Pink Eye: Causes, Symptoms, Diagnosis & Treatment

Pinkeye (also referred to as conjunctivitis) is redness and swelling of the conjunctiva, the mucous membrane that lines the eyelid and eye surface. The lining of the eye is typically clear. If irritation or infection happens, The lining becomes red and swollen. See pictures of a normal eye and an eye with conjunctivitis or pink eye.

Pinkeye is very common. It usually is not serious and goes away in 7 to 10 days without medical treatment.

Most cases of pinkeye are caused by:

• Infections caused by viruses or bacteria.
• Dry eyes from lack of tears or exposure to wind and sun.
• Chemicals, fumes, or smoke (chemical conjunctivitis).
• Allergies.

Viral and bacterial pinkeye are contagious and spread very easily. Since most pinkeye is caused by viruses for which there is usually no medical treatment, preventing its spread is important. Poor hand-washing is the main cause of the spread of pinkeye. Sharing an object, such as a washcloth or towel, with a person who has pinkeye can spread the infection.

Anyone can get pink eye, but preschoolers, schoolchildren, college students, teachers and daycare workers are particularly at risk for the contagious types of pink eye because they work closely with others in the classroom.

What Causes Pink Eye?

There are four main causes of pink eye:

• Viruses
• Bacteria
• Allergens (like pet dander or dust mites)
• Irritants (like smog or swimming pool chlorine) that infect or irritate the eye and eyelid lining

It can be difficult to determine the exact cause of pink eye because some signs and symptoms may be the same no matter the cause.

Symptoms of Pink Eye

Pink eye may affect one or both eyes. Its signs and symptoms include:

• Redness
• Itchiness
• A gritty feeling
• A discharge that forms a crust during the night that may prevent your eye or eyes from opening in the morning
• Tearing

How do you get Pink Eye?

Bacterial and viral conjunctivitis can be quite contagious. The most common ways to get the contagious form of pink eye include:

• Direct contact with an infected individual’s secretions, usually through hand-to-eye contact;
• Spread of the infection from bacteria living in the person’s own nose/sinus; and
• Not cleaning contact lenses properly and using poorly fitting contact lenses or decorative contacts.

Children are usually most susceptible to getting pink eye from bacteria or viruses because they are in close contact with so many others in school or day care centers and because they don’t practice good hygiene.

How is pink eye diagnosed?

Conjunctivitis can be diagnosed with an eye examination by a healthcare provider. In some cases, the type of conjunctivitis can be determined by assessing the person’s signs, symptoms, and recent health history (such as whether the person has recently been exposed to someone with conjunctivitis or has a pattern of seasonal allergy). Most cases resolve with time, and there is usually no need for treatment or laboratory tests, unless the person’s history suggests bacterial conjunctivitis.

Viral Conjunctivitis

Viral conjunctivitis is often diagnosed based on a person’s history and symptoms. It tends to occur in both eyes and often accompanies a common cold or respiratory tract infection. Laboratory tests usually are not needed to diagnose viral conjunctivitis; however, testing may be done if a more severe form of viral conjunctivitis is suspected. More severe causes include herpes simplex virus (which usually involves blisters on the skin), varicella-zoster virus (chickenpox and shingles), rubella or rubeola (measles). This testing is performed using a sample of the discharge from an infected eye.

Bacterial Conjunctivitis

Bacterial conjunctivitis tends to occur in one eye and may accompany an ear infection. A sample of the discharge from the affected eye may be obtained for laboratory tests to determine which type of bacteria is causing the pink eye and how best to treat it.

Allergic Conjunctivitis

Allergic conjunctivitis tends to occur in both eyes and often accompanies allergy symptoms, such as an itchy nose, sneezing, and scratchy throat. Allergic conjunctivitis may occur seasonally when pollen counts are high, and it can cause the person’s eyes to itch intensely. A detailed health history may help determine the source of the allergic reaction.

Treatment for Pink Eye

Pinkeye caused by a virus usually goes away without any treatment. If a doctor thinks that the pinkeye is due to a bacterial infection, antibiotic eye drops or ointment will be prescribed.

Sometimes it can be a challenge to get kids to tolerate eye drops several times a day. If you’re having trouble, put the drops on the inner corner of your child’s closed eye when the child opens the eye, the medicine will flow into it. If you continue to have trouble with drops, ask the doctor about antibiotic ointment. It can be applied in a thin layer where the eyelids meet, and will melt and enter the eye.

If your child has allergic conjunctivitis, your doctor may prescribe anti-allergy medicine, either as pills, liquid, or eye drops.

You also can give acetaminophen or ibuprofen to relieve discomfort (check instructions for correct amount).

Using cool or warm compresses on the eyes may make your child more comfortable. Clean the edges of the infected eye carefully with warm water and gauze or cotton balls. This can also remove the crusts of dried discharge that may cause the eyelids to stick together first thing in the morning.

If your child wears contact lenses, your doctor or eye doctor may recommend that the lenses not be worn until the infection is gone. Then, disinfect the lenses and their storage case at least twice before letting your child wear them again. If your child wears disposable contact lenses, throw away the current pair and use a new pair after the infection is gone.

When to see a doctor

Make an appointment with your doctor if you notice any signs or symptoms you think might be pink eye. Pink eye can be highly contagious for as long as two weeks after signs and symptoms begin. Early diagnosis and treatment can protect people around you from getting pink eye too.

If you wear contact lenses, stop using them as soon as your symptoms begin. If your eyes don’t get better within 12 to 24 hours, make an appointment with your eye doctor. He or she can check whether you have a more serious eye infection related to contact lens use.

In addition, other serious eye conditions can cause eye redness. Seek urgent care if you also experience pain, light sensitivity or blurred vision.