Pink Eye: Everything You Need to Know about Conjunctivitis

Conjunctivitis, commonly known as pink eye, is a type of irritation that affects the conjunctiva — the transparent tissue that covers the white part of your eye and the inside of your eyelids.

If you have conjunctivitis, one or both of your eyes will appear red and swollen. They may have a sticky discharge, causing you to feel discomfort, itchiness and an unpleasant, burning feeling in the affected eyes.

Most of the time, conjunctivitis is caused by a virus. However, conjunctivitis can also be caused by bacteria and allergic reactions. In some people, conjunctivitis may develop because of fungi, contact lenses, air pollution and a variety of other causes. 

Conjunctivitis typically clears up on its own over time. However, depending on the cause of your conjunctivitis, your healthcare provider may prescribe medication to treat your symptoms and speed up your recovery.

Below, we’ve listed the symptoms that you may experience if you have conjunctivitis (pink eye), as well as the specific factors that may have caused it. We’ve also explained how conjunctivitis is diagnosed and treated, as well as what you can do to prevent it from developing again. 

Symptoms of Conjunctivitis (Pink Eye)

Conjunctivitis typically doesn’t affect your vision. However, it can cause a range of unpleasant and annoying symptoms. These include:

• Swelling of your eyelids and/or conjunctiva (the clear layer that lines the white parts of your eyes)

• A noticeable pink or red color in the white parts of your eyes

• Discharge, or either pus or mucus, from your eyes

• Crusting of your eyelids and eyelashes after waking

• Discomfort or difficulty using contact lenses

• A persistent feeling that something is in your eyes

• Irritation, itching and a burning sensation

• An urge to rub or touch your eyes

• Increased tear production

Conjunctivitis can be caused by a virus, bacteria or allergies. Depending on the specific cause of your conjunctivitis, you may experience other symptoms.

If you have viral conjunctivitis, you may also experience cold or flu symptoms at the same time as conjunctivitis. Viral conjunctivitis typically develops in one eye before spreading to the other and can often cause a watery discharge.

Bacterial conjunctivitis may cause pus to discharge from your eyes. This may make your eyes feel sticky and uncomfortable. Bacterial conjunctivitis sometimes develops at the same time as other bacterial infections, such as ear infections. 

Allergic conjunctivitis usually affects both eyes at the same time. It may cause symptoms such as severe swelling, tearing and itching in the eyes. Allergic conjunctivitis may  develop at the same time as other allergy symptoms, such as asthma, sneezing and allergic rhinitis.

When Should You Talk to a healthcare provider?

If your conjunctivitis is caused by a virus, it will usually clear up on its own over the course of one to two weeks without treatment. However, you should talk to a healthcare provider if you experience any of the following symptoms:

• Blurred vision or sensitivity to light that doesn’t improve when you clean your eyes

• Pain in your eyes

• Intense redness in your eyes

• Other symptoms of an infection, such as aches or fever

According to the American Academy of Ophthalmology, you should also talk to a healthcare provider if your symptoms haven’t improved after one week or more, or if they’re getting worse over time.

If your newborn child has conjunctivitis, you should contact a healthcare provider as soon as possible for assistance. You should also talk to a healthcare provider if:

• You have a weakened immune system due to cancer treatment, HIV/AIDS, medication use or any other treatment.
  
  

• You’re prescribed antibiotics to treat bacterial conjunctivitis, but haven’t experienced any improvement in your symptoms 24+ hours after using medication. 

What Causes Conjunctivitis (Pink Eye)?

Conjunctivitis is usually caused by a viral infection. The same viruses that cause the common cold and other upper respiratory tract infections can cause you to develop conjunctivitis. Some cases of conjunctivitis are also caused by the herpes virus and certain viral STDs.

Other common causes of conjunctivitis include bacterial infections (bacterial conjunctivitis) and allergens (allergic conjunctivitis). Some cases of conjunctivitis may also be caused by irritants, such as certain chemicals, smoke, dust and other substances that can irritate the eyes. 

As we mentioned above, each type of conjunctivitis can cause different symptoms. There are also several other differences between viral, bacterial and allergic conjunctivitis.

