Pink Eye: What You Should Know

Medically Reviewed by Poonam Sachdev on April 09, 2024
13 min read

Conjunctivitis, also known as pink eye, is an inflammation of the conjunctiva -- the thin, clear tissue that lies over the white part of the eye and lines the inside of the eyelid.

Pink eye causes redness, itching, pain, burning, discharge, and swelling in and around the eyes. It might make your vision blurry and make you sensitive to light, but you’ll still be able to see. 

Pink eye can happen to anyone, regardless of age, but it's common in children. It can be highly contagious, spreading rapidly in schools and day-care centers, but it’s rarely serious. It's unlikely to damage your vision, especially if you find and treat it quickly. When you take care to prevent its spread and do everything your doctor suggests, pink eye clears up with no long-term problems.

What does pink eye look like?

Pink eye looks like the whites of one or both eyes are pink or red. You may have swelling around your eyes and could see white, yellow, or green discharge.

Pink eye vs. stye

Stye and pink eye are eye infections with similar symptoms. Like pink eye, symptoms of a stye include itchy, sore, and watery eyes and sensitivity to light. But unlike conjunctivitis, a stye causes a small pus-filled bump in the upper or lower eyelid. It also happens due to a bacterial infection, most commonly Staphylococcus aureus and Staphylococcus epidermidis.

Several things could be to blame, but the most common causes of pink eye are:

  • Viruses, including the kind that causes the common cold
  • Bacteria
  • Allergens such as pollen, dust, or smoke. It could also be due to a special type of allergy that affects some people who wear contact lenses.

Other causes include:

  • Irritants such as shampoos, dirt, smoke, and pool chlorine
  • A reaction to eye drops
  • A reaction to wearing contact lens
  • Fungi, amoebas, and parasites

Conjunctivitis sometimes results from an STD. Gonorrhea can bring on a rare but dangerous form of bacterial conjunctivitis. It can lead to vision loss if you don’t treat it. Chlamydia can cause conjunctivitis in adults. If you have chlamydia, gonorrhea, or other bacteria in your body when you give birth, you can pass pink eye to your baby through your birth canal.

Pink eye, caused by some bacteria and viruses, can spread quickly from person to person. But it isn’t a serious health risk if diagnosed promptly. However, if it happens in a newborn, tell a doctor immediately, as it might be an infection that can affect the baby’s eyesight.

Who is at risk for pink eye?

Though pink eye can happen to anyone, newborn babies are at a higher risk of having it. You also may be more at risk if:

  • You interact with someone who has pink eye.
  • You just had a cough, cold, or other respiratory infection.
  • You wear contact lenses.
  • You’ve been exposed to an allergen.

Pink eye and COVID-19

Pink eye may be the only symptom of COVID when the virus infects the eyes, according to a 2020 case report. But more research is needed, as it's rarely the sole COVID symptom. Most people with COVID show symptoms such as fever or chills, cough, tiredness, difficulty breathing, loss of taste or smell, sore throat, runny nose, vomiting, and body aches.

Is pink eye contagious?

Pink eye may be contagious, depending on the type. Cases caused by a viral or bacterial infection can spread to other people, but those caused by allergies or irritants don’t.

Pink eye symptoms may be the same regardless of their cause. It's hard to know which type of conjunctivitis you have without your doctor testing it. So, regularly wash your hands and avoid touching your eyes to prevent spreading or catching it.

Viral pink eye

Viral pink eye is the most common and may be the most contagious form. It's usually caused by the virus that causes the common cold. It tends to start in one eye, causing lots of tears and a watery discharge. Within 24-48 hours, it affects the other eye, too. You might feel a swollen lymph node in front of your ear or under your jawbone.

You may also have cold symptoms such as a fever, sore throat, and runny nose.

Viral pink eye has no cure but will go away on its own. Your symptoms may worsen in the first 3-5 days, but you’ll get better within 1-3 weeks.

Bacterial pink eye 

Bacteria that cause pink eye include:

  • Staphylococcus aureus
  • Streptococcus pneumoniae
  • Haemophilus influenzae
  • Moraxella catarrhalis
  • Chlamydia trachomatis
  • Neisseria gonorrhoeae

Bacterial strains affect children more often than adults. These infections spread easily and are typically seen from December through April. Bacterial pink eye usually infects one eye but can show up in both. Your eye will release a lot of yellow, white, or green pus and mucus. If treated with antibiotic eye drops or ointment, it goes away quickly without causing eye problems. 

Allergic conjunctivitis

Allergic pink eye may occur when allergens in the air, such as dust mites, cat dander, and pollen, enter the eye. It often occurs in people with allergic conditions such as hay fever and asthma. Symptoms such as tearing, itching, and redness in the eyes may happen suddenly, seasonally, or all year round. You might also have an itchy, runny nose and sneezing.

It doesn’t spread from person to person, and symptoms usually go away once you’re no longer exposed to the allergen.

