Pink Eye: A Complete Guide to Conjunctivitis

Pink eye, or conjunctivitis, is a common eye problem caused by an infection or inflammation of the conjunctiva, the outermost layer of the eyeball which causes the pinkish hue.

Pink eye can be caused by bacterial infections, viruses, eye allergies, or contact-lens related problems. There may be discharge present. Often the condition appears in one eye, then spreads to the other. Most types of pink eye are contagious. Depending on which type you have, symptoms may last between three and ten days and treatment can involve over the counter eye drops or antibiotics. Scroll down for a description of each type.

How Did I Get Pink Eye?

Pink eye / Conjunctivitis

You can contract it simply by touching your eye after touching an infected surface or object such as a doorknob or shopping cart.

You can also get it from shaking hands or sharing towels and pillows with someone who is infected and then touching your eye without washing them properly.

Other times, it develops as a symptom of a disease. For example, pink eye is a symptom of chlamydia. If you are subject to seasonal allergies, you may experience pink eye during times of the year when pollen and other allergens fill the air.

Over-use of certain types of contact lenses, such as extended-wear lenses, or improperly cleaning contact lenses can also cause this condition. Learn more about common lens-care mistakes.

All forms of pink eye turn the white part of the eye pink or red.

Let’s go over the various types of pink eye now:

Viral and bacterial conjunctivitis are the most common types. The viral form is caused by the same virus as the common cold, and usually improves on its own over the course of seven to ten days.

For the first ten days viral conjunctivitis is very contagious. The symptoms of bacterial form are worse than those of viral one.

Allergic conjunctivitis is non-contagious and is caused by common allergies such as animal dander, pollen, and dust.

Most people can tolerate a moderate to high level of exposure, but others are more sensitive. Avoiding the use of such eye drops generally prevents the condition from happening over and over again.

Herpes simplex conjunctivitis is also caused by a virus, but it differs slightly from normal viral type. Although the viral form can cause a burning sensation and pain, with herpes simplex conjunctivitis, the pain and burning may be unbearable.

This form causes additional symptoms such as blisters on the conjunctiva or eyelids. If it spreads to the cornea, it may cause serious problems with your vision. Thankfully anti-viral drops, ointments, and pills are available to treat this problem.

Giant papillary conjunctivitis is non-contagious and usually seen in people who wear soft contact lenses. It is caused by over-wear of the lenses.

Certain cleaning solutions may also contribute to this problem. This type of conjunctivitis may require a contact-lens wearer to switch to a different type of contact lens. Soft contact lenses may need to be replaced with rigid gas-permeable (RGP) lenses or daily disposable contact lenses.

Changing the cleaning solution may be helpful, but some patients need to stop wearing contact lenses for several weeks, or even forever.

Vernal conjunctivitis is usually found in people and families with a history of allergies, asthma, and eczema. This type is defined as long-term swelling of the outer lining of the eyes due to an allergic reaction.

More causes include:

Epidemic keratoconjunctivitis is extremely contagious, and there are often large outbreaks in schools. It is an infection that derives from the same virus as the common cold. It’s spread through contact with infected people, instruments, and other items. There is no treatment for it. And like the common cold, it must run its course.

Non-infectious conjunctivitis is typically the result of irritated eyes. Typical culprits are dust, smoke, perfume, and strong chemicals. This type can also develop if an irritant is ingested. Allergic and giant papillary conjunctivitis belong to this category.

If I Have Pink Eye, Am I Contagious?

Bacterial and viral types are contagious, but allergic pink eye is not. It can be hard to tell which type you are suffering from. Allergic conjunctivitis usually goes away quickly on its own or when the irritating agent is removed and the eyes are rinsed out.

The infectious types of pink eye are the ones to be concerned about because they can spread very easily.

For example, a person who has pink eye and rubs his eyes and then uses the same hand to open a door could end up infecting someone else who touches that door than touches their eye.

Which Symptoms Are Associated With Pink Eye?

Some symptoms are unique to certain types of pink eye. The most noticeable sign is the pinkish to reddish color of the eyes. Irritation and itchiness are two other common symptoms.

Tearing is also common as the eyes naturally produce more tears in order to relieve the discomfort.

Some types of conjunctivitis cause discharge, especially viral and bacterial types. This discharge may be yellow or green. It’s been known to cause the eyelids to stick together, or it can flow out of the eyes.