Viral Conjunctivitis

Because viral conjunctivitis is spread by infectious viruses, it’s very contagious. This type of conjunctivitis can spread quickly during cold and flu season via sneezing, couching, touching and other forms of contact.

Bacterial Conjunctivitis

Bacterial conjunctivitis is also contagious, especially in environments in which certain bacteria can spread easily. Like viral conjunctivitis, bacterial conjunctivitis is often seasonal and tends to occur more frequently from December through April.

Several different types of bacteria can cause bacterial conjunctivitis. The most common are:

• Staphylococcus aureus

• Streptococcus pneumoniae

• Haemophilus influenzae

• Moraxella catarrhalis

Although the bacteria listed above are the most common sources of bacterial conjunctivitis, it’s also possible for it to develop from other bacteria, including bacterial STDs such as chlamydia and gonorrhea.

Bacterial conjunctivitis can spread through contaminated items, such as makeup and lotions, as well as through poor hygiene and physical contact with the eyes (for example, touching your eye without first washing your hands).

Allergic Conjunctivitis

Allergic conjunctivitis, which is caused by both natural and artificial allergens, tends to develop in people with existing allergies, such as asthma, eczema or hay fever. Unlike viral or bacterial conjunctivitis, allergic conjunctivitis isn’t contagious.

Several different allergens can cause allergic conjunctivitis. The most common are:

• Pollen from trees, plants, weeds and grasses

• Molds

• Pet dander

• Dust mites

• Cosmetics and personal care products

• Medications

Allergic conjunctivitis can occur seasonally, usually when airborne pollen and mold spores are at their peak level. If you live in an environment with indoor allergens, such as pet dander or dust mites, it’s also possible to catch allergic conjunctivitis at other times of the year. 

Other Causes of Conjunctivitis

Most cases of conjunctivitis are caused by viruses, bacteria or allergies. However, conjunctivitis can also develop when certain non-viral, bacterial or allergen substances irritate the eyes. Other potential causes of conjunctivitis include:

• Irritating chemicals. Certain chemicals, including the chlorine used in swimming pools and other chemical vapors, can irritate the eyes and lead to chemical conjunctivitis.
  
  

• Fungi. Certain fungal eye infections can cause conjunctivitis. Fungal eye infections are extremely rare but, in some cases, can lead to serious complications that require urgent treatment.
  
  

• Amoeba and parasites. Some ocular parasitic infections can cause irritation to the eyes and conjunctivitis.
  
  

• Contact lenses. Wearing contact lenses can potentially cause an allergic reaction called giant papillary conjunctivitis (GPC), in which the inside of your eyelids may become itchy, red, swollen and painful.
  
  

• Loose eyelashes and other foreign bodies. These may irritate your eyes and lead to conjunctivitis. 

Diagnosis of Conjunctivitis (Pink Eye)

If you’re worried that you might have conjunctivitis, it’s best to talk to a healthcare provider. Your healthcare provider will typically perform an eye examination to check for any symptoms of conjunctivitis. They may also ask you about your symptoms, medical history, allergies, habits and general lifestyle.

The precise symptoms of conjunctivitis can vary based on its cause. To determine the cause, severity and effects of conjunctivitis, your healthcare provider may ask you to do a number of tests. These may include:

• Visual acuity tests. You may need to complete a test of your ability to identify letters and/or numbers from a distance. This can help your healthcare provider determine if your vision is affected by conjunctivitis.
  
  

• Evaluation of the eye using bright light and magnification. This can help your healthcare provider check the condition and function of your eyes and determine which parts of your eyes are affected by conjunctivitis.
  
  

• Culture or smear testing. Your healthcare provider may collect a sample from your conjunctiva or eyelids using a swab. This can be used to identify the specific bacteria that may be the cause of your conjunctivitis.
  
  This type of testing is often used for chronic conjunctivitis that doesn’t respond to normal treatments.

Your healthcare provider may also check other parts of your body to determine if your conjunctivitis is related to another health issue, such as a viral or bacterial infection. 