You can manage allergic conjunctivitis with allergy eye drops.

Pink eye in newborns

Pink eye in newborns is called neonatal conjunctivitis or ophthalmia neonatorum. It can be caused by a bacterial or viral infection, a blocked tear duct, or irritation from topical medicines given to the baby at birth. 

It’s a serious form of pink eye, so get medical help immediately if your baby has discharge in their eye or if their eyelids look puffy and tender. Quick treatment can prevent permanent eye damage or blindness. A doctor might treat it with antibiotics.

Giant papillary conjunctivitis

Giant papillary conjunctivitis (GPC) is linked to long-term contact lens use, but it can also happen around surgery stitches near the eyelid. Doctors think it’s an allergic reaction to a chronic foreign body in the eyes.

See a doctor immediately if you notice pink eye symptoms, especially if you wear contacts, an artificial eye, or have stitches around your eyes. Left untreated, GPC can cause serious eye problems.

Your doctor may recommend eye drops or ointments and advise you to change your contact lenses or reduce the number of times you wear them. You could feel better within a week of starting treatment but may need to stop wearing contact lenses for a month to fully heal.

You can also reduce your risk of GPC by using lens solutions with unpreserved salt solution and removing your contact lenses before bed.

Conjunctivitis symptoms depend on the cause of the inflammation, but may include:

  • More tears than usual
  • Green or white discharge from the eye
  • Burning eyes
  • Blurred vision
  • Light sensitivity
  • Swollen lymph nodes (often from a viral infection)

Early-stage pink eye symptoms

The earliest signs of pink eye include:

  • Redness in the white of the eye or inner eyelid
  • Swollen conjunctiva
  • Thick discharge that crusts over the eyelashes, especially after sleep. It can make your eyelids stick shut when you wake up.
  • Itchy eyes

Call your doctor if:

  • There’s a lot of yellow or green discharge from your eye, or if your eyelids are stuck together in the morning
  • You have severe pain in your eye when you look into a bright light
  • Your vision is affected by pink eye
  • You have a high fever, shaking chills, face pain, or vision loss (very unlikely symptoms)

Call your doctor right away if your newborn has pink eye, as it could permanently harm their vision.

Your eye doctor may tell you to come into the office immediately. If you're an adult with a mild case of pink eye and can’t reach your eye doctor, call your primary care doctor. 

If your symptoms remain mild but the redness doesn’t improve within 2 weeks, you need to consult your eye doctor.

Your eye doctor will ask you questions about your symptoms, such as: 

  • When did you start having your eye symptoms?
  • Does anyone else living with you have the same symptoms?
  • Does your eye release any discharge?
  • Is the discharge watery, thin, thick, sticky, or mucus-like?
  • Are your eyes very itchy?
  • Have you ever had seasonal allergies?

They may also give you an eye exam and use a cotton swab to remove fluid from your eyelid to test in a lab. Test results will show bacteria or viruses that may have caused conjunctivitis, including those that can cause an STD. Then, your doctor can prescribe the right treatment.

If your doctor tells you that you have pink eye, you may want to ask these questions:

  • Is my pink eye contagious?
  • If it’s contagious, how do I avoid spreading it?
  • Do I need to stay home from work or school?

What is commonly misdiagnosed as pink eye?

Don’t assume that all red, irritated, or swollen eyes are pink eye (viral conjunctivitis). Your symptoms could also be caused by seasonal allergies, a stye, iritis, chalazion (an inflammation of the gland along the eyelid), or blepharitis (an inflammation or infection of the skin along the eyelid). These conditions aren’t contagious.

Conjunctivitis treatment depends on the cause:

Viruses. Viruses that cause the common cold can also cause pink eye. Just as a cold must run its course, the same is true for this form of conjunctivitis, which usually lasts 4-7 days. Remember, it can be very contagious, so do everything you can to prevent its spread. Antibiotics won't help anything caused by a virus. Pink eye caused by the herpes virus can be serious, however, and may need prescription antiviral eye drops, ointment, or pills.

Bacteria.  If bacteria, including those related to STDs, cause your pink eye, you’ll take antibiotics. You may need to apply eye drops or ointments to the inside of your eyelid three to four times a day for 5-7 days. For more stubborn infections or rare cases of pink eye caused by gonorrhea or chlamydia, you might get an oral antibiotic. You'll need to take pills for several days. The infection should improve within a week. Take or use the medicines as instructed by your doctor, even after the symptoms go away.

Irritants.  For pink eye caused by an irritating substance, use water to wash the substance from the eye for 5 minutes. Your eyes should begin to improve within 4 hours. If your conjunctivitis is caused by acid or alkaline material such as bleach, immediately rinse the eyes with lots of water and call your doctor immediately.

Allergies.  Conjunctivitis tied to allergies should improve once you get your allergy treated and avoid your allergy triggers. Antihistamines (either oral or drops) can give relief in the meantime. Remember that taking antihistamines by mouth can make your eyes even drier if you have dry eyes. See your doctor if you think your pink eye is due to an allergy.

