Pinkeye

Overview

Pinkeye (also called conjunctivitis) is redness and swelling of the conjunctiva, the mucous membrane that lines the eyelid and eye surface. The lining of the eye is usually clear. If irritation or infection occurs, the lining gets red and swollen.

Pinkeye is very common. It usually isn't 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. They spread very easily. 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.

Viral pinkeye

Viral pinkeye is often caused by an adenovirus, which is a common respiratory virus that can also cause a sore throat or upper respiratory infection. The herpes virus can also cause viral pinkeye.

Symptoms include:

  • Redness in the white of the eye.
  • Swelling of the eyelids.
  • An itching or burning feeling of the eyelids.
  • Swollen and tender areas in front of the ears.
  • A lot of tearing.
  • Clear or slightly thick, whitish drainage.

Viral pinkeye symptoms usually get better on their own in 7 to 10 days. But they may last up to 3 weeks and can become ongoing or chronic.

Pinkeye may be more serious if you:

  • Have a condition that decreases your body's ability to fight infection (impaired immune system).
  • Have vision in only one eye.
  • Wear contact lenses.

If the pinkeye is caused by a virus, the person can usually return to day care, school, or work when symptoms start to improve. This most often takes 3 to 5 days. Medicines aren't usually used to treat viral pinkeye, so it's important to prevent the spread of the infection. Pinkeye caused by a herpes virus, which is rare, can be treated with an antiviral medicine. Home treatment of viral pinkeye symptoms can help you feel more comfortable while the infection goes away.

Bacterial pinkeye

An infection may occur when bacteria enter the eye or the area around the eye. Some common infections that cause pinkeye include:

Symptoms include:

  • Redness in the white of the eye.
  • Gray or yellow drainage from the eye. This drainage may cause the eyelashes to stick together.
  • Mild pain.
  • Swelling of the upper eyelid. It may make the lid appear to droop (pseudoptosis).

Bacterial pinkeye may cause more drainage than viral pinkeye. Bacterial infections usually last 7 to 10 days without antibiotic treatment and 2 to 4 days with antibiotic treatment. The person can usually return to day care, school, or work 24 hours after an antibiotic has been started if symptoms have improved. Prescription antibiotic treatment usually kills the bacteria that cause pinkeye.

Red eye

Red eye is a more general term that includes not only pinkeye but also many other problems that cause redness on or around the eye, not just the lining. Pinkeye is the main cause of red eye. Red eye has other causes, such as:

  • Foreign objects, such as metal or insects.
  • Scrapes, sores, or injury to or infection of deeper parts of the eye (for example, uveitis, iritis, or keratitis).
  • Glaucoma.
  • Infection of the eye socket and areas around the eye.

Swollen, red eyelids may also be caused by styes, a lump called a chalazion, inflammation of the eyelid (blepharitis), or lack of tears (dry eyes).

Health Tools

Health Tools help you make wise health decisions or take action to improve your health.

Actionsets are designed to help people take an active role in managing a health condition.

Check Your Symptoms

Do you think you have pinkeye?
Pinkeye (conjunctivitis) is redness and swelling of the conjunctiva, which lines the eyelid and covers the surface of the eye.
Yes
Pinkeye
No
Pinkeye
How old are you?
Less than 3 months
Less than 3 months
3 months to 3 years
3 months to 3 years
4 years or older
4 years or older
Are you male or female?
Male
Male
Female
Female

The medical assessment of symptoms is based on the body parts you have.

