Pink eye is most commonly used to describe conjunctivitis caused by an infection. Conjunctivitis means swelling of the conjunctiva, which is the membrane lining the outside of the eyeball and the inside of the eyelid.
There are two main types of infectious pink eye: bacterial and viral. Many of the symptoms are similar, but there are some differences. For instance, bacterial infections are more common in young children while viral infections are more common in older kids and adults. And although they both cause your eyes to look red, bacterial conjunctivitis usually produces a discharge from the eye while viral conjunctivitis might cause clear tearing.
Most cases of pink eye will go away on their own, but there are ways to help get rid of it, including medications and home remedies as well. While you have the infection, wash your hands copiously to make sure you don’t spread it to others.
Topical antibiotics in the form of either eye drops or ointment can only help treat pink eye caused by bacteria, not pink eye caused by a virus. But you may not even need them to beat the bacteria.
Bacterial pink eye may go away on its own in as little as three to five days. (Viral pink eye usually goes away in seven to 14 days.)
“The only reason to treat [mild bacterial pink eye] is to shorten the course of disease and get kids back to school faster or adults back to work faster,” says K. David Epley, MD, a clinical spokesperson for the American Academy of Ophthalmology.
If the infection goes on longer than three to five days, if the discharge is increasing, or if your eye is severely red or hurting, you may have a more serious case that also warrants treatment. “These would be indications that something is awry,” says Dr. Epley.
Most viral pink eye infections just need to run their course. But there are a handful of viruses that can cause eye symptoms that can be treated with antiviral medications prescribed by your doctor in the form of eye drops, ointments, or pills.
“Antivirals are something we do use if we think it’s the right virus, [but] there are only a few viruses we can treat that way,” says Dr. Epley. “The herpes family is one we have effective medications for.”
For example, the varicella zoster virus–which causes chickenpox and shingles–is a herpes virus and can also cause pink eye. “It’s often extremely painful, and you can have decreased vision and sensitivity to light,” says Matthew Gorski, MD, an ophthalmologist with Northwell Health in Great Neck, New York.
Often this type of pink eye also comes with a blistering rash around the eye and forehead, he adds. If you have any of these symptoms, see your eye doctor right away.
The American Academy of Ophthalmology recommends that all adults age 50 or over get a shingles vaccine to prevent herpes zoster ophthalmicus, or shingles affecting the eye. It can cause not only pink eye but, in rare cases, damage to the cornea that may require a transplant.
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Viral and bacterial conjunctivitis can also come with stinging, burning, itching, a sticky feeling, and blurred vision from the buildup of mucus.
“You can use an eyewash to rinse out the mucus,” says Dr. Epley. “It also flushes away some of the bacteria or viruses.”
Look for over-the-counter products that say “eyewash” or “sterile saline.” Sterile saline solutions typically used for contact lenses will do the trick, just make sure you don’t get the cleaner by mistake. “That would not be pleasant to get in your eye,” says Dr. Epley.
Putting a wet compress over your eyes won’t make pink eye go away, but it can help ease the symptoms. Use compresses carefully, though; otherwise, you run the risk of infecting your other eye or someone else.
Even better than using a gel pack, ice pack, or washcloth–which need to be cleaned between uses–is putting ice cubes and a piece of gauze in a zip-top plastic bag. Let the gauze get really cold, press it on your eye for 30 to 60 seconds, then throw it away. Pop a fresh piece of gauze into the same plastic bag as needed. “You can keep putting new gauze pads in the sandwich bags because [the bags] haven’t touched the eye,” Dr. Epley says.
If you prefer warmer compresses, they’re fair game too. “I tell patients to do what feels good for the eyes,” Dr. Gorski says.
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Artificial tears may help with the dryness and discomfort that can accompany pink eye. These are readily available over the counter.
“They’re thicker [than eyewashes] and are more like a tear,” says Dr. Epley. “Because they coat the surface of the eye a little, they can be more comfortable. Your eyes don’t sting and burn so much when you’re blinking.”
As with compresses, though, you have to be careful when using artificial tears not to spread the infection. “If you have one eye that has pink eye and if you’re putting tears in both eyes, you could contaminate the other eye,” says Dr. Gorski.
“Any time you’re having any change in your eyes, immediately take your contacts out,” Dr. Gorski says.
Talk to your doctor before putting them back in after the pink eye is gone. Disposable lenses can be tossed. At the very least, non-disposable contacts need to be well sterilized before you wear them again. “You don’t have to throw them out, but put them through a super-sterilization process, not just the simple overnight cleaning but deeper cleaning,” Dr. Epley says.
Take similar measures with eye makeup if you get pink eye. “Certainly if you wear makeup, you don’t want to put it on again,” says Amy Coburn, MD, a clinical ophthalmologist with Houston Methodist Hospital.
Antihistamines are more effective for conjunctivitis or pink eye caused by allergies, which often comes with significant itching. But antihistamines may also help if infectious pink eye is causing itchiness. Multiple different brands of antihistamine eye drops are available over the counter.
In general with conjunctivitis, “treatment really depends on pinpointing the cause and drilling down into what it is,” says Dr. Coburn.
You may need your doctor’s help to do this and to rule out more serious problems. “Mild redness and mild crusting in the morning can be watched from home,” Dr. Gorski says. “However, if you ever have pain, significant discomfort, any change of vision, or sensitivity to light, you should go see an eye doctor.”