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Pink Eye: What You Should Know
Conjunctivitis, also known as pink eye, is an inflammation of the conjunctiva -- the thin, clear tissue that lies over the white part of the eye and lines the inside of the eyelid.
Pink eye can be contagious and is often associated with children, but anyone can get it. Treatment will depend on whether your pink eye is due to a virus, bacteria, allergies, or an irritating substance. (Photo Credit: iStock/Getty Images)
Pink eye causes redness, itching, pain, burning, discharge, and swelling in and around the eyes. It might make your vision blurry and make you sensitive to light, but you'll still be able to see.
Pink eye can happen to anyone, regardless of age, but it's common in children. It can be highly contagious, spreading rapidly in schools and day-care centers, but it's rarely serious. It's unlikely to damage your vision, especially if you find and treat it quickly. When you take care to prevent its spread and do everything your doctor suggests, pink eye clears up with no long-term problems.
What does pink eye look like?
Pink eye looks like the whites of one or both eyes are pink or red. You may have swelling around your eyes and could see white, yellow, or green discharge.
Pink eye vs. Stye
Stye and pink eye are eye infections with similar symptoms. Like pink eye, symptoms of a stye include itchy, sore, and watery eyes and sensitivity to light. But unlike conjunctivitis, a stye causes a small pus-filled bump in the upper or lower eyelid. It also happens due to a bacterial infection, most commonly Staphylococcus aureus and Staphylococcus epidermidis.
Several things could be to blame, but the most common causes of pink eye are:
Other causes include:
Conjunctivitis sometimes results from an STD. Gonorrhea can bring on a rare but dangerous form of bacterial conjunctivitis. It can lead to vision loss if you don't treat it. Chlamydia can cause conjunctivitis in adults. If you have chlamydia, gonorrhea, or other bacteria in your body when you give birth, you can pass pink eye to your baby through your birth canal.
Pink eye, caused by some bacteria and viruses, can spread quickly from person to person. But it isn't a serious health risk if diagnosed promptly. However, if it happens in a newborn, tell a doctor immediately, as it might be an infection that can affect the baby's eyesight.
Who is at risk for pink eye?
Though pink eye can happen to anyone, newborn babies are at a higher risk of having it. You also may be more at risk if:
Pink eye and COVID-19
Pink eye may be the only symptom of COVID when the virus infects the eyes, according to a 2020 case report. But more research is needed, as it's rarely the sole COVID symptom. Most people with COVID show symptoms such as fever or chills, cough, tiredness, difficulty breathing, loss of taste or smell, sore throat, runny nose, vomiting, and body aches.
Is pink eye contagious?
Pink eye may be contagious, depending on the type. Cases caused by a viral or bacterial infection can spread to other people, but those caused by allergies or irritants don't.
Pink eye symptoms may be the same regardless of their cause. It's hard to know which type of conjunctivitis you have without your doctor testing it. So, regularly wash your hands and avoid touching your eyes to prevent spreading or catching it.
Viral pink eye
Viral pink eye is the most common and may be the most contagious form. It's usually caused by the virus that causes the common cold. It tends to start in one eye, causing lots of tears and a watery discharge. Within 24-48 hours, it affects the other eye, too. You might feel a swollen lymph node in front of your ear or under your jawbone.
You may also have cold symptoms such as a fever, sore throat, and runny nose.
Viral pink eye has no cure but will go away on its own. Your symptoms may worsen in the first 3-5 days, but you'll get better within 1-3 weeks.
Bacterial pink eye
Bacteria that cause pink eye include:
Bacterial strains affect children more often than adults. These infections spread easily and are typically seen from December through April. Bacterial pink eye usually infects one eye but can show up in both. Your eye will release a lot of yellow, white, or green pus and mucus. If treated with antibiotic eye drops or ointment, it goes away quickly without causing eye problems.
Allergic conjunctivitis
Allergic pink eye may occur when allergens in the air, such as dust mites, cat dander, and pollen, enter the eye. It often occurs in people with allergic conditions such as hay fever and asthma. Symptoms such as tearing, itching, and redness in the eyes may happen suddenly, seasonally, or all year round. You might also have an itchy, runny nose and sneezing.
It doesn't spread from person to person, and symptoms usually go away once you're no longer exposed to the allergen.
You can manage allergic conjunctivitis with allergy eye drops.
