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Pinkeye

Topic Overview

Anatomy of the eye

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 becomes red and swollen. See pictures of a normal eye and an eye with conjunctivitis.

Pinkeye is very common. It usually is not 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 and spread very easily. Since most pinkeye is caused by viruses for which there is usually no medical treatment, preventing its spread is important. 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. For more information, see Prevention.

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 of viral pinkeye include:

  • Redness in the white of the eye.
  • Swelling of the eyelids.
  • 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 last 5 to 7 days but 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 begin to improve, typically in 3 to 5 days. Medicines are not usually used to treat viral pinkeye, so it is 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 develop when bacteria enter the eye or the area around the eye. Some common infections that cause pinkeye include:

Symptoms of bacterial pinkeye 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, which 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, including:

  • Foreign bodies, such as metal or insects. For more information, see the topic Objects in the Eye.
  • Scrapes, sores, or injury to or infection of deeper parts of the eye (for example, uveitis, iritis, or keratitis). For more information, see the topic Eye Injuries.
  • Glaucoma. For more information, see the topics Eye Problems, Noninjury and Glaucoma.
  • Infection of the eye socket and areas around the eye. For more information, see the topic Eye Problems, Noninjury.

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). For more information, see the topics Styes and Chalazia and Eyelid Problems (Blepharitis).

Check your symptoms to decide if and when you should see a doctor.

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  Eye Problems: Using Eyedrops and Eye Ointment

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
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

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.
Eye Injuries

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.

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.

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.

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.

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.

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.

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, herbal remedies, and 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.

Call 911 Now

Based on your answers, you need emergency care.

Call911or other emergency services now.

Eye Problems, Noninjury

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.

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.

Home Treatment

Home treatment for pinkeye will help reduce your pain and keep your eye free of drainage. If you wear contacts, remove them and wear glasses until your symptoms have gone away completely. Thoroughly clean your contacts and storage case.

Cold compresses or warm compresses (whichever feels best) can be used. If an allergy is the problem, a cool compress may feel better. If the pinkeye is caused by an infection, then a warm, moist compress may soothe your eye and help reduce redness and swelling. Warm, moist compresses can spread infection from one eye to the other. Use a different compress for each eye, and use a clean compress for each application.

When cleaning your eye, wipe from the inside (next to the nose) toward the outside. Use a clean surface for each wipe so that drainage being cleaned away is not rubbed back across the eye. If tissues or wipes are used, make sure they are put in the trash and are not allowed to sit around. If washcloths are used to clean the eye, put them in the laundry right away so that no one else picks them up or uses them. After wiping your eye, wash your hands to prevent the pinkeye from spreading.

After pinkeye has been diagnosed:

  • To learn how to prevent the spread of pinkeye, see Prevention.
  • Do not go to day care or school or go to work until pinkeye has improved.
    • If the pinkeye is caused by a virus, the person can usually return to day care, school, or work when symptoms begin to improve, typically in 3 to 5 days. Medicines are not usually used to treat viral pinkeye, so preventing its spread is important. Home treatment of the symptoms will help you feel more comfortable while the infection goes away.
    • If the pinkeye is caused by bacteria, the person can usually return to day care, school, or work after the infection has been treated for 24 hours with an antibiotic and symptoms are improving. Prescription antibiotic treatment usually kills the bacteria that cause pinkeye.
  • Use medicine as directed. Medicine may include eyedrops and eye ointment.
    Click here to view an Actionset.Eye Problems: Using Eyedrops and Eye Ointments

For pinkeye related to allergies, antihistamines, such as loratadine (Claritin) or cetirizine (Zyrtec), may help relieve your symptoms. Don't give antihistamines to your child unless you've checked with the doctor first.

Symptoms to watch for during home treatment

Call your doctor if any of the following occur during home treatment:

If you wear contacts, be sure to remove your contacts when your eye problem starts.

Prevention

Pinkeye is spread through contact with the eye drainage, which contains the virus or bacteria that caused the pinkeye. Touching an infected eye leaves drainage on your hand. If you touch your other eye or an object when you have drainage on your hand, the virus or bacteria can be spread.

The following tips help prevent the spread of pinkeye.

  • Wash your hands before and after:
    • Touching the eyes or face.
    • Using medicine in the eyes.
  • Do not share eye makeup.
  • Do not use eye makeup until the infection is fully cured, because you could reinfect yourself with the eye makeup products. If your eye infection was caused by bacteria or a virus, throw away your old makeup and buy new products.
  • Do not share contact lens equipment, containers, or solutions.
  • Do not wear contact lenses until the infection is cured. Thoroughly clean your contacts before wearing them again.
  • Do not share eye medicine.
  • Do not share towels, linens, pillows, or handkerchiefs. Use clean linens, towels, and washcloths daily.
  • Wash your hands and wear gloves if you are looking into someone else's eye for a foreign object or helping someone else apply an eye medicine.
  • When in the wind, heat, or cold, wear eye protection to prevent eye irritation.
  • Wear safety glasses when working with chemicals.

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:

  • What are your main symptoms?
  • How long have you had your symptoms?
  • Have you had any vision changes, increased pain in the eye, or increased sensitivity to light?
  • Have you had this problem before? If so, do you know what caused the problem at the time? How was it treated?
  • Do you wear contact lenses or eyeglasses?
  • Does anyone in your family or at your workplace have signs of an eye infection, such as drainage from the eye or red and swollen eyes?
  • Have you been exposed to fumes or chemicals?
  • What home treatment measures have you tried? Did they help?
  • What prescription or nonprescription medicines have you tried? Did they help?
  • Do you have any health risks?

Related Information

Credits

By Healthwise Staff
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Specialist Medical Reviewer Kathleen Romito, MD - Family Medicine
Current as of June 4, 2014

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

© 1995-2014 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.

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