Conjunctivitis Treatment and Prevention

Because conjunctivitis has several different causes, there’s no one-size-fits-all treatment that’s right for everyone. Your healthcare provider will recommend the most effective treatment based on the type of conjunctivitis you have, your general health and other factors. 

Treatments for Viral Conjunctivitis

Viral conjunctivitis tends to only produce mild symptoms. Most cases of viral conjunctivitis will clear up on their own over one to two weeks. Some cases of viral conjunctivitis may take up to three weeks to fully clear.

If your healthcare provider thinks that your viral conjunctivitis requires treatment, they may prescribe antiviral medication to prevent the growth of the virus and speed up recovery. Antiviral medications are often used for conjunctivitis caused by herpes viruses, such as the herpes simplex virus.

Treatments for Bacterial Conjunctivitis

Bacterial conjunctivitis may require treatment with antibiotics, particularly if you have symptoms such as discharge, if you have a weakened  immune system, or if your conjunctivitis is caused by a bacteria that could cause complications.

To treat bacterial conjunctivitis, your healthcare provider may prescribe antibiotic eye drops or an ointment for you to apply to your eyes. These medications may help to speed up your recovery, lower your chance of spreading the infection to others and reduce your risk of developing complications.

If your bacterial conjunctivitis is mild, your healthcare provider may not prescribe antibiotics. Most of the time, bacterial conjunctivitis improves within a few days of using antibiotics, although it can take up to two weeks for the infection to completely disappear.

Treatments for Allergic Conjunctivitis

If your conjunctivitis is caused by an allergic reaction, your healthcare provider may prescribe medication to control the allergic reaction. Certain medications, such as eye drops containing antihistamines and vasoconstrictors, may help to control your symptoms.

Your healthcare provider may recommend making changes to your habits and environment to avoid further cases of allergic conjunctivitis.

Home Remedies and Lifestyle Changes

If you have conjunctivitis, it’s best to follow the instructions of your healthcare provider. You may also be able to relieve your symptoms and make recovering easier by using the following home remedies and lifestyle changes:

• If your eyes are painful, use over-the-counter pain relief medications. Drugs like ibuprofen (Advil) can help to reduce any pain or discomfort you experience while you recover from conjunctivitis.
  
  

• Remove discharge with a wet washcloth (warm compress). If your eyes feel sticky and difficult to open, place a warm, damp washcloth over your eyes and leave it there until it’s cool. This will clear away dry mucus and make opening your eyes easier.
  
  Make sure to wash the cloth as soon as possible after you’re finished to avoid spreading the infection to others. Use a fresh washcloth every time. Use one washcloth for each of your eyes to avoid spreading bacteria or viral particles from one eye to the other.
  
  

• Use lubricating eye drops to ease discomfort. These over-the-counter eye drops add moisture to your eyes, allowing your tear film to work more effectively to keep your eyes clean and less likely to dry out.

Prevention

If you’re worried about getting conjunctivitis, there are simple steps that you can take to reduce your risk of being exposed to conjunctivitis-causing bacteria or viruses from other people. 

If you already have conjunctivitis, you can reduce your risk of spreading the bacteria or virus to others by making some small changes to your regular habits.

If You Don’t Have Conjunctivitis

Conjunctivitis spreads from infected people to others through bacteria or viral particles. If you’re near or in direct contact with a person with visible conjunctivitis symptoms, you can take several steps to lower your risk of becoming infected:

• Avoid touching your eyes. Touching the area around your eyes could spread bacteria and viruses that cause conjunctivitis to your eyes and eyelids. Avoid touching your eyes and face with unwashed hands, especially after spending time around other people.
  
  

• Wash your hands regularly using soap and water. Make sure to wash for at least 20 seconds to get rid of viruses and bacteria that could cause conjunctivitis. Use soap and warm water, or, if these aren’t available, a hand sanitizer with 60+ percent alcohol.
  
  

• Take special care after contact with an infected person. If you’ve spent time with a person who has visible symptoms of conjunctivitis, take special care to thoroughly wash your hands as soon as possible.
  
