Pink Eye (Conjunctivitis): Symptoms, Treatment and Common Myths

Pink eye, also known as conjunctivitis, is inflammation of the thin, clear membrane that covers the white part of the eye and lines the inside of the eyelids. It can cause redness, irritation, discharge, itching, and a gritty or burning sensation.

While pink eye is often associated with a contagious infection, not every red or irritated eye is contagious, and not every case of conjunctivitis needs antibiotic eye drops.

Ken Kreidl, MD, board-certified ophthalmologist and eye surgeon, explains what causes pink eye, how to recognize common symptoms, when treatment may be needed, and when an ophthalmologist should evaluate a red or irritated eye.

What Causes Pink Eye (Conjunctivitis)?

Conjunctivitis can have several causes. Identifying the cause is important because treatment varies depending on what is irritating or inflaming the eye.

Common causes include:

• Viral conjunctivitis: Often associated with viruses that also cause colds and other respiratory infections. Viral pink eye can be highly contagious.
• Allergic conjunctivitis: Triggered by allergens such as pollen, dust, or pet dander and often causes significant itching and watery eyes.
• Bacterial conjunctivitis: Caused by bacteria and may produce thicker eye discharge.
• Dry eye: Dryness and irritation can cause redness and inflammation that may resemble conjunctivitis.
• Blepharitis: Inflammation along the eyelids can cause red, irritated, gritty, or crusty eyes.

Because several eye conditions can cause similar symptoms, an eye examination may be needed to determine what is causing a red or irritated eye.

What Are the Symptoms of Pink Eye?

Symptoms of conjunctivitis can affect one or both eyes and may include:

• Red or bloodshot eyes
• Itching
• Burning or irritation
• Watery eyes
• Thick or watery discharge
• Crusting around the eyelids, particularly after sleeping
• A gritty or sandy feeling in the eye
• Eye discomfort
• Sensitivity to light

Viral conjunctivitis may occur along with or shortly after symptoms of a respiratory infection, such as a cold or sore throat.

Is Pink Eye Contagious?

Some types of pink eye are contagious, while others are not.

Viral and bacterial conjunctivitis can spread from person to person. Allergic conjunctivitis, dry eye, and other noninfectious causes of eye inflammation are not contagious.

Good hand hygiene is especially important if you have infectious conjunctivitis. Avoid rubbing or touching your eyes, wash your hands regularly, and don’t share towels, pillows, cosmetics, eye drops, or other personal items that may come into contact with the eyes.

Does Pink Eye Need Antibiotics?

Not always.

Antibiotic eye drops treat certain types of bacterial conjunctivitis, but they do not treat viral or allergic conjunctivitis.

Viral conjunctivitis generally improves as the body’s immune system clears the infection. Antibiotic eye drops won’t eliminate the virus and may cause unnecessary side effects.

That’s one reason it’s important to determine the cause rather than assuming every red eye needs an antibiotic.

How Is Pink Eye Treated?

Treatment for conjunctivitis depends on the cause.

For many cases of viral conjunctivitis, treatment focuses on relieving symptoms while the infection resolves. Lubricating eye drops and cool compresses may help reduce irritation and discomfort.

Allergic conjunctivitis may require treatment to control the allergic response, while bacterial conjunctivitis may sometimes be treated with antibiotic eye drops. More significant inflammation or other eye conditions may require prescription treatment from an ophthalmologist.

If you’re unsure what is causing your symptoms, an eye doctor can examine your eyes and recommend appropriate treatment.

What Can I Do at Home for Pink Eye?

If you have conjunctivitis or significant eye irritation:

• Wash your hands frequently with soap and water.
• Avoid touching or rubbing your eyes.
• Don’t share towels, washcloths, pillows, cosmetics, or other personal items.
• Use lubricating eye drops if recommended to relieve symptoms.
• Try a cool compress to soothe irritated eyes.
• Use a clean tissue or cloth to remove discharge, then gently wash your hands.
• Don’t share eye drops with another person.
• Avoid wearing contact lenses while your eyes are red, irritated, or infected.

If you wear contact lenses and develop a red or painful eye, remove your contacts. Contact lens wear can increase the risk of more serious corneal infections, so evaluate persistent or severe symptoms promptly.

Pink Eye: Common Myths

Myth: Every Case of Pink Eye Needs Antibiotic Eye Drops
Fact: Antibiotics only work against bacterial infections. They don’t treat viral or allergic conjunctivitis. Treatment should match the underlying cause of the inflammation.

Myth: You Can Catch Pink Eye by Looking at Someone Who Has It
Fact: You can’t develop conjunctivitis simply by looking at someone. Infectious conjunctivitis can spread through contact with infectious secretions and contaminated hands or objects.

Myth: Eye Drops Can Kill the Virus That Causes Viral Pink Eye
Fact: Antibiotic eye drops don’t treat viruses. Most cases of viral conjunctivitis are managed with supportive care while the infection runs its course. In certain situations, an ophthalmologist may prescribe additional treatment to control significant inflammation.

When Should I See an Ophthalmologist for Pink Eye or a Red Eye?

Although many cases of conjunctivitis resolve without complications, some symptoms can indicate a more serious eye condition.

• Contact an ophthalmologist promptly if you experience:
• Blurred or decreased vision
• Moderate to severe sensitivity to light
• Significant eye pain
• Severe redness or swelling
• Symptoms that are getting worse rather than better
• Significant eye redness, irritation, or pain while wearing contact lenses

Not every red eye is pink eye. Eye pain, vision changes, or significant light sensitivity can signal other eye conditions that require timely diagnosis and treatment.

Let’s Talk

Boulder Medical Center board-certified ophthalmologists provide comprehensive medical and surgical eye care in Boulder, Colorado. If you are experiencing significant eye redness, pain, vision changes, or other concerning eye symptoms, schedule an appointment with BMC Ophthalmology.