Your eye doctor may have you return in several days to ensure your pink eye improves with the medication prescribed.

How long is pink eye contagious after starting drops?

Pink eye is contagious until your eyes stop tearing and releasing a discharge, whether or not you’ve started eye drops. About 24 hours after starting antibiotic drops, you should see improvement in symptoms.

How long does pink eye last?

Pink eye may last 2-5 days for mild bacterial infections without treatment. But sometimes, it may last up to 2 weeks. Antibiotics can shorten the duration of bacterial conjunctivitis.

Pink eye lasts 7-14 days for most viral infections. However, some cases of viral conjunctivitis may need 2-3 weeks to completely clear.

A lot of it comes down to cleanliness:

  • Wash your hands often with soap and warm water, especially before eating.
  • Keep your eyes clean. Wash any discharge from your eyes several times a day using a fresh cotton ball or paper towel. Afterward, discard the cotton ball or paper towel and wash your hands with soap and warm water.
  • Wash or change your pillowcase every day until the infection goes away. Clean your bed linens, pillowcases, and towels in hot water and detergent when you do the laundry. Keep your towels, washcloths, and pillows separate from those of others, or use paper towels.
  • Don’t touch or rub your infected eye with your fingers. Use tissues to wipe.
  • While treating pink eye, don’t wear -- and never share -- eye makeup, eye drops, or contact lenses. Wear glasses until your eye heals. Throw away disposable lenses, or be sure to clean extended-wear lenses and all eyewear cases.
  • Use a warm compress, such as a washcloth soaked in warm water. Put it on your eye for a few minutes, three to four times a day. This will ease your pain and help break up some of the crust that may form on your eyelashes.
  • Don’t put a patch over your eye. It may worsen the infection.
  • Protect your eyes from dirt and other things that irritate them.
  • Limit eye drops. Don’t use them for more than a few days unless your eye doctor tells you to. Nonprescription “artificial tears,” a type of eye drops, may help ease itching and burning from the irritants causing your pink eye. But you shouldn’t use other types of eye drops because they may irritate the eyes, including those promoted to treat eye redness. Don’t use the same bottle of drops for an uninfected eye.

If your child has bacterial or viral pink eye, keep them home from school or day care until their eyes no longer tear up or produce discharge. Once symptoms have cleared up, it's safe to go back to school or work, but everyone should continue to maintain good hygiene practices.

Usually, pink eye clears up on its own or after you take any medicines your doctor prescribes, with no lasting problems. Mild pink eye is almost always harmless and will get better without treatment.

But some forms of conjunctivitis can become serious and may affect your ability to see because they can scar your cornea, the clear protective covering at the front of your eye. They include conjunctivitis caused by gonorrhea, chlamydia, or certain strains of the adenovirus.

If caused by a virus, pink eye gets better in 2-3 weeks. If caused by bacteria, antibiotics may speed up the healing process.

See a doctor immediately if you have symptoms, including:

  • Eye pain
  • Blurry vision
  • Light sensitivity
  • Feeling something in your eyes

You can take steps to prevent pink eye:

Keep your hands clean. Wash them thoroughly and often, especially if you touch your eye or the area around it.

Don't overshare. Infection can also enter the body through your nose and mouth. So, don’t share washcloths, bath towels, pillowcases, or handkerchiefs with others, even with family. Don’t use other people's eyedrops or cosmetics, especially eyeliner pencils and mascara.

Avoid allergy triggers. If allergies cause your pink eye, avoid the allergens that trigger your symptoms. Don’t rub your eyes, which may make it worse. Splash your face and eyes with cold water, or use a cool compress. Use aqueous-based “artificial tears.” Stick with your allergy treatment.

Clean contact lenses carefully. Sometimes, chemicals used to clean contact lenses can irritate your eyes. You may find relief if you change how you clean your contacts, but be sure to disinfect them before you put them back in your eyes.

Throw away infected items.To avoid another infection, throw away makeup tools, contact lenses, and the contact lens solution and cases you used when you had pink eye.

Pink eye causes red, itchy, watery eyes that produce discharge. Mild cases of conjunctivitis may go away on their own, but it’s best to see a doctor for diagnosis and proper treatment. Pink eye doesn't usually have major complications. But if a newborn has red, puffy eyes, they should receive treatment immediately to avoid damage to their vision. Maintain good personal hygiene and avoid touching your eyes, even after your pink eye clears.

Should I stay home if I have pink eye?

Stay at home if you have pink eye symptoms such as tearing and discharge, because you could spread it to others. Talk to your doctor to confirm if your form of pink eye isn’t contagious.

How long do you stay contagious with pink eye?

You’re contagious with pink eye as long as you have eye tearing and discharge.

What kills the pink eye-causing germs on surfaces?

An antimicrobial cleaner such as bleach can kill the bacteria or viruses that cause pink eye on most surfaces.