Pink eye in newborns
Pink eye in newborns is called neonatal conjunctivitis or ophthalmia neonatorum. It can be caused by a bacterial or viral infection, a blocked tear duct, or irritation from topical medicines given to the baby at birth.
It's a serious form of pink eye, so get medical help immediately if your baby has discharge in their eye or if their eyelids look puffy and tender. Quick treatment can prevent permanent eye damage or blindness. A doctor might treat it with antibiotics.
Giant papillary conjunctivitis
Giant papillary conjunctivitis (GPC) is linked to long-term contact lens use, but it can also happen around surgery stitches near the eyelid. Doctors think it's an allergic reaction to a chronic foreign body in the eyes.
See a doctor immediately if you notice pink eye symptoms, especially if you wear contacts, an artificial eye, or have stitches around your eyes. Left untreated, GPC can cause serious eye problems.
Your doctor may recommend eye drops or ointments and advise you to change your contact lenses or reduce the number of times you wear them. You could feel better within a week of starting treatment but may need to stop wearing contact lenses for a month to fully heal.
You can also reduce your risk of GPC by using lens solutions with unpreserved salt solution and removing your contact lenses before bed.
Conjunctivitis symptoms depend on the cause of the inflammation, but may include:
Early-stage pink eye symptoms
The earliest signs of pink eye include:
Call your doctor if:
Call your doctor right away if your newborn has pink eye, as it could permanently harm their vision.
Your eye doctor may tell you to come into the office immediately. If you're an adult with a mild case of pink eye and can't reach your eye doctor, call your primary care doctor.
If your symptoms remain mild but the redness doesn't improve within 2 weeks, you need to consult your eye doctor.
Your eye doctor will ask you questions about your symptoms, such as:
They may also give you an eye exam and use a cotton swab to remove fluid from your eyelid to test in a lab. Test results will show bacteria or viruses that may have caused conjunctivitis, including those that can cause an STD. Then, your doctor can prescribe the right treatment.
If your doctor tells you that you have pink eye, you may want to ask these questions:
What is commonly misdiagnosed as pink eye?
Don't assume that all red, irritated, or swollen eyes are pink eye (viral conjunctivitis). Your symptoms could also be caused by seasonal allergies, a stye, iritis, chalazion (an inflammation of the gland along the eyelid), or blepharitis (an inflammation or infection of the skin along the eyelid). These conditions aren't contagious.
Conjunctivitis treatment depends on the cause:
Viruses. Viruses that cause the common cold can also cause pink eye. Just as a cold must run its course, the same is true for this form of conjunctivitis, which usually lasts 4-7 days. Remember, it can be very contagious, so do everything you can to prevent its spread. Antibiotics won't help anything caused by a virus. Pink eye caused by the herpes virus can be serious, however, and may need prescription antiviral eye drops, ointment, or pills.
Bacteria. If bacteria, including those related to STDs, cause your pink eye, you'll take antibiotics. You may need to apply eye drops or ointments to the inside of your eyelid three to four times a day for 5-7 days. For more stubborn infections or rare cases of pink eye caused by gonorrhea or chlamydia, you might get an oral antibiotic. You'll need to take pills for several days. The infection should improve within a week. Take or use the medicines as instructed by your doctor, even after the symptoms go away.
Irritants. For pink eye caused by an irritating substance, use water to wash the substance from the eye for 5 minutes. Your eyes should begin to improve within 4 hours. If your conjunctivitis is caused by acid or alkaline material such as bleach, immediately rinse the eyes with lots of water and call your doctor immediately.
Allergies. Conjunctivitis tied to allergies should improve once you get your allergy treated and avoid your allergy triggers. Antihistamines (either oral or drops) can give relief in the meantime. Remember that taking antihistamines by mouth can make your eyes even drier if you have dry eyes. See your doctor if you think your pink eye is due to an allergy.
Your eye doctor may have you return in several days to ensure your pink eye improves with the medication prescribed.
How long is pink eye contagious after starting drops?
Pink eye is contagious until your eyes stop tearing and releasing a discharge, whether or not you've started eye drops. About 24 hours after starting antibiotic drops, you should see improvement in symptoms.
How long does pink eye last?
Pink eye may last 2-5 days for mild bacterial infections without treatment. But sometimes, it may last up to 2 weeks. Antibiotics can shorten the duration of bacterial conjunctivitis.
Pink eye lasts 7-14 days for most viral infections. However, some cases of viral conjunctivitis may need 2-3 weeks to completely clear.
