’t use the same bottle of drops in the other eye if it’s not infected.
Other things you can do to relieve the symptoms of pink eye include:
- Stop wearing your contact lenses until your symptoms go away.
- Place cool compresses on your eyes (or warm if it feels better) and don’t share washcloths or towels with others.
- Wash your face and eyelids with mild soap or baby shampoo and rinse with water to remove irritating substances.
Can pink eye come back?
Pink eye can come back, especially if you have allergy-related pink eye. Every time you’re in contact with the allergen (a substance that triggers allergies), your eyes may react.
If you have bacterial or viral pink eye, you can also accidentally reinfect yourself. To avoid coming down with another case of contagious pink eye:
- Wash your bed linens, pillowcases, towels and washcloths in hot water and detergent. Change them frequently.
- Avoid wearing eye makeup until the infection goes away. Throw out old eye makeup and any makeup used just before the start of the infection.
- Wear glasses instead of contact lenses. Clean your glasses often.
- Throw away disposable contact lenses. Thoroughly clean extended wear lenses and all eyewear cases. Use only sterile contact solution. Wash your hands before inserting or removing lenses.
- If you’ve used eye drops for an infected eye, don’t use the same eye drops in a non-infected eye.
Should I go to the doctor for pink eye?
You don’t necessarily need to see a doctor for pink eye. Most of the time, you can treat the symptoms at home until it goes away on its own. But you should never hesitate to call your healthcare provider if you have any concerns.
Some symptoms can be a sign of a serious problem, such as an ulcer, which can result in permanent vision loss. Call your healthcare provider or seek medical care right away if you experience:
- An increase in sensitivity to light, especially if it’s severe.
- Blurred vision or decrease in vision.
- Eye pain.
- Feeling like there is something stuck in your eye.
- Large amount of discharge from your eyes.
- Worsening symptoms.
What questions should I ask my doctor?
- What’s causing my pink eye?
- How can I relieve my symptoms at home?
- How do I use my prescription medication?
- How can I keep pink eye from spreading?
- What new or worsening symptoms should I contact you about?
- Are there any requirements my child has to meet before returning to school/daycare?
