Pink Eye (Conjunctivitis) Symptoms, Causes, Treatments

Pink eye is a common name for conjunctivitis, a condition that causes inflammation and redness of the membranes inside the eyes. Viruses, bacterial infections, allergies, or chemical agents can cause pink eye. Sometimes it is the result of a chronic medical condition. Most commonly, a virus or bacterial infection causes pink eye.

Infectious forms of pink eye are highly contagious. It is easily transmitted among humans by contact with an infected person or objects that are shared with an infected person. Coughing and sneezing are other possible routes of spread. Children with pink eye will need to stay home from school or daycare for a short period of time. Pink eye due to allergic reactions or contact with chemical agents is not contagious.

The hallmark sign of pink eye is redness of the eye (sclera). Pink eye is very common and rarely causes long-term problems or vision damage.

When infections cause pink eye, the infections usually start first in one eye and then spread to the other eye within a few days. Allergic reactions usually involve both eyes right away. Swelling of the eyelids may be seen; this is particularly common with bacterial infections and allergies.

Increased production of tears (watery eyes) is common in viral and allergic pink eye.

Other symptoms of pink eye include itching and burning of the eyes.

Watery eyes are common with viral and allergic pink eye. When the eye drains greenish-yellow fluid as seen here, this is most likely to be caused by bacterial pink eye.

Sometimes people with pink eye awaken in the morning with their eyes "stuck shut" due to discharge that is produced during sleep.

Mild sensitivity to light can accompany pink eye. But severe pain, severe sensitivity to light, and vision changes are all signs that the infection may have spread beyond the conjunctiva. These symptoms should prompt a visit to the doctor for an examination.

Sometimes pink eye can feel like there is something in your eye, or a feeling of sand in the eye. Children with pink eye may describe their symptoms this way.

Pink eye can often be diagnosed simply by observing the typical symptoms and signs. In some cases, the doctor will examine the eye with a slit lamp instrument, as shown here. Samples of discharge from the eyes may be taken and sent to a lab to identify the infection in some cases.

Chronic pink eye can signal the presence of an underlying medical disease. These are most commonly rheumatic diseases including rheumatoid arthritis and lupus. Pink eye can also be associated with Kawasaki disease (an uncommon disease that causes fever in infants and young children) and inflammatory bowel diseases like Crohn's disease and ulcerative colitis.

In rare cases, pink eye develops in people who have COVID-19, the novel coronavirus. Experts estimate that only 1% to 3% of those infected with SARS-CoV-2, the virus that causes COVID-19, develop pink eye. Without accompanying COVID-19 symptoms such as fever, coughing, and shortness of breath, your pink eye probably is caused by something else.

Italy's first confirmed case of COVID-19 was a 65-year-old woman whose symptoms included pink eye. Healthcare workers swabbed her eyes for signs of the virus. They found that it lasted longer in her eyes than in the back of her nose. Her pink eye cleared in 20 days, but the virus was still detected up to one day later in her eyes.

Antibiotics, in the form of eyedrops, pills, or ointment, are the recommended treatment for bacterial pink eye. Antibiotics do not work for viral infections; there is no specific treatment for viral infection. The viral infection typically lasts for four to seven days. Treatment of allergies can help improve symptoms of allergic pink eye. Chemical pink eye should be treated immediately by a doctor after washing the affected eye for five minutes.

Cold or warm compresses applied to the eyes can help clear the discharge associated with viral or bacterial pink eye. Use a different washcloth for each eye, and use clean washcloths each time you wash. Wiping from the inside to the outside of the eye area is the best way to clean your eyes.

If symptoms have improved, you can usually go back to school or work 24 hours after starting antibiotics for bacterial pink eye. Viral pink eye is different; you can spread the condition if you have symptoms. Your doctor can tell you when it is safe to return to work or school.

Always wash your hands well and frequently if you or your child has pink eye, and try not to touch the eye area. Wash hands after applying medications to the eyes. To avoid spreading the infection, do not share towels or other products, change linens and towels daily, disinfect surfaces like countertops and doorknobs, and throw away tissues after each use. If you use makeup, throw away any makeup that you used on the eye area while you are infected.