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Red, Irritated, Watering Eyes? Chances Are You’ve Got Pink Eye

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on May 20, 2021.

Is Pink Eye Contagious?

Did you wake up with a bloodshot eye with your eyelids stuck together? You might have pink eye.

  • Pink eye, also known as conjunctivitis, is highly contagious if it is caused by a bacterial or viral infection (infectious conjunctivitis).
  • Infectious conjunctivitis is more common in children than in adults as bacteria and viruses are easily spread among children when they play. Antibiotic treatment of bacterial conjunctivitis is NOT always required because the condition is self-limited and usually clears up on its own. However, if you wear contact lenses, you will probably receive an antibiotic treatment.
  • Pink eye generally remains contagious from when the symptoms first appear, while the eye is watering and producing a discharge, and for about two weeks, as long as the eyes are red.
  • Due to contagiousness, 24 hours of treatment and clearing of drainage is usually recommended before returning to school or work. Ask your doctor specifically when you or your child can return to outside activities.

Pink eye that is caused by irritants, allergens or environmental factors is not contagious.

How Did I Get Pink Eye?

Not sure how you got this? Viral and bacterial forms of conjunctivitis can be spread easily from person to person by coughing or sneezing. Bacteria or viruses can get in your eyes through contact with contaminated objects including dirty hands, towels and cosmetics.

Newborn babies may develop neonatal conjunctivitis due to exposure to bacteria as they pass through the birth canal. The sexually transmitted diseases of gonorrhea, herpes and chlamydia can also cause conjunctivitis in newborns during birth. Young babies may also get conjunctivitis because tear ducts do not properly form until they are about 6 months old.

Allergic conjunctivitis is caused by exposure to allergens such as pollen or dust mites. Irritant conjunctivitis is caused by the eye coming into contact with substances that irritate the conjunctiva such as chlorinated water, shampoo or a foreign body in the eye.

What Are the Symptoms of Pink Eye?

Symptoms of pink eye will depend on the cause.

Common symptoms include:

  • a red and bloodshot teary eye
  • a gritty or irritated feeling in the eye, especially when you rub it
  • a discharge which can form a crust on the eyelid overnight
  • excessive tearing, burning, itching and sensitivity to light.

What Are the Symptoms of Infectious Pink Eye?

After becoming infected, eye symptoms usually develop within 24 to 72 hours. The white part of the eye will feel red and gritty and this is followed by a discharge.

A bacterial infection usually occurs in both eyes and produces more discharge. Typically the discharge is thick and green or yellow in color and causes your eyelids to stick together in the morning. Your lymph nodes in front of the ears may be enlarged.

A viral infection usually only occurs in one eye with less mucous discharge, but may be more watery and not colored. Viral conjunctivitis often accompanies other symptoms such as a sore throat and nasal congestion. The eyelids may be swollen and sensitive to bright light. The eyes do not usually itch. Symptoms usually resolve in 1 to 2 weeks.

Other Forms of Conjunctivitis

If you have allergic conjunctivitis (caused by pollen, cosmetics or other substances) your eye will be red, teary and very itchy but there will be no colored discharge. Usually both eyes are affected.

Symptoms are usually seasonal, like in the spring, summer or fall, and accompanied by other typical allergy symptoms such as sneezing, itchy nose, and scratchy throat.

Irritant or environmental conjunctivitis symptoms include pain, sensitivity to bright lights, watering and blurred vision.

How is Pink Eye Treated?

The type of treatment you will receive for pink eye will depend on the cause. You might receive no treatment, an antibiotic or antihistamine eye drop, or simple lubricants. Corticosteroid eye drops (alone or combined with antibiotics) are not usually used to treat acute conjunctivitis and can be linked with serious side effects.

If you think you have pink eye you should see your doctor, especially if there is a pain inside your eye, your vision is blurred or if your eyes hurt in the light.

Babies with pink eye should be taken to the doctor because they are prone to developing bacterial conjunctivitis which can be serious and is highly contagious.

Contact lens wearers should remove lenses until they seek advice from a healthcare provider. People who wear contacts have a higher chance of developing a more serious condition that could lead to permanent eye damage.

Treatment for Infectious Pink Eye

Your doctor will prescribe antibiotic eye drops or eye ointment, if needed, if you are diagnosed with pink eye caused by bacteria. Mild bacterial conjunctivitis may improve in 2 to 5 days without antibiotic treatment but can take 2 weeks to go away completely.

