Conjunctivitis (pink eye)

Conjunctivitis, commonly called pink eye, is an inflammation or infection of the conjunctiva, the transparent membrane that lines the inner eyelid and covers the white part of your eyeball. Conjunctivitis is most commonly caused by a viral or bacterial infection, and can be highly contagious.

Young parents and child walking outsideYoung parents and child walking outside

Causes and types of conjunctivitis

Most cases of pink eye are caused by a virus, but there are a few other causes that determine the type, including:

  • Allergic conjunctivitis. Occurs in people who have seasonal allergies and come into contact with an allergen that triggers an allergic reaction in their eyes. Giant papillary conjunctivitis is a type of allergic conjunctivitis caused by the chronic presence of a foreign body in the eye, such as hard or rigid contact lenses, or soft contact lenses that are not cleaned and/or replaced frequently.
  • Bacterial conjunctivitis. An infection most often caused by staphylococcal or streptococcal bacteria from your own skin or respiratory system, commonly transferred to your eye(s) via an unclean contact lens. Wash your hands with warm water before handling contact lenses. Ophthalmia neonatorum is a severe form of bacterial conjunctivitis that occurs in newborn babies when an infant is exposed to chlamydia or gonorrhea while passing through the birth canal. This is why doctors apply an antibiotic ointment to newborn babies’ eyes as a standard prophylactic treatment.
  • Chemical conjunctivitis. Caused by irritants like eye makeup, air pollution, chlorine in swimming pools and exposure to noxious chemicals.
  • Viral conjunctivitis. Most commonly caused by contagious viruses associated with the common cold, mainly rhinovirus. It develops through exposure to the coughing or sneezing of someone with an upper respiratory infection.

Other causes

In rare cases, pink eye can be caused in babies from an incompletely opened tear duct.

Sexually transmitted diseases like chlamydia and gonorrhea can be rare causes as well.

Signs and symptoms of conjunctivitis

Though pink eye can be irritating, it rarely affects your vision. The most common symptoms are:

  • A burning, gritty or itching feeling in one or both eyes.
  • Discharge from one or both eyes during the day that may form a crust during the night that prevents you from opening your eye(s) in the morning.
  • Excessive tearing.
  • Increased sensitivity to light.
  • Pink or redness in the whites of one or both eyes.
  • Swollen eyelids.

If you are experiencing any of these symptoms, see your primary care provider for a personalized treatment plan.

Treatments for conjunctivitis

Your primary care provider can help ease the discomfort of pink eye. Your treatment plan will depend on the cause and type of conjunctivitis you have:

  • Allergic conjunctivitis. You should remove or avoid the irritant. Cool compresses and artificial tears can relieve discomfort in mild cases. In more severe cases, your provider may prescribe nonsteroidal anti-inflammatory medications and antihistamines
  • Bacterial conjunctivitis. Treated with antibiotic eye drops or ointments. You should feel relief in just 3–4 days, but you need to take the entire course of antibiotics to prevent recurrence.
  • Viral conjunctivitis. Antibiotics will not cure a viral infection, so the virus has to run its course, which may take up to 3 weeks. You can relieve your symptoms with cool compresses and artificial tear solutions. In more severe cases, your provider may prescribe topical steroid drops to reduce the discomfort from inflammation.
  • Chemical conjunctivitis. Treated with careful flushing of the eyes with saline, and you may also need to use topical steroids. Severe chemical injuries, particularly alkali burns, are medical emergencies and require specialized care from eye doctors.

Relieving pink eye symptoms at home

To help you cope with the symptoms of pink eye, these steps may help:

  • Using artificial tears. These over-the-counter eye drops may relieve symptoms. Some contain antihistamines or other medications that can be helpful for allergic conjunctivitis.
  • Applying a cold compress for your eyes. Soak a clean, lint-free cloth in cool water and wring it out before applying it gently to your closed eyelids. Use a warm compress if that feels better to you. If pink eye affects only one eye, do not touch both eyes with the same cloth to reduce the risk of spreading.
  • Stop wearing contact lenses. Ask your provider how long, and if you should throw away your disposable contacts, cleaning solution and lens case.

References

Center for Disease Control and Prevention (CDC). Pink Eye (Conjunctivitis) (https://www.cdc.gov/conjunctivitis/index.html)

American Optometric Association. Conjunctivitis (pink eye) (https://www.aoa.org/healthy-eyes/eye-and-vision-conditions/conjunctivitis?sso=y)

National Center for Biotechnology Information (NCBI): National Library of Medicine. Conjunctivitis (https://www.ncbi.nlm.nih.gov/books/NBK541034/)