Pink Eye (Conjunctivitis)

  • Pinkeye (conjunctivitis) can be due to infectious or noninfectious causes.
  • Infectious pink eye is highly contagious.
  • Bacterial or viral infections are common causes of infectious pinkeye.
  • Avoiding contact with infected people, disinfection of household surfaces, and good hygienic practices can prevent contagious pinkeye spread.
  • Noninfectious pinkeye can be caused by an allergy, chemical irritation, underlying inflammatory diseases, or trauma.


Symptoms and Signs of Pink Eye (Conjunctivitis)

Pinkeye is characterized by reddening the eyes’ conjunctiva, discharge from the eyes. It can be accompanied by other signs of infection like sinus congestion and runny nose.

Common pinkeye symptoms and Signs

  • Cough
  • Earache
  • Eye Discharge
  • Eye Pain
  • Eye Redness
  • Itching Eyes
  • Pus Drainage From Eye
  • Runny Nose
  • Sinus Congestion
  • Swollen Eyelids
  • Swollen Lymph Nodes
  • Tearing

Pink Eye (Conjunctivitis)

Pinkeye, or conjunctivitis, is inflammation of the membranes (conjunctiva) covering the white parts of the eyes and the membranes on the eyelids’ inner part. These membranes react to a wide range of bacteria, viruses, allergy-provoking agents, irritants, and toxic agents, and underlying diseases within the body.

  • Viral and bacterial forms of conjunctivitis are common in childhood, but they occur in adults as well. Pinkeye can occur in people of any age.
  • Overall, however, there are many causes of pinkeye. These can be classified as either infectious or noninfectious.
  • Pinkeye does not cause any vision changes.


Viral Pinkeye Causes, Symptoms, and Treatment


Viral pinkeye

The leading cause of a red, inflamed eye is a viral infection. Adenoviruses are the type of virus that is most commonly responsible for the infection. Other viruses that can cause pinkeye include

  • herpes simplex virus (HSV),
  • varicella-zoster virus (VZV),
  • poxvirus (molluscum contagiosum, vaccinia),
  • picornavirus (enterovirus 70, Coxsackie A24), and
  • human immunodeficiency virus (HIV).


Viral pink eye symptoms are usually associated with more watery discharge from the eye that is not green or yellow in color. The discharge may resemble an increase in tears or watery eyes. Viral pinkeye is most common in late fall and early spring. Often, viral “cold-like” symptoms, such as sinus congestion and runny nose, are also present. The eyelids may be swollen or puffy, and the inner eyelids reddened. Sometimes looking at bright lights is painful so that the individual experiences sensitivity to light.


While viral pink eye may not require an antibiotic, those affected should see a doctor. Occasionally, this form of pinkeye can be associated with the cornea (the clear portion of the front of the eyeball).


This infection must be correctly detected and treated. Viral pink eye is highly contagious and typically remains contagious for 10 to 12 days after the onset of symptoms. The symptoms of viral pinkeye can last one to two weeks. Symptoms are pronounced for the first three to five days after symptoms appear, with slow resolution over the following one to two weeks.


Bacterial Pinkeye

Bacterial pinkeye

Staphylococci and Streptococci are types of bacteria that commonly cause pinkeye. Gonococci and chlamydia may also cause bacterial pinkeye. Symptoms of pinkeye caused by bacteria occur rapidly and can include

  • eye pain or burning,
  • swelling,
  • itching,
  • redness,
  • a moderate to a large amount of oozing or eye discharge, usually thick and yellow or greenish in color,
  • swelling of the lymph nodes in front of the ears.


The discharge commonly accumulates after sleeping. Affected children may awaken with crusty eyelashes, most unhappy that their “eyes are stuck shut,” requiring a warm washcloth applied to the eyes to remove the discharge. Bacterial conjunctivitis is treated by repeated warm washcloths applied to the eyes (try using these to a child’s eye one eye at a time during a favorite video). It requires antibiotic eye drops or ointment prescribed by the doctor.


Be careful not to use the medication prescribed for someone else or from an old infection. These may be inappropriate for the current infection or may have been contaminated from other infections by accidentally touching the medicine bottle to infected areas. A safe, effective, and potentially less frightening method of putting drops into the eyes of children involves asking the child to lie down flat, with instructions to merely “close your eyes,” and placing the recommended number of drops in the inner corner of the eye, next to the bridge of the nose, and letting them make a little “lake” there. When the child relaxes and opens the eyes, the medicine will flow gently into the infected mucous membranes without the need to “force open” the eyes.


When someone thinks he (or she) has bacterial conjunctivitis (bacterial pinkeye), it is essential to see a doctor immediately for several reasons.

  • First, suppose the cause is a bacterial infection. In that case, an antibiotic will be needed to help the infection-fighting immune system to kill this infection.
  • Types of topical ophthalmic (eye drops) antibiotics often used for pinkeye include besifloxacin (Besivance), gatifloxacin (Zymaxid), levofloxacin (Levaquin, Quixin, Iquix), moxifloxacin (Moxeza, Vigamox), tobramycin (Tobrex), ciprofloxacin (Ciloxan), erythromycin (Ilotycin), and others.
  • Secondly, suppose someone is experiencing other symptoms such as a runny nose, cough, earache, etc. In that case, there is a good chance that the same bacteria cause these symptoms. An oral antibiotic may also be needed to treat this infection: the antibiotic eye drops or ointment for the eyes.
    • Oral antibiotics are also required for some types of bacterial pinkeye.
    • Finally, a doctor will want to exclude the possibility that the infection has spread to areas where the symptoms may not yet be recognizable.


Chlamydia Pinkeye

Chlamydia pinkeye

Pinkeye infection with chlamydia is an uncommon form of bacterial pinkeye in the U.S. Still, it is widespread in Africa and Middle Eastern countries.


Chlamydia can cause pinkeye in adults and babies. It is a cause of pinkeye in adolescents and adults that can be sexually transmitted.

Chlamydia pinkeye is typically treated with erythromycin (E-Mycin, Eryc, Ery-Tab, PCE, Pediazole, Ilosone) or oral tetracycline (Sumycin), except in children less than eight years of age, because of possible discoloration of the teeth.


Allergic Pinkeye

Allergic pinkeye

Allergic conjunctivitis symptoms and signs are usually accompanied by intense itching, tearing, and swelling of the eye membranes. Eye pain is minimal or absent with allergic conjunctivitis.

Frequent causes include seasonal pollens, animal dander, and dust. It is frequently seasonal and accompanied by other typical allergy symptoms such as

  • sneezing,
  • itchy
  • nose, or
  • Scratchy throat.


Moist, cold compresses applied to the eyes, and over-the-counter (OTC) decongestant eye drops can provide relief. Avoiding exposure to the allergen particle that leads to the allergic reaction is most helpful. A doctor can prescribe stronger medications if these home remedies are not adequate.


Chemical Pinkeye

Chemical pinkeye

Chemical pinkeye can result when any irritating substance enters the eyes. Common offending irritants are

  • household cleaners,
  • sprays of any kind,
  • smoke,
  • a foreign body in the eye,
  • smog,
  • industrial pollutants.


Prompt, thorough washing of the eyes with substantial amounts of water is vital if an irritating substance enters the eye. A doctor or local poison control center should be contacted at once, even if the irritant or chemical is thought to be safe. Some of the most common household products like bleach and furniture polish can be very damaging.