Conjunctivitis (pink eye) – the signs and how to get rid of it

From the symptoms of this contagious eye infection to treating it effectively, and when you might need to see a doctor.


What are the symptoms?

What causes it?

Self-care tips to treat it at home

When to see a doctor

How is it diagnosed?

What are the treatments?

Preventing the spread

Conjunctivitis – or ‘pink eye’ –  is a common eye infection that usually causes itching or soreness. It can be viral, bacterial, or allergy-related and usually gets better on its own. Find out more about the signs, symptoms, treatment, and when you might need to see a doctor.


Conjunctivitis is a common eye infection that causes inflammation and swelling of the conjunctiva – thin layers of tissue that cover the whites of your eye. Once inflamed or infected, you may notice a pink or red tinge to your eye (or eyes) which is why conjunctivitis is also called ‘pink eye’ or ‘red eye’. 

Symptoms can vary from itchy and sore eyes to sticky and crusty lashes, but you may not always need medication to treat it. This will depend on how severe it is and which type of conjunctivitis you have, which can include:

- infectious conjunctivitis (viral or bacterial)
- allergic conjunctivitis
- chemical conjunctivitis.

Viral and bacterial conjunctivitis are the most common types and these are also contagious, which means taking care to stop it spreading to other people.

## What are the symptoms?

If you have conjunctivitis it usually affects both eyes, which can:

- look pink or red
- feel irritated, sore or gritty (as if something is in it)
- have a sticky discharge or crustiness that sticks to lashes
- be itchy
- water or tear up
- be swollen.

If you wear contact lenses, bacterial infections can be more severe and there is a risk of a bacterial corneal ulcer developing, which can be painful and make your eyes sensitive to light. [Contact your doctor](https://www.livehealthily.com/health-library/conditions/conjunctivitis-infective#when-to-see-a-doctor) if you have these symptoms.

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## What causes it?

Conjunctivitis is most often caused by an infection (viral or bacterial) or allergies.

- __Bacterial conjunctivitis__ – caused by staphylococcal or streptococcal bacteria resulting from poor hygiene, such as rubbing your eye with unclean hands or using contaminated cosmetics (always avoid sharing products with others). This type can also be spread by [sexually transmitted infections (STIs)](https://www.livehealthily.com/health-library/conditions/sexually-transmitted-infections) such as chlamydia.

- __Viral conjunctivitis__ – usually caused by an upper respiratory infection, such as a [cold](https://www.livehealthily.com/health-library/conditions/common-cold), through coming into contact with someone sneezing or coughing. 

- __Allergic conjunctivitis__ – caused by an irritant, such as pollen, and is a reaction to something you are allergic to.

Other causes of conjunctivitis can include chemicals coming into contact with your eyes, wearing contact lenses, and things that get in your eye, such as an eyelash.

## Self-care tips to treat it at home

Conjunctivitis may not require any treatment at all. It can get better on its own, usually within a couple of weeks, although it can be sooner.

There are some things that may help relieve or soothe symptoms in the meantime, including:

- __bathing your eyelids__ – use clean cotton wool pads with cooled boiled water to soften crusty areas and wipe away any discharge
- __applying a compress__ – soak a clean cloth in water, wring it out, and apply gently to your closed eyelids. Use warm water for viral/bacterial conjunctivitis, while cold water may help soothe allergy-related itchiness
- __not rubbing or touching your eyes__
- __using eye drops__ – to stop dryness and discomfort. Your pharmacist can recommend the best ones to use
- __taking allergy-specific medication__ (such as antihistamines or pollen allergy/[hay fever](https://www.livehealthily.com/health-library/conditions/hay-fever) products) – if this is the trigger
- __minimizing your trigger__ – for example, if the cause is an allergen such as pollen, avoid going outdoors when the count is high, or wear protective wraparound sunglasses
- __not wearing contact lenses__ – until your eyes are better. 

## When to see a doctor

Certain symptoms could be a sign of something more serious, so see a doctor urgently if:

- you have pain in your eyes
- your eyes are sensitive to light
- you have vision changes, such as seeing wavy lines, flashing, or blurriness
- you have very red eyes (in 1 eye or both)

You should make an appointment with your doctor If your symptoms do not get better after 7 days. Also see a doctor if you wear contact lenses, and have spots on your eyelids alongside conjunctivitis symptoms – this could indicate a lens allergy.  


## How is it diagnosed?

If you do go and see your doctor with suspected conjunctivitis, they’ll be able to diagnose it based on:

- your symptoms
- your health history
- an eye examination.

If conjunctivitis is particularly severe or it’s suspected to be caused by something that poses a high risk to your eye – for example, a serious bacterial infection, STI or foreign body in your eye – then a swab may be taken and sent to be lab-tested. 

## What are the treatments?

Treatment will depend on the type of conjunctivitis your doctor diagnoses. 

If you have: 

- __viral conjunctivitis__ – self-care tips may be enough to treat it until symptoms improve, like a cold. If it’s particularly bad your doctor may prescribe antiviral medication. Antibiotic drops will not help.
- __bacterial conjunctivitis__ – you may need antibiotic drops or ointment, although some cases will clear up on their own with self-care, usually within 2 weeks. 
- __allergic conjunctivitis__ – it’s best to try to identify and avoid your trigger, such as dust or pollen. Ask your doctor or pharmacist about the best allergy medication for you, such as antihistamine eye drops. Again, antibiotics will not help
- __conjunctivitis caused by irritants__ – treatment will depend on when the contact happened and how bad the symptoms are. Ideally, you should carefully flush any chemicals or irritants out of the affected eye with water or saline for several minutes afterward. You may also need a topical steroid to calm inflammation
- __STI-related conjunctivitis__ – your doctor will prescribe a course of antibiotic tablets (ceftriaxone) for an STI, such as chlamydia. 

## Preventing the spread

Viral and bacterial conjunctivitis are easily spread, so if you have either type follow these steps to contain it and stop others from catching it: 

- avoid touching your eyes – even if they are itchy 
- wash your hands frequently using warm water and soap
- do not share towels or bedding and change yours regularly – clean them in a hot wash with detergent
- cover your mouth and nose when sneezing or coughing – throw any used tissues in the trash
- get rid of eye makeup and start a new mascara
- do not share makeup, particularly eye products or cosmetics
- follow your eye doctor’s advice on contact lens hygiene (once you can wear them again).

Neither chemical or allergic conjunctivitis types are contagious.

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References

Juliet Blank

Jo Wheatley

Dr Tamer T Malak

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