Pink eye: Symptoms, treatment, and what to do next

As a parent, you never wish for a morning like this: when your child wakes up with a red, itchy, watery eye. (It’s no picnic when it happens to you either.) The fear? It’s conjunctivitis, also known as pink eye, which can be very contagious. Fortunately, it’s rarely serious and will clear up without any long-term problems if treated promptly.

Fun fact: “Pink eye” is the most searched urgent care term online. That’s probably because about 6 million people in the United States are affected by it each year, adding up to more than 3 million lost school days annually.

Let’s take a closer look at common pink eye symptoms and causes — and what to do if you think you or your child have it.

What to Do if You Think You Have Pink Eye

While pink eye is highly common and contagious, the good news is that it’s also highly treatable. You may be wondering what to do if you think you have pink eye. The first thing you’ll want to do is stop wearing your contact lenses right away. This will help to relieve symptoms and help prevent recurrences. Additionally, you’ll want to stop wearing any eye makeup and discard any makeup that might be contaminated to further prevent the spread of pink eye.

You can use over-the-counter lubricating eye drops or “artificial tears” to reduce inflammation and dryness caused by pink eye. You can also use a warm, damp washcloth over your eye for symptom relief. You must use a clean washcloth each time to help prevent the spread of infection.

There is no real “pink eye test,” and many cases of pink eye will clear on their own in a week or two without medication. However, there are times when it may be necessary to call your doctor about pink eye. See your doctor if you are experiencing any of the following symptoms:

Pain in your eye(s)
Blurred vision
Sensitivity to light
Eye(s) are producing a lot of pus or mucus
Inability to open the eye(s)
Intense redness of the eye(s)
Fever or achiness
Your symptoms have continued for a week or more
Your symptoms are getting worse

What is Conjunctivitis?

Conjunctivitis is an inflammation or infection of the conjunctiva, which is the membrane on the outer eyeball and the inner eyelid. Conjunctivitis symptoms include red, itchy eyes with a watery or mucus-like discharge, which can vary in color from yellow to green. Translation: It’s uncomfortable and unattractive.

Most pink eye cases – 70 percent – are caused by a virus. Typical viral conjunctivitis is usually accompanied by a cold. So, it’s not uncommon for someone with a cold to wake up with crusty eyelids from the discharge. Viral conjunctivitis doesn’t always require treatment and often goes away within a week or two as your cold diminishes.

Types of Pink Eye

While pink generally has many similar identifying symptoms, there are multiple types, each of which can require different treatment approaches.

1. Viral Pink Eye

Viral pink eye can be caused by the common cold, measles, chickenpox, and other viruses. This is the most common type of conjunctivitis. Viral pink eye typically runs its course within 7 to 10 days and does not require treatment by a medical professional. You may be tempted to treat the viral pink eye with antibiotics in hopes of getting rid of your pink eye sooner. However, it’s important to note that antibiotics do not help treat viral pink eye, as these drugs are not effective against viruses.

Viral pink eye is often seen in both eyes. It may be accompanied by cold symptoms and often presents with increased production of watery tears. What to do about pink eye will depend on whether your pink eye is viral or bacterial.

2. Bacterial Pink Eye

Bacterial pink eye is caused by various types of bacteria and usually involves more significant eye discharge in the form of pus or mucus, which can be yellow or green in color.

Unlike the viral pink eye, bacterial pink eye is often seen in one eye versus both. In some cases, mild bacterial pink eye may get better without antibiotic treatment, however, it is best to speak with your healthcare provider about the best treatment options for you. If you suspect you have bacterial pink eye, seek medical help as you may need an antibiotic to help clear the infection.

Additionally, you should avoid wearing contact lenses, which can complicate the infection. Learn more fun facts about antibiotics and protect yourself against other common infections.

3. Allergic Pink Eye

Allergic pink eye is often caused by seasonal allergies and is often accompanied by swollen glands and other typical allergy symptoms like itchy eyes, runny nose, sneezing, dry scratchy throat and dark circles under the eyes.

Allergic conjunctivitis can be seasonal and its course is limited. Allergic pink eye can also occur year-round due to indoor allergens, like dust and animal dander.

Simple over-the-counter antihistamines can usually provide relief. There are prescription eye drops that are very effective, but these can be expensive.

Causes of Pink Eye

Conjunctivitis can be caused by a virus, bacteria, or allergies. Other causes may include a foreign body in the eye, such as eyelashes, chemical irritants like soap, or indoor and outdoor air pollution, such as smoke or dust.

Bacterial and viral conjunctivitis can be easily spread from person to person. Allergic conjunctivitis is not contagious.

Viral Conjunctivitis

Viral conjunctivitis is an eye infection caused by a virus and is highly contagious. The most common cause of viral conjunctivitis is adenoviruses. The adenovirus may also cause the common cold, which is why on top of getting a cold, you might also get viral conjunctivitis.

You can pick up this infection by simply touching an object with the virus and then rubbing your eye. The virus is also airborne, meaning you can get it through droplets in the air.

Bacterial Conjunctivitis

Bacterial conjunctivitis is an eye infection caused by bacteria, and like viral conjunctivitis, is highly contagious. This infection is typically caused by staphylococcal or streptococcal bacteria from an object or person but is also spread by respiratory droplets.

You can pick up bacterial conjunctivitis by touching your eyes, sharing eye makeup, or having contact with someone with the virus.

