Conjunctivitis, also known as pinkeye, is an inflammation of the conjunctiva. The conjunctiva is the thin clear tissue that lies over the white part of the eye and lines the inside of the eyelid.
Children get it a lot. It can be highly contagious (it spreads rapidly in schools and day-care centers), but it’s rarely serious. It's very unlikely to damage your vision, especially if you find it and treat it quickly. When you take care to prevent its spread and do all the things your doctor recommends, pinkeye clears up with no long-term problems.
What Causes Pinkeye?
Several things could be to blame, including:
- Viruses, including the kind that causes the common cold
- Bacteria
- Irritants such as shampoos, dirt, smoke, and pool chlorine
- A reaction to eye drops
- An allergic reaction to things like pollen, dust, or smoke. Or it could be due to a special type of allergy that affects some people who wear contact lenses.
- Fungi, amoebas, and parasites
Conjunctivitis sometimes results from a sexually transmitted disease (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 pinkeye to your baby through your birth canal.
Pinkeye caused by some bacteria and viruses can spread easily from person to person, but it isn’t a serious health risk if diagnosed promptly. If it happens in a newborn, though, tell a doctor right away, as it might be an infection that threatens the baby’s vision.
“Pinkeye” isn’t an official medical term. Most eye doctors would probably associate the term pinkeye with mild conjunctivitis caused by bacteria or a virus.
What Are the Types of Pinkeye?
Viral strains are the most common -- and may be the most contagious -- forms. They tend to start in one eye, where they cause lots of tears and a watery discharge. Within a few days, the other eye gets involved. You might feel a swollen lymph node in front of your ear or under your jawbone.
Bacterial strains usually infect one eye but can show up in both. Your eye will put out a lot of pus and mucus.
Allergic types produce tearing, itching, and redness in both eyes. You might also have an itchy, runny nose.
Ophthalmia neonatorum is a severe form that affects newborns. It can be caused by dangerous bacteria. Get it treated right away to prevent permanent eye damage or blindness.
Giant papillary conjunctivitis is linked with the long-term use of contacts or an artificial eye (ocular prosthesis). Doctors think it’s an allergic reaction to a chronic foreign body in your eye.
What Are the Symptoms of Pinkeye?
They depend on the cause of the inflammation, but may include:
- Redness in the white of the eye or inner eyelid
- Swollen conjunctiva
- More tears than usual
- Thick yellow discharge that crusts over the eyelashes, especially after sleep. It can make your eyelids stick shut when you wake up.
- Green or white discharge from the eye
- Itchy eyes
- Burning eyes
- Blurred vision
- More sensitive to light
- Swollen lymph nodes (often from a viral infection)
When to Call Your Doctor
Make the call 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 obviously affected by pinkeye
- You have a high fever, shaking chills, face pain, or vision loss. (These are very unlikely symptoms.)
Call your doctor right away if your newborn has pinkeye, as it could permanently harm their vision.
Your eye doctor may tell you to come into the office to be seen immediately. If you can’t reach your eye doctor, call your primary care doctor if the pinkeye is mild in an adult
If your symptoms remain mild but the redness doesn’t improve within 2 weeks, you need to consult your eye doctor.
How Is Conjunctivitis Diagnosed?
Don’t assume that all red, irritated, or swollen eyes are pinkeye (viral conjunctivitis). Your symptoms could also be caused by seasonal allergies, a sty, 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.
Your eye doctor will ask you about your symptoms and give you an eye exam, and may use a cotton swab to take some fluid from your eyelid to test in a lab. That will help find bacteria or viruses that may have caused conjunctivitis, including those that can cause a sexually transmitted disease. Then your doctor can prescribe the right treatment.
If your doctor tells you that you have pinkeye, you may want to ask these questions:
- Is my pinkeye contagious?
- If it’s contagious, how do I avoid spreading it?
- Do I need to stay home from work or school?
What’s the Treatment for Pinkeye?
The treatment depends on the cause.
Viruses. This type of pinkeye often results from the viruses that cause a common cold. Just as a cold must run its course, the same is true for this form of pinkeye, which usually lasts from 4 to 7 days. Remember, it can be very contagious, so do everything you can to prevent its spread. Antibiotics will not help anything caused by a virus. Pinkeye caused by the herpes virus can be very serious and may need prescription antiviral eye drops, ointment, or pills.
Bacteria. If bacteria, including those related to STDs, caused your pinkeye, 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 to 7 days. For more stubborn infections or for rare cases of pinkeye caused by gonorrhea or chlamydia, you might get an oral antibiotic. You would 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 pinkeye 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 was caused by acid or alkaline material such as bleach, immediately rinse the eyes with lots of water and call your doctor right away.
Allergies. Conjunctivitis tied to allergies should improve once you get your allergy treated and avoid your allergy trigger. Antihistamines (either oral or drops) can give relief in the meantime. (But remember that if you have dry eyes, taking antihistamines by mouth can make your eyes even drier.) See your doctor if you think your pinkeye is due to an allergy.
Your eye doctor may have you return in several days to make sure your pinkeye is improving with the medication prescribed.
What Can I Do to Relieve Symptoms of Pinkeye?
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. When you do the laundry, clean your bed linens, pillowcases, and towels in hot water and detergent. Keep your own towels, washcloths, and pillows separate from others, or use paper towels.
- Don’t touch or rub your infected eye with your fingers. Use tissues to wipe.
- Don’t wear, and never share, eye makeup, eye drops, or contact lenses. Wear glasses until your eye heals. And 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 eases the pain and helps break up some of the crust that may form on your eyelashes.
- Limit eye drops. Don’t use them for more than a few days unless your eye doctor tells you to. It could make the redness worse.
- Don’t put a patch over your eye. It may worsen the infection.
- Protect your eyes from dirt and other things that irritate them.
- Nonprescription "artificial tears," a type of eye drops, may help ease itching and burning from the irritating things that cause your pinkeye. 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 in an uninfected eye. It also helps to learn how to use eye drops the right way.
What About Work and School?
If your child has bacterial or viral pinkeye, keep them home from school or day care until they are no longer contagious. It's usually safe to return to school when symptoms are gone. But keep up the good hygiene!
What Are the Complications of Pinkeye?
Usually, pinkeye clears up on its own or after you take any medicines your doctor prescribes, with no lasting problems. Mild pinkeye is almost always harmless and will get better without treatment.
But some forms of conjunctivitis can become serious and sight-threatening, because they can scar your cornea. They include conjunctivitis caused by gonorrhea, chlamydia, or certain strains of the adenovirus.
If caused by a virus, pinkeye gets better in 2 to 3 weeks. If caused by bacteria, antibiotics may speed up the process.
How Can I Prevent Pinkeye?
- Keep your hands clean. Wash them thoroughly and often, especially if you touch your eye or the area around it.
- 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, particularly eyeliner pencils and mascara.
- If your pinkeye is tied to allergies, avoid your triggers. 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.
- 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.