By Dr. Joseph King | King LASIK
Dr. King is an ophthalmologist at King LASIK, serving patients in Seattle, Portland, Tacoma, Olympia, Tri-Cities, Everett, Vancouver, and the Scottsdale/Phoenix area.
Waking up with red, crusty, irritated eyes is never a good start to the day. Pink eye is one of the most common eye conditions we see, and it causes a lot of anxiety and confusion. Is it contagious? Do I need antibiotics? Can I go to work or send my child to school?
Here is what most people do not realize: not all pink eye is the same. There are three completely different types, and they require different treatments and different precautions. Watch our overview below, then read on to find out which type you may be dealing with and what to do about it.
What Is Pink Eye?
Pink eye, or conjunctivitis, is inflammation of the conjunctiva, the clear membrane that covers the white of your eye and lines your eyelids. When inflamed, the eye turns red or pink, hence the name. The type of conjunctivitis you have changes everything about how it should be treated.
The 3 Types of Pink Eye
Viral Conjunctivitis
Viral conjunctivitis is the most common and most contagious type. It causes burning, red eyes with watery discharge and spreads quickly in schools and crowded spaces. It is usually caused by the same viruses responsible for the common cold, so it often comes with a runny nose or sore throat. The watery discharge is the telltale sign, and it frequently starts in one eye before spreading to the other within a day or two.
Bacterial Conjunctivitis
Bacterial conjunctivitis is less common but also highly contagious. The distinguishing feature is thick, sticky discharge, often yellow, white, or greenish, that can cause eyelashes to stick together overnight. It causes sore, red eyes and spreads easily through direct contact.
Allergic Conjunctivitis
Allergic conjunctivitis is fundamentally different because it is not an infection at all. It occurs when your eyes react to environmental triggers like pollen, pet dander, cigarette smoke, or pool chlorine. Intense itching is the defining symptom, along with redness, watering, and puffy eyelids.
Here is the critical distinction: allergic conjunctivitis is not contagious. You cannot catch it or spread it.
Who Gets Pink Eye and How Does It Spread?
Children are far more likely than adults to develop viral or bacterial pink eye. Kids in school and daycare are in close contact, less consistent about hand washing, and they touch their faces constantly. When an outbreak starts, it can spread remarkably fast.
Adults tend to develop pink eye differently, most commonly through improper contact lens care. Not cleaning lenses correctly, wearing them too long, sleeping in lenses not designed for overnight use, or using decorative contacts that do not fit properly can all lead to infections that, if left untreated, may progress to corneal ulcers.
Other common transmission routes include touching contaminated surfaces like gym equipment or doorknobs and then rubbing your eyes, direct contact with bodily fluids from an infected person, and bacteria spreading from your own nose or sinuses.
Symptoms to Watch For
Regardless of type, common symptoms of conjunctivitis include:
- Redness or pinkness in the eye
- A gritty sensation, like something is stuck in the eye
- Discharge that can cause eyelashes to stick together
- Burning or itching
- Watery or puffy eyes
- Blurry vision
The type of discharge and the presence of associated symptoms like cold symptoms or allergies help our team determine which type of conjunctivitis you have.
Treatment: What Works and What Does Not
This is where it really matters to know which type you are dealing with.
Viral conjunctivitis has no specific treatment. Antibiotics do not work on viruses. Your body clears it on its own within one to two weeks. Cool compresses and artificial tears can help with comfort in the meantime. Discard any eye drops used during the infection afterward to avoid reinfection.
Bacterial conjunctivitis may need antibiotic eye drops, but not always. Mild cases often resolve on their own. Our team assesses severity to determine whether antibiotics are necessary. Importantly, antibiotics will not help viral or allergic pink eye.
Allergic conjunctivitis responds well to allergy eye drops that address itching and puffiness. Identifying and avoiding your triggers is also an important part of long-term management.
Most cases of conjunctivitis resolve within one to two weeks. If symptoms persist beyond that or worsen, it is important to see an ophthalmologist to rule out something more serious.
When to Stay Home and How to Prevent Spreading It
If you have allergic conjunctivitis, you are not contagious and can attend school, work, or the gym safely.
If you have viral or bacterial pink eye, stay home and avoid contact with others until your eyes are no longer red with discharge.
To prevent spreading conjunctivitis:
- Wash your hands frequently, especially before eating and after sneezing
- Use a clean towel every time you wipe your eyes
- Do not wear contact lenses while infected, and replace them with fresh ones after recovery
- Avoid eye makeup during an infection, and replace all makeup afterward. Bacteria can survive in makeup and cause serious corneal infections
- Never share eye makeup
- Avoid touching your eyes, and wash your hands immediately if you do
It is especially important to see an ophthalmologist promptly if you have had recent eye surgery, are experiencing vision loss, or have significant eye pain.
Book a Free Consult
Red, irritated eyes that are not improving deserve a proper evaluation. Our expert surgeons at King LASIK and K2 Vision are here to help you get the right diagnosis and the right treatment, without the guesswork. Serving patients across Seattle, Portland, Tacoma, Olympia, Tri-Cities, Everett, Vancouver, and the Scottsdale/Phoenix area, we make it easy to be seen at any of our seven convenient locations. Book a Free Consult today, in person or virtually by phone or Zoom.