A lot of it comes down to cleanliness:
If your child has bacterial or viral pink eye, keep them home from school or day care until their eyes no longer tear up or produce discharge. Once symptoms have cleared up, it's safe to go back to school or work, but everyone should continue to maintain good hygiene practices.
Usually, pink eye clears up on its own or after you take any medicines your doctor prescribes, with no lasting problems. Mild pink eye is almost always harmless and will get better without treatment.
But some forms of conjunctivitis can become serious and may affect your ability to see because they can scar your cornea, the clear protective covering at the front of your eye. They include conjunctivitis caused by gonorrhea, chlamydia, or certain strains of the adenovirus.
If caused by a virus, pink eye gets better in 2-3 weeks. If caused by bacteria, antibiotics may speed up the healing process.
See a doctor immediately if you have symptoms, including:
You can take steps to prevent pink eye:
Keep your hands clean. Wash them thoroughly and often, especially if you touch your eye or the area around it.
Don't overshare. Infection can also enter the body through your nose and mouth. So, don't share washcloths, bath towels, pillowcases, or handkerchiefs with others, even with family. Don't use other people's eyedrops or cosmetics, especially eyeliner pencils and mascara.
Avoid allergy triggers. If allergies cause your pink eye, avoid the allergens that trigger your symptoms. Don't rub your eyes, which may make it worse. Splash your face and eyes with cold water, or use a cool compress. Use aqueous-based "artificial tears." Stick with your allergy treatment.
Clean contact lenses carefully. Sometimes, chemicals used to clean contact lenses can irritate your eyes. You may find relief if you change how you clean your contacts, but be sure to disinfect them before you put them back in your eyes.
Throw away infected items.To avoid another infection, throw away makeup tools, contact lenses, and the contact lens solution and cases you used when you had pink eye.
Pink eye causes red, itchy, watery eyes that produce discharge. Mild cases of conjunctivitis may go away on their own, but it's best to see a doctor for diagnosis and proper treatment. Pink eye doesn't usually have major complications. But if a newborn has red, puffy eyes, they should receive treatment immediately to avoid damage to their vision. Maintain good personal hygiene and avoid touching your eyes, even after your pink eye clears.
Should I stay home if I have pink eye?
Stay at home if you have pink eye symptoms such as tearing and discharge, because you could spread it to others. Talk to your doctor to confirm if your form of pink eye isn't contagious.
How long do you stay contagious with pink eye?
You're contagious with pink eye as long as you have eye tearing and discharge.
What kills the pink eye-causing germs on surfaces?
An antimicrobial cleaner such as bleach can kill the bacteria or viruses that cause pink eye on most surfaces.
What Is Eye Syphilis?
Eye syphilis is a manifestation of syphilis. Sometimes, it is the first sign of infection. It can affect almost any part of the eye and resemble a range of other eye diseases.
Common symptoms of eye syphilis include redness, inflammation, and vision changes. Early treatment with antibiotics can be effective. However, delaying treatment may lead to irreversible damage.
In this article, learn about what causes eye syphilis and how to treat it.
Ocular or eye syphilis is a manifestation of syphilis, a sexually transmitted infection (STI) that can affect many parts of the body.
As the infection spreads, it can inflame and damage the eyes. It can also lead to tissue death and vision loss. However, treatment is available.
Eye syphilis is an uncommon manifestation of syphilis. It likely affects fewer than 1% of people with syphilis in the United States.
Learn more about syphilis.
Eye syphilis occurs when a bacterium called Treponema pallidum enters a person's body — usually through sexual contact — and causes infection. Transmission usually happens when the person with syphilis has sexual contact while they have active, transmissible sores.
As bacteria spread through the body, they can affect a wide range of functions, including the eyes.
Syphilis is not the only STI that can result in eye issues. Others include:
Learn more about how syphilis and other STIs are transmitted.
The symptoms of eye syphilis can emerge up to 6 months after initial contact with the bacteria.
They can appear at any stage of syphilis and vary widely, depending on the part of the eye affected and the stage at which they appear.
Symptoms can include:
Doctors divide the development of syphilis into four stages:
As the stages progress, bacteria spread through the bloodstream, increasing the risk of symptoms appearing throughout the body, including the eyes. Eye symptoms are most likely to occur 4–10 weeks after infection in stage 2. However, they can appear before or after this stage.