  If you’re treating or live with someone who has conjunctivitis, you should also wash your hands after coming into contact with any items they use, such as touching their bedding, helping them apply eye drops, or coming into direct contact with any shared items.
  
  

• Avoid sharing items with an infected person. If your friend, partner or family member has conjunctivitis, avoid sharing things like towels, pillows, washcloths, makeup brushes, personal care products or any other items that they regularly use.

If You Have Viral or Bacterial Conjunctivitis (Pink Eye)

Viral and bacterial conjunctivitis are highly contagious. If you have conjunctivitis that’s caused by a virus or bacteria, it’s important that you take the following preventative measures to lower its ability to spread to other people in your community:

• Avoid touching your eyes. Touching your eyes can spread the bacteria or virus onto your skin, increasing your chance of infecting others. This can also make it more likely for the conjunctivitis to spread to your other eye.
  
  

• Wash your hands frequently. Wash your hands often with soap and water. This kills any bacteria or viral particles that are on your skin. Try to wash for at least 20 seconds using soap and water to get rid of as much bacteria or viral particles as possible.
  
  It’s particularly important to wash your hands after you apply eye drops or ointments. If soap and water isn’t available, use an antibacterial hand sanitizer with a 60 percent or higher alcohol content.
  
  

• Wash your eyes safely and often. If your eyes are producing discharge, clean it away with a fresh cotton ball or fresh, damp washcloth. Make sure to wash your hands before and after cleaning your eyes.
  
  After you’re finished cleaning, dispose of any used cotton balls in the garbage and wash any washcloths with detergent to avoid spreading viruses or bacteria.
  
  

• Avoid swimming pools. Viral conjunctivitis can spread in swimming pools, even if the water is chlorinated. If you or your child has conjunctivitis, avoid using swimming pools until the infection clears up.
  
  

• Avoid sharing personal items. Items such as towels, washcloths, pillows, eyeglasses and eyeglass cases, contact lenses, pillows, makeup and makeup brushes can all carry the viral particles and bacteria that can spread conjunctivitis.
  
  

• Wash pillowcases, sheets, towels and washcloths thoroughly and often. Use hot water and detergent to get rid of bacteria and viruses as effectively as possible. After you finish, wash your hands thoroughly.
  
  

• If you wear eyeglasses or contact lenses, follow your healthcare provider’s instructions to keep them sanitary. You may need to adjust your normal method of cleaning and storing your contact lenses or glasses to avoid contaminating other items.
  
  If you wear contact lenses, your healthcare provider may suggest that you stop wearing them until the conjunctivitis has cleared up.
  
  

• If only one eye is infected, use a different eye drop dispenser for each eye. This may help to lower the risk of the bacteria or virus that’s causing your conjunctivitis from spreading into your other eye.

Once your conjunctivitis has disappeared, it’s important to take several steps to reduce your risk of developing a recurrent conjunctivitis infection. Make sure that you:

• Carefully dispose of eye and/or face makeup, makeup brushes, contact lenses and contact solutions that you used while you had conjunctivitis. These may still have virus particles or bacteria that could cause you to become infected again.
  
  

• Carefully clean any eyeglasses, extended wear lenses and eyeglass or lens cases that you used while you had conjunctivitis. Although you don’t need to permanently dispose of these, it’s important to clean them to get rid of any bacteria or virus particles.
  
  

• Follow your healthcare provider’s instructions to prevent reinfection. Your healthcare provider may also give you specific advice to avoid getting reinfected. Follow your healthcare provider’s instructions closely to minimize your risk of getting conjunctivitis again. 

Talk to a healthcare provider About Conjunctivitis (Pink Eye)

If you have conjunctivitis (pink eye), talking to a healthcare provider can help you learn more about how to deal with your symptoms, treat your infection and recover as quickly as possible.

Consult with a licensed healthcare provider now to discuss your symptoms and learn more about what you can do to treat and manage conjunctivitis (pink eye). 

If appropriate, the provider can write you a prescription on the spot and send it directly to a local pharmacy of your choice, allowing you to get the relief you need fast, all without having to go to a healthcare provider’s office.