Pink Eye
Pink eye (conjunctivitis) is inflammation in your eyes. It happens when the membrane that covers the white of your eye is irritated. Viral and bacterial infections are the most common causes. You may not need treatment. But visit a healthcare provider if you have symptoms that are getting worse after a few days.
What Is Pink Eye?
ink eye is inflammation in the conjunctiva in your eye. The conjunctiva is the clear membrane that covers part of your eye and the inside of your eyelid. The medical name for pink eye is conjunctivitis. It’s extremely common. It can affect one eye or both at the same time.
Pink eye can be short term (acute) or long term (chronic). Acute pink eye lasts for fewer than four weeks. Chronic pink lasts for more than four weeks.
Pink eye caused by an infection can easily spread. You can accidentally pass it to other people or spread it from one eye to the other.
What does conjunctivitis look like?
Just like it sounds, pink eye can make the white part of your eye look pink or reddish. It can also make your eyelids look puffy or droopy. You may notice discharge coming from your affected eyes.
Pink eye causes
Lots of issues and conditions can cause pink eye. Healthcare providers usually divide conjunctivitis into two categories — infectious and noninfectious.
Infectious pink eye
This happens when an infection causes conjunctivitis. Any type of infection can cause pink eye, including:
- Viral infections: Infections from the adenovirus family are the most common cause of acute pink eye. Other viral infections that can cause viral conjunctivitis include measles, mumps, COVID-19, eye herpes, molluscum contagiosum and hand, foot and mouth disease. Some viruses that cause sexually transmitted infections (STIs) can lead to pink eye.
- Bacterial infections: Bacterial infections are the second most common cause of pink eye. The bacteria that cause staph infections, strep throat and some types of meningitis can all cause bacterial conjunctivitis. STIs like chlamydia, gonorrhea and syphilis can, too.
- Fungal and parasitic infections: It’s possible for a fungus or parasite to cause pink eye. But it’s much less common than pink eye from a viral or bacterial infection.
Noninfectious conjunctivitis
This happens when something other than an infection causes conjunctivitis. This is pink eye that doesn’t spread to you from other people, animals or contaminated objects.
Examples include:
- Allergens: Molds, pollen or other substances that cause allergies can irritate your conjunctiva. This is called allergic conjunctivitis.
- Irritants or toxic substances: Anything that gets in your eye can cause inflammation. This includes soap, cosmetics, dirt, smoke or pool chlorine. Your contact lenses or contact solution can irritate your eyes sometimes, too, even if they usually don’t. Some medications can cause pink eye as a side effect.
- Eye injuries: Anything that damages your conjunctiva can lead to conjunctivitis.
- Other health conditions: Autoimmune diseases can irritate your eyes. It’s much less common, but so can tumors or eye cancers.
Symptoms of pink eye
The most common conjunctivitis symptoms include:
- Red eye.
- Thick eye discharge (yellow, green or white).
- Crusting on your eyelashes or eyelids.
- Feeling like something’s stuck in your eye.
- Dry, watery, itchy, irritated eyes.
- Burning eyes.
- Blurred vision (may come and go).
- Light sensitivity.
- Swollen eyelids.
- Eye pain (usually mild).
Pink eye can share symptoms with lots of other eye conditions. An eye doctor can help you understand what’s affecting your eyes.
What are the complications of pink eye?
Untreated conjunctivitis can cause permanent eye damage and even blindness. But this is rare. Complications that can lead to vision loss include:
- Trachoma.
- Uveitis.
- Corneal inflammation and cornea-conjunctiva inflammation.
- More severe corneal diseases, especially corneal ulcers and recurrent corneal erosions.
See an eye doctor or your primary care provider if symptoms are getting worse after more than a few days. That’s the best way to avoid complications.
How doctors diagnose pink eye
A healthcare provider will diagnose conjunctivitis with an eye exam. They’ll examine your eye and ask about the symptoms. Tell your provider when you first noticed symptoms and how they’ve changed or gotten worse.
Your provider may also test for bacterial infections. They’ll use a soft-tipped swab to collect some of the fluid oozing from your eye for lab testing. Your provider can use the results to guide your treatment.
You might need a follow-up appointment. Your provider will make sure your eyes are healing and check for signs of complications.
How is conjunctivitis treated?
Most of the time, you can treat pink eye symptoms at home until they get better. Your healthcare provider will suggest ways to manage symptoms, including:
- NSAIDs like ibuprofen.
- Corticosteroids.
- Applying a warm or cool compress to your eye (don’t share washcloths or towels with others).
- Artificial tears.
- Wearing your glasses instead of contact lenses while you have symptoms.