  • If you are transgender or nonbinary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
  • If your symptoms aren’t related to those organs, you can choose the gender you identify with.
  • If you have some organs of both sexes, you may need to go through this triage tool twice (once as "male" and once as "female"). This will make sure that the tool asks the right questions for you.
Have you had an eye injury within the past week?
Yes
Eye injury within past week
No
Eye injury within past week
Do you have other eye symptoms, such as vision changes or dark specks or shadows that float across your field of vision?
Yes
Other eye symptoms
No
Other eye symptoms
Do you have symptoms of a serious illness?
Yes
Symptoms of serious illness
No
Symptoms of serious illness
Does light make your eyes hurt?
Yes
Sensitivity to light
No
Sensitivity to light
Does the light hurt so much that you have trouble opening your eyes?
Yes
Hard to open eyes because of discomfort with light
No
Hard to open eyes because of discomfort with light
Do you have any eye pain?
Yes
Eye pain
No
Eye pain
How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?
8 to 10: Severe pain
Severe eye pain
5 to 7: Moderate pain
Moderate eye pain
1 to 4: Mild pain
Mild eye pain
Does it feel like there is something in the eye?
This is worse than the eye feeling gritty or a little irritated. This actually may make it hard to keep the eye open.
Yes
Feels like something is in eye
No
Feels like something is in eye
Is it very hard or impossible to open the eye because of the discomfort?
Yes
Hard to open eye because of discomfort with feeling something in eye
No
Hard to open eye because of discomfort with feeling something in eye
Is there any redness in the part of the eye that's usually white?
This does not include a blood spot on the eye.
Yes
Redness in part of eye that's usually white
No
Redness in part of eye that's usually white
Has the eye been red for more than 24 hours?
Yes
Eye red for more than 24 hours
No
Eye red for more than 24 hours
Do you think the eyelid or the skin around the eye may be infected?
Symptoms could include redness, pus, increasing pain, or a lot of swelling. (A small bump or pimple on the eyelid, called a stye, usually is not a problem.) You might also have a fever.
Yes
Symptoms of infection around eye
No
Symptoms of infection around eye
Do you think you may have a fever?
Yes
Possible fever
No
Possible fever
Do you have diabetes or a weakened immune system?
What weakens the immune system in an adult or older child may be different than in a young child or baby.
Yes
Diabetes or immune problem
No
Diabetes or immune problem
Is there any pus coming from the area around the eye (not from the eye itself)?
Yes
Pus from area around eye
No
Pus from area around eye
Is there any blood in the eye?
This includes blood spots on the surface of the eye.
Yes
Blood spot or blood in eye
No
Blood spot or blood in eye
Is there any blood in the colored part of the eye?
Blood that is only in the white part of the eye is usually not as serious as blood in the colored part of the eye.
Yes
Blood is in colored part of eye
No
Blood is in colored part of eye
Does the blood cover more than one-fourth of the white part of the eye?
Yes
Blood covers more than one-fourth of white of the eye
No
Blood covers more than one-fourth of white of the eye
Is there any new drainage from the eyes?
Yes
New drainage from eyes
No
New drainage from eyes
Is there any pus or thick drainage coming from the eye (not from the skin around the eye)?
This does not include water or thin, watery drainage. Pus is thicker and may make the eyelids stick together.
Yes
Pus draining from eye
No
Pus draining from eye
Have you had this type of drainage for more than 24 hours?
Yes
Drainage for more than 24 hours
No
Drainage for more than 24 hours
Are you having a contact lens problem?
Yes
Contact lens problem
No
Contact lens problem
Can you remove the contact lenses?
Yes
Able to remove contact lenses
No
Unable to remove contact lenses
Does removing the contact lenses make the eye problem better?
Yes
Removing contact lenses helps
No
Removing contact lenses helps
Have you had eye problems for more than 2 weeks?
Yes
Eye problems for more than 2 weeks
No
Eye problems for more than 2 weeks

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

  • Your age. Babies and older adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
  • Medicines you take. Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, herbal remedies, or supplements can cause symptoms or make them worse.
  • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

  • Try home treatment to relieve the symptoms.
  • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

Symptoms of serious illness may include:

  • A severe headache.
  • A stiff neck.
  • Mental changes, such as feeling confused or much less alert.
  • Extreme fatigue (to the point where it's hard for you to function).
  • Shaking chills.

Symptoms of serious illness in a baby may include the following:

  • The baby is limp and floppy like a rag doll.
  • The baby doesn't respond at all to being held, touched, or talked to.
  • The baby is hard to wake up.

Pain in adults and older children

  • Severe pain (8 to 10): The pain is so bad that you can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain.
  • Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it's severe when it's there.
  • Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

Pain in children under 3 years

It can be hard to tell how much pain a baby or toddler is in.

  • Severe pain (8 to 10): The pain is so bad that the baby cannot sleep, cannot get comfortable, and cries constantly no matter what you do. The baby may kick, make fists, or grimace.
  • Moderate pain (5 to 7): The baby is very fussy, clings to you a lot, and may have trouble sleeping but responds when you try to comfort him or her.
  • Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds when you try to comfort him or her.

Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in adults are:

  • Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.
  • Long-term alcohol and drug problems.
  • Steroid medicines, which may be used to treat a variety of conditions.
  • Chemotherapy and radiation therapy for cancer.
  • Other medicines used to treat autoimmune disease.
  • Medicines taken after organ transplant.
  • Not having a spleen.

Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in children are:

  • Diseases such as diabetes, cystic fibrosis, sickle cell disease, and congenital heart disease.
  • Steroid medicines, which are used to treat a variety of conditions.
  • Medicines taken after organ transplant.
  • Chemotherapy and radiation therapy for cancer.
  • Not having a spleen.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care in the next hour.
  • You do not need to call an ambulance unless:
    • You cannot travel safely either by driving yourself or by having someone else drive you.
    • You are in an area where heavy traffic or other problems may slow you down.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

  • Make an appointment to see your doctor in the next 1 to 2 weeks.
  • If appropriate, try home treatment while you are waiting for the appointment.
  • If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care today.
  • If it is evening, watch the symptoms and seek care in the morning.
  • If the symptoms get worse, seek care sooner.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Sometimes people don't want to call 911. They may think that their symptoms aren't serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Eye Problems, Noninjury
Eye Injuries

Self-Care

  • Wash your hands often. Always wash them before and after you treat pinkeye or touch your eyes or face.
  • Use moist cotton or a clean, wet cloth to remove crust. Wipe from the inside corner of the eye to the outside. Use a clean part of the cloth for each wipe.
  • Put cold or warm wet cloths on your eye a few times a day if the eye hurts.
  • Do not wear contact lenses or eye makeup until the pinkeye is gone. Throw away any eye makeup you were using when you got pinkeye. Clean your contacts and storage case. If you wear disposable contacts, use a new pair when your eye has cleared and it is safe to wear contacts again.
  • If the doctor gave you antibiotic ointment or eyedrops, use them as directed. Use the medicine for as long as instructed, even if your eye starts looking better soon. Keep the bottle tip clean, and do not let it touch the eye area.
  • To put in eyedrops or ointment:
    • Tilt your head back, and pull your lower eyelid down with one finger.
    • Drop or squirt the medicine inside the lower lid.
    • Close your eye for 30 to 60 seconds to let the drops or ointment move around.
    • Do not touch the ointment or dropper tip to your eyelashes or any other surface.
  • Do not share towels, pillows, or washcloths while you have pinkeye.

Treating viral pinkeye in a child

Make your child comfortable

  • Use moist cotton or a clean, wet cloth to remove the crust from your child's eyes. Wipe from the inside corner of the eye to the outside. Use a clean part of the cloth for each wipe.
  • Put cold or warm wet cloths on your child's eyes a few times a day if the eyes hurt or are itching.
  • Do not have your child wear contact lenses until the pinkeye is gone. Clean the contacts and storage case.
  • If your child wears disposable contacts, get out a new pair when the eyes have cleared and it is safe to wear contacts again.

Prevent pinkeye from spreading

  • Wash your hands and your child's hands often. Always wash them before and after you treat pinkeye or touch your child's eyes or face.
  • Do not have your child share towels, pillows, or washcloths while your child has pinkeye. Use clean linens, towels, and washcloths each day.
  • Do not share contact lens equipment, containers, or solutions.

Treating bacterial pinkeye in a child

Use antibiotics as directed

If the doctor gave your child antibiotic medicine, such as an ointment or eyedrops, use it as directed. Do not stop using it just because your child's eyes start to look better. Your child needs to take the full course of antibiotics. If your child isn't able to hold still, have another adult help you with their care.

To put in eyedrops or ointment:

  • Tilt your child's head back and pull the lower eyelid down with one finger.
  • Drop or squirt the medicine inside the lower lid.
  • Have your child close the eye for 30 to 60 seconds to let the drops or ointment move around.
  • Keep the bottle tip clean. Do not touch the tip of the bottle or tube to your child's eye, eyelid, eyelashes, or any other surface.

Make your child comfortable

  • Use moist cotton or a clean, wet cloth to remove the crust from your child's eyes. Wipe from the inside corner of the eye to the outside. Use a clean part of the cloth for each wipe.
  • Put cold or warm wet cloths on your child's eyes a few times a day if the eyes hurt or are itching.
  • Do not have your child wear contact lenses until the pinkeye is gone. Clean the contacts and storage case.
  • If your child wears disposable contacts, get out a new pair when the eyes have cleared and it is safe to wear contacts again.

Prevent pinkeye from spreading

  • Wash your hands and your child's hands often. Always wash them before and after you treat pinkeye or touch your child's eyes or face.
  • Do not have your child share towels, pillows, or washcloths while your child has pinkeye. Use clean linens, towels, and washcloths each day.
  • Do not share contact lens equipment, containers, or solutions.
  • Do not share eye medicine.

When to call for help during self-care

Call a doctor if any of the following occur during self-care at home:

  • Vision changes, such as blurred vision, loss of vision, or double vision.
  • Pain or drainage that does not get better.
  • New blood in the eye.
  • New sensitivity to light.
  • New signs of infection, such as redness, swelling, pus, or a fever.
  • Symptoms occur more often or are more severe.

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Credits

Current as of: January 24, 2022

Author: Healthwise Staff
Medical Review:
William H. Blahd Jr. MD, FACEP - Emergency Medicine
Kathleen Romito MD - Family Medicine
Adam Husney MD - Family Medicine