Allergic Conjunctivitis

Unlike viral and bacterial conjunctivitis, allergic conjunctivitis is not contagious but rather the result of your body’s reaction to an allergen. Common allergens that may cause allergic conjunctivitis may include tree pollen, plants, grasses, weeds, molds, dust mites, pet dander, or cosmetics.

If you are experiencing symptoms of allergic conjunctivitis, you may want to speak with your healthcare provider, as allergy medications and specific eye drops may provide relief.

Symptoms of Pink Eye

Does pink eye cause swelling under the eye? Should you expect green, goopy eyes? Let’s talk about symptoms.

The most common pink eye symptoms include:

Pinkness or redness in one or both eyes
Itchiness in one or both eyes
Swelling of the conjunctiva (the thin layer that lines the white part of the eye and the inside of the eyelid)
Swelling of the eyelid(s)
Increased tear production
Irritation and burning in one or both eyes
Discharge from pus or mucus in one or both eyes
Crusting of eyelids or lashes, especially in the morning

It’s important to know how different types of pink eye may progress:

Viral conjunctivitis: Redness and watery eyes typically worsen over the first few days and peak within 3 to 5 days before then gradually improving.
Bacterial conjunctivitis: Without treatment, discharge, redness, and swelling may increase over the first few days, but antibacterial treatment can usually improve it within a few days.
Allergic conjunctivitis: Because this is an allergic reaction, symptoms are likely to continue for as long as someone is being exposed to the trigger. Treatment can help alleviate them within a few days.

In mild cases, you may experience slight irritation, redness, itchiness, and discharge. It’s unlikely to interfere with your daily activities and may even go away without treatment.

In severe cases, you’re more likely to have intense and disruptive symptoms. Without treatment, they can persist for weeks or longer and may even pose the risk of corneal ulcers or scarring, vision loss, or a systemic infection.

What to Know About Pink Eye in Children

Pink eye in infants can be caused by an infection, irritation, or a blocked tear duct. When caused by an infection, pink eye in infants can be very serious. You can manage pink eye at home with warm compresses, artificial tears, and good hygiene. Seek urgent care if your baby develops a fever, excessive fussiness or the eye becomes very red and swollen, as these symptoms could indicate a more serious infection.

Pink eye is one of the most common infections kids pick up at school. The symptoms of pink eye in children are similar to those in adults. In older kids, ongoing pain, light sensitivity or changes in vision are red flags requiring prompt medical attention. Keep kids out of school until they’re no longer contagious (usually 24 hours after starting antibiotics) and encourage hand washing and not sharing personal items.

Understanding how to take care of pink eye begins with understanding the cause of pink eye. For example, if your doctor suspects your child has viral pink eye, they are not likely to receive an antibiotic. However, if a bacterial infection causes your child’s pink eye, they may be treated with antibiotic eye drops or an antibiotic ointment.

Allergic pink eye in children may be treated with eye drops or oral allergy medications.

If you’re caring for a child with viral or bacterial pink eye, you’ll want to wash your hands often to help prevent spreading it to yourself or other family members.

How to Prevent Conjunctivitis

We know that pink eye can spread quickly, but you can significantly reduce the risk of getting conjunctivitis or spreading it to someone else by following these simple steps:

Wash your hands often with soap and warm water for at least 20 seconds.
If you don’t have access to soap and water, use an alcohol-based hand sanitizer that contains at least 60% alcohol to clean your hands.
Don’t touch or rub your eyes with your hands.
Wash any discharge from around your eye(s) several times a day using a clean, wet washcloth.
Don’t share towels or washcloths.
Wash pillowcases, sheets, washcloths, and towels often in hot water and detergent.
Throw away and replace any eye and face makeup or cosmetic brushes you used while infected.
Throw away any disposable contact lenses and cases you used while your eyes were infected.

How Contagious Is Pink Eye?

Pink eye is very contagious and is spread to others in the same way other viruses like the cold and flu are spread.

If you touch an object or surface with the pink eye virus or bacteria on it and then touch your eyes, you can easily be infected by it. It is important to note that the pink eye virus can survive on surfaces for up to two weeks. Just like with a cold, you can also get pink eye through close contact, like hugging or shaking hands with an infected individual.

Additionally, people who use extended-wear contact lenses have an increased risk for pink eye as the bacteria can live and grow on these lenses.

Pink Eye Treatment

Relief from the pink eye is within your control. Depending on the cause, there are several over-the-counter treatments, home remedies, and natural alternatives that can help alleviate your symptoms.

To remove crusties from your eyes, use a warm compress (with a dab of baby shampoo) to wipe, starting at the inside of the eye and moving outward. Many people also find that artificial tears, antihistamine drops, or placing cucumber slices or chamomile tea bags over their eyes are helpful.

Be sure to frequently wash your hands, pillowcases, and towels to prevent reinfecting yourself. Help prevent the spread of pink eye by sanitizing surfaces like countertops, doorknobs, bedding, and towels. Avoid using contact lenses and eye makeup (discard any that might be contaminated) while you have an active infection.

Overall, what to do for pink eye will depend on your symptoms. For example, you should need to seek medical care for any of the following:

You think your infant has pink eye, as the infection could harm the baby’s vision.
You have heavy yellow or green eye discharge.
You wake up with your eyelids sticking together.
You have eye pain, blurred vision, high fever, or chills.

If you need help assessing and treating pink eye, come see the experts at our urgent care centers. You can walk in without an appointment, or you can check in online. We’ll have you back to feeling better in no time.

Written by Sarah Thebarge, Physician Assistant and refreshed on September 4th 2024