British Columbia Specific Information
Pinkeye, also called conjunctivitis, is a common childhood illness. Pinkeye usually makes the whites of your eyes turn red or pink, and can cause them to tear or become itchy. Pus can make your eyelids sticky, especially when you sleep. For more information about pinkeye, see HealthLinkBC File #82 Pinkeye (Conjunctivitis).
Pink eye (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.
Pink eye is very common. It usually is not serious and goes away in 7 to 10 days without medical treatment.
Most cases of pink eye 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).
Viral and bacterial pink eye are contagious and spread very easily. Since most pink eye is caused by viruses for which there is usually no medical treatment, preventing its spread is important. Poor handwashing is the main cause of the spread of pink eye. Sharing an object, such as a face cloth or towel, with a person who has pink eye can spread the infection. For more information, see Prevention.
Viral pink eye
Viral pink eye 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 pink eye.
Symptoms of viral pink eye 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 pink eye symptoms usually last 5 to 7 days but may last up to 3 weeks and can become ongoing or chronic.
Pink eye 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 pink eye is caused by a virus, the person can usually return to daycare, school, or work when symptoms begin to improve, typically in 3 to 5 days. Medicines are not usually used to treat viral pink eye, so it is important to prevent the spread of the infection. Pink eye caused by a herpes virus, which is rare, can be treated with an antiviral medicine. Home treatment of viral pink eye symptoms can help you feel more comfortable while the infection goes away.
Bacterial pink eye
An infection may develop when bacteria enter the eye or the area around the eye. Some common infections that cause pink eye include:
Symptoms of bacterial pink eye 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 pink eye may cause more drainage than viral pink eye. 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 daycare, school, or work 24 hours after an antibiotic has been started if symptoms have improved. Prescription antibiotic treatment usually kills the bacteria that cause pink eye.
Red eye is a more general term that includes not only pink eye but also many other problems that cause redness on or around the eye, not just the lining. Pink eye 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, Non-Injury and Glaucoma.
- Infection of the eye socket and areas around the eye. For more information, see the topic Eye Problems, Non-Injury.
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.
Health Tools help you make wise health decisions or take action to improve your health.
Check Your Symptoms
The medical assessment of symptoms is based on the body parts you have.
- If you are transgender or non-binary, 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.
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, or natural health products 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. 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.
Home treatment for pink eye 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 pink eye 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 face cloths 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 pink eye from spreading.
After pink eye has been diagnosed:
- To learn how to prevent the spread of pink eye, see Prevention.
- Do not go to daycare or school or go to work until pink eye has improved.
- If the pink eye is caused by a virus, the person can usually return to daycare, school, or work when symptoms begin to improve, typically in 3 to 5 days. Medicines are not usually used to treat viral pink eye, so preventing its spread is important. Home treatment of the symptoms will help you feel more comfortable while the infection goes away.
- If the pink eye is caused by bacteria, the person can usually return to daycare, 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 pink eye.
- Use medicine as directed. Medicine may include eyedrops and eye ointment.
For pink eye 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:
- Eye pain continues or increases.
- Sensitivity to light (photophobia) develops.
- Signs of an infection develop.
- Symptoms become more severe or frequent.
If you wear contacts, be sure to remove your contacts when your eye problem starts.
Pink eye is spread through contact with the eye drainage, which contains the virus or bacteria that caused the pink eye. 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 pink eye.
- 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 face cloths 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 non-prescription medicines have you tried? Did they help?
- Do you have any health risks?
Current as of: February 26, 2020
Author: Healthwise Staff
Medical Review: William H. Blahd Jr. MD, FACEP - Emergency Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine
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