Commonly used antibiotics include:

Eye drops may need to be used frequently during the day and an eye ointment is often used at night or every four to six hours during the day. Azithromycin drops are instilled twice a day for the first 2 days, then once a day through day 7.

The quinolones ciprofloxacin and ofloxacin may be preferred in contact lens wearers to target common Pseudomonas infections.

Viral conjunctivitis is usually treated with antihistamine / decongestant drops if needed.

Using Eye Drops Safely

How to use eye drops?

  • First, wash your hands.
  • Then allow the bottle of eye drops to warm in your hands. This is particularly important if the eye drops have come straight from the fridge and helps to avoid the shock of cold drops touching the eye.
  • Wash away any discharge from the eyelids with warm water. Tip your head back or lie on a flat surface and then gently pull your lower eyelid down.
  • Position the bottle so the drop will fall directly into the lower lid pocket. Squeeze the bottle for the required number of drops. Close your eye and blink to spread the drops.
  • Gently pressing the inner corner of your eye can stop bad tasting medication from dripping back into your throat.
  • If you use more than one kind of drop, wait 10 to 15 minutes before you use the second one.

Using Eye Ointments

  • Wash your hands first and wash away any discharge from the eyelids with warm water. If you are using both an eye drop and eye ointment, instill the eye drops first.
  • Hold the tube in your warm hand to soften the ointment. Do not let the tip of the tube touch anything, including your eyes, fingers or counter.
  • Gently pull down your lower eye lid and position the nozzle at the inner part of your eye near your nose.
  • Squeeze a ribbon of ointment into your lower eyelid and move towards the outer edge of your eye. Use the amount your doctor tells you to use.
  • Give the tube a half turn as this helps to cut the ribbon of ointment. When done, wahs your hands again.
  • Your vision may be cloudy at first. Use a clean tissue to wipe away excess ointment that is around your eye(s).

Treatment for Seasonal Allergic or Irritant Pink Eye

Conjunctivitis that is not infectious can also be treated, but not with antibiotics.

If you are diagnosed with allergic conjunctivitis the best treatment is to avoid the allergen. An application of a cold moist towel to the eyes and lubricating eye drops may help also. Your doctor may recommend an over-the-counter (OTC) antihistamine or decongestant eye drop to help relieve itching and redness. Eye make-up is best avoided to avoid further irritation.

Antihistamine examples include:

Allergic conjunctivitis may also respond to prescription ophthalmic antihistamines, such as:

  • Bepreve (bepotastine ophthalmic)
  • Lastacaft (alcaftadine ophthalmic)
  • Patanol (olopatadine ophthalmic): also Pataday and Pazeo
  • Zerviate (cetirizine hydrochloride).
  • Lotemax: a prescription steroid eye drop may be prescribed in more severe cases.

Ophthalmic mast cell stabilizers include:

Irritant pink eye requires prompt flushing with water and inspection for any damage to the eye. If vision is impaired or you have pain, go to the emergency room or see an ophthalmologist for further evaluation.

Stop the Spread: Pink Eye in Children

If your child is diagnosed with pink eye here are a few tips to stop the spread and protect family members and friends.

  • Keep the eyes clear of discharge by washing the eyes gently with warm water.
  • Use a soft cloth or swab and use it only once. If only one eye is infected be very careful to use a clean cloth for each eye to avoid contamination. Wash the cloth in hot water immediately after use to limit spread of bacteria.
  • Try to stop your child rubbing their eyes and make sure both your hands and your child's stay clean.
  • Make sure your child is not sharing wash cloths or towels and keep toys that are held close to the face wiped or washed.
  • Change pillowcases frequently.
  • Finally, keep your child away from school or daycare while their eyes are inflamed or producing a discharge.

Self-Help and Prevention

You can help to prevent infectious conjunctivitis. Maintaining good personal hygiene will help prevent the spread of infectious pink eye. This means:

  • Washing your hands frequently
  • Having your own washcloth and towel and do not share
  • Using only your pillow and regularly change pillow cases.
  • Renewing your mascara and other eye make-up frequently is also recommended, and don't share eye make-up. Take off eye make-up before bed.
  • Keeping your hands away from your eyes.

To prevent conjunctivitis in newborns babies, all pregnant women should be tested for gonorrhea and chlamydia infections, and treated if needed. As another preventive measure, newborns routinely are treated at birth with an antibiotic eye drop like erythromycin.

Stay up-to-date with the latest news and medication approvals for conjunctivitis and share your stories on the Conjunctivitis Support Group.

Finished: Red, Irritated, Watering Eyes? Chances Are You’ve Got Pink Eye

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