If an irritant gets in your eye, you need to rinse it out. Flush your eyes with warm water for five minutes. If a strong acid or alkaline substance (like drain cleaner) gets in your eye, flush your eyes the same way. Then, get immediate emergency medical attention.
Your provider might give you medications to treat a specific cause, including:
- Antivirals: Many viruses that cause pink eye don’t need treatment. But your provider will treat herpes simplex, chickenpox/shingles or an STI. These infections have a higher risk of complications.
- Antibiotics: Eye drops, ointments and pills can all treat bacterial infections.
- Antifungals or antiparasitics: These medications treat infections from fungi or parasites.
- Allergy medications: Your provider will suggest prescription or over-the-counter antihistamines or decongestants to manage allergies.
- Immunosuppressants: These medications can treat autoimmune diseases. They calm your immune system and can prevent it from damaging your eyes.
How long does pink eye last?
How long conjunctivitis lasts depends on what caused it. Viral infections typically last up to two weeks. It’s rare, but some may last longer. Bacterial infections usually last up to 10 days. Allergy-related pink eye lasts as long as you’re around the allergen causing the reaction.
When should I see my healthcare provider?
Visit a healthcare provider if you think you have pink eye and the symptoms keep getting worse after a few days.
Some symptoms can be a sign of a serious problem, like an eye ulcer. Visit a healthcare provider right away if you experience:
- A severe sensitivity to light.
- Blurred vision or a decrease in vision.
- Severe eye pain.
- Feeling like there’s something stuck in your eye.
- A large amount of eye discharge.
- Worsening symptoms.
What can I expect if I have conjunctivitis?
The outlook for pink eye is good, especially with treatment. Milder cases often go away on their own.
Call your provider if it seems like treatments aren’t helping. They may be able to adjust your medications.
Can conjunctivitis come back?
Yes, pink eye can come back. Allergy-related pink eye is the most likely kind to happen again. Your eyes may react every time you’re exposed to an allergen.
If you have bacterial or viral pink eye, you can accidentally reinfect yourself. To avoid that, you should:
- 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, makeup tools and any makeup you used right before you got pink eye.
- Wear glasses instead of contact lenses while you have conjunctivitis. Clean your glasses often.
- Throw away the contacts and the case you were using right before you noticed symptoms. Only use sterile contact solution. Wash your hands before touching your eyes and contacts.
How can you prevent conjunctivitis?
You may not always be able to prevent pink eye. But you can lower your risk of some types by:
- Washing or sanitizing your hands frequently: Use soap and water if your hands look or feel dirty. If they don’t look or feel dirty, you can use an alcohol-based hand sanitizer (at least 60% alcohol).
- Wearing eye protection: Make sure you wear the right eyewear for any work or hobbies. If you wear glasses, don’t assume they’re enough to protect your eyes.
- Never sharing things that touch your eyes: Grooming and hygiene items can spread conjunctivitis very easily. Don’t share makeup tools, personal grooming items, washcloths or anything else that directly touches your eyes.
- Safely using eye drops: Wash your hands before picking up the bottle. Only touch your face with the hand that isn’t holding the bottle. Make sure the bottle tip doesn’t touch your eye. After you put the drops in, set the bottle down, wash your hands and then put it away.
References
- American Academy of Ophthalmology. Multiple EyeWiki and EyeSmart pages reviewed.
- Centers for Disease Control and Prevention (U.S.). Conjunctivitis (Pink Eye) (https://www.cdc.gov/conjunctivitis/index.html). Last reviewed 11/12/2021. Accessed 5/17/2024.
- Godoy-Mancilla J, Oyarzun-Barrientos C, Marín-Cornuy M, Carrasco-Sanhueza E, Águila-Torres P. Bacterial eye infections associated with sexual transmission infections: A review (https:/pubmed.ncbi.nlm.nih.gov/35027140/). Arch Soc Esp Oftalmol (Engl Ed). 2022 Jan;97(1):17-27. Accessed 5/17/2024.
- Horton JC. Disorders of the Eye. In: Loscalzo J, Fauci A, Kasper D, Hauser S, Longo D, Jameson J, eds. Harrison’s Principles of Internal Medicine. 21st ed. McGraw-Hill Education; 2022.
- National Library of Medicine (U.S.). Multiple StatPearls pages reviewed.
- Ramirez DA, Porco TC, Lietman TM, Keenan JD. Epidemiology of Conjunctivitis in US Emergency Departments (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5773254/). JAMA Ophthalmol. 2017 Oct;135(10):1119-1121. Accessed 5/17/2024.
- Sah R, Sharma N, Priyadarshini K, Titiyal JS. Contact lenses for the treatment of ocular surface diseases (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10276751/). Indian J Ophthalmol. 2023 Apr;71(4):1135-1141. Accessed 5/17/2024.
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