Let’s go over the specific symptoms of each form of conjunctivitis:

Viral Conjunctivitis Symptoms

  • Watery eyes accompanied by discharge
  • Discomfort
  • Itchiness
  • The infection usually affects one eye, but it can often affect both
  • Eyelid swelling, which may be very severe
  • Possible blurred vision

Bacterial Conjunctivitis Symptoms

  • Watery eyes with yellow or green discharge
  • Irritation and redness
  • The infection usually starts in one eye and may spread to the other

Allergic Conjunctivitis Symptoms

  • Itching and redness
  • Swollen or puffy eyes and eyelids

Herpes Simplex Conjunctivitis Symptoms

  • Severe burning sensations
  • Severe pain
  • Blisters may develop on conjunctiva or eyelids

Giant Papillary Conjunctivitis Symptoms

  • Inability to tolerate contact lenses
  • Large amount of discharge
  • Excessive tearing
  • Red bumps on underside of eyelids
  • Itching, especially after removal of the lenses.

Vernal Conjunctivitis Symptoms

  • Burning and watery eyes
  • Itchiness
  • Photophobia (discomfort in bright light)
  • Bumps may appear on underside of eyelids
  • Area around cornea may become swollen and rough

Epidemic Keratoconjunctivitis Symptoms

  • History of recent cold symptoms or sore throat
  • Redness and irritation of the eyes
  • Light sensitivity (photophobia)
  • Thin, watery discharge
  • Swollen lymph nodes by the ear on affected side
  • Blurred vision
  • Severe swelling of the eyelids

Should I See A Doctor If I Have a Pink Eye?

In short, yes. Your doctor will be able to figure out things like:

  • Which type of pink eye you have
  • If you’re contagious
  • If you need medicine

Here are some questions to ask your eye doctor:

  • How did I get it?
  • What can I do to prevent it from spreading to others?
  • How long will I need to stay away from work, school, public places, etc?
  • Which type do I have?
  • If treatment is not working, how long should I wait to contact you again?

Diagnosing pink eye usually begins with a complete history and physical examination.

Infectious forms of pink eye are diagnosed by their symptoms and appearance. As a result, a slit lamp examination is performed on the eye.

The slit lamp magnifies the surface of the eye and allows the eye doctor to see an inflamed conjunctiva, infected cornea, or infected front part of the eye.

Viral conjunctivitis is harder to diagnose. Doctors can tell the difference between viral and bacterial forms solely by its appearance. The viral form is usually accompanied by a cold symptoms or a sore throat.

How to Avoid Pink Eye

Here are some basic ways to prevent pink eye from spreading:

  • Wash your hands frequently, especially before touching your eye
  • Use antibacterial hand sanitizer frequently, especially if you are unable to wash your hands with soap and water
  • If allergic conjunctivitis is the problem, remove yourself from the area in which the allergens are present
  • Use cold compresses on your eyes periodically to lessen symptoms if due to allergies; use warm compresses several times per day for all other types
  • Avoid touching your eyes directly
  • Avoid sharing towels, washcloths, make-up, goggles, sunglasses, eye drops, or pillows
  • Keep your eyewear clean at all times
  • Disinfect common household items frequently, especially if a member of the household has it
  • Discontinue using current contact lenses, make-up, and eye drops.

How Is Pink Eye Treated?

Treatment depends on what type of the eye disease you have. While the problem may go away after a few weeks, sometimes symptoms last over a month.

For bacterial infections, a doctor must prescribe an antibiotic to attack the bacteria. The antibiotic can be via eye drops or ointments that are applied to the eyes.

For types caused by allergies, treatment generally starts with over-the-counter antihistamine allergy eye drops.

Over-the-counter medications are used for most cases of viral conjunctivitis. Most of all the virus just needs to run its course while medication soothes the symptoms.

Warm compresses are great for removing the sticky residue around the eyes. In severe cases, mild steroids are applied directly to the eye.

Complications of Pink Eye

There are several complications that can arise:

  • Blurred and/or reduced vision
  • Scarring of the cornea
  • Spreading the condition to others
  • Recurrence
  • Abscess around the eye
  • Long-term dry eye symptoms

Sources and References:
We have strict guidelines for each of our sources and references. We rely upon vision, eye and medical information from peer-reviewed studies, medical associations and academic research institions.
  • J. Weizer, MD and J.D. Stein, MD, MS “Reader’s Digest Guide to Eye Care” (Quantum Publishing Ltd, 2009) 52-54
  • M. Beers, MD “The Merck Manual of Medical Information” 2nd Home Edition (Pocket Books, 2003) 1296-1297
  • J. Anshel, MD “Smart Medicine for Your Eyes – A Guide to Natural, Effective, and Safe Relief of Common Eye Disorders” (SquareOne Publishers, 2011) 294-295