An infant born with congenital syphilis — passed on from the birthing parent — may have damage to the retina and interstitial keratitis. This is where blood vessels grow into the cornea, the clear layer at the front of the eye.
Symptoms of eye syphilis can resemble those of many other eye conditions, including pink eye or conjunctivitis. Anyone with concerns about eye symptoms should contact a doctor.
Learn more about how to recognize symptoms of syphilis and other STIs.
To diagnose eye syphilis, a doctor will order a complete eye exam and blood tests. Blood tests will check for signs of infection with T. Pallidum bacteria and antibodies to the bacteria.
Blood tests are the only definitive way to identify eye syphilis, as many other eye conditions have similar symptoms. However, the presence of a rash or other symptoms that typically occur with syphilis can also help guide the diagnosis.
The doctor may also recommend screening for other STIs, such as HIV, as they have similar risk factors.
Eye syphilis may be difficult to detect in infants, as newborns share antibodies with their birthing parent. Experts recommend regular monitoring of newborns at risk of syphilis to detect any issues at an early stage.
Find out whether Medicare covers testing for STIs.
Treatment for syphilis — including eye syphilis — is with antibiotics. A person may need ongoing doses of penicillin for 10–14 days.
In addition, options to help manage symptoms include:
Getting treatment for eye syphilis can also help reduce the risk of other syphilis complications.
Getting supportThe National Institutes of Health provides a list of resources about STIs, including where to find more information on testing and prevention.
Eye syphilis is one aspect of syphilis. People who receive early treatment for syphilis usually recover without long-term effects.
However, the disease does not go away completely but remains latent in the body. In around one-third of these cases, syphilis will then progress to the third stage.
Without treatment, around 25% of people experience a relapse at some point. In these cases, a relapse of eye symptoms can also occur.
People who do not receive treatment for syphilis will experience a wide range of health issues. They may lose their vision due to eye involvement.
Anyone with a history of syphilis or eye syphilis can help protect their health by consulting a medical professional if any concerning symptoms appear.
Here are some questions people often ask about eye or ocular syphilis.
Is ocular syphilis sexually transmitted?Eye syphilis is a complication of syphilis, a bacterial infection that passes from one person to another through contact during vaginal, anal, or oral sex. It is also possible to pass it on to a newborn during delivery.
In rare cases, a person can acquire it through blood or skin-to-skin contact.
Is ocular syphilis reversible?Ocular syphilis can lead to irreversible damage, but early treatment can prevent this. The longer a person waits for medical assistance, the higher the risk of irreversible damage, including vision loss.
Is pink eye the same as syphilis?Eye syphilis can have similar symptoms to pink eye and many other eye conditions when the external, or conjunctiva, part of the eye is involved. However, very few cases of pink eye stem from syphilis.
Who should test for an STI, and how often?The Centers for Disease Control and Prevention (CDC) recommends testing for STIs:
Eye or ocular syphilis is a complication of syphilis, a sexually transmitted bacterial infection. It can cause damage to a wide range of eye structures.
Eye syphilis is treatable with antibiotics. Without treatment, it can lead to irreversible eye damage and vision loss.
Anyone with concerns about eye symptoms should contact a doctor.
Herpes Simplex
Herpes simplex is a viral infection caused by the herpes simplex virus. Infections are categorized based on the part of the body infected. Oral herpes involves the face or mouth. It may result in small blisters in groups often called cold sores or fever blisters or may just cause a sore throat.
Genital herpes, often simply known as herpes, may have minimal symptoms or form blisters that break open and result in small ulcers. These typically heal over two to four weeks.
Tingling or shooting pains may occur before the blisters appear. Herpes cycles between periods of active disease followed by periods without symptoms. The first episode is often more severe and may be associated with fever, muscle pains, swollen lymph nodes and headaches. Over time, episodes of active disease decrease in frequency and severity.
Other disorders caused by herpes simplex include: herpetic whitlow when it involves the fingers, herpes of the eye, herpes infection of the brain, and neonatal herpes when it affects a newborn, among others.
There are two types of herpes simplex virus, type 1 (HSV-1) and type 2 (HSV-2). HSV-1 more commonly causes infections around the mouth while HSV-2 more commonly causes genital infections. They are transmitted by direct contact with body fluids or lesions of an infected individual. Transmission may still occur when symptoms are not present.
Genital herpes is classified as a sexually transmitted infection. It may be spread to an infant during childbirth. After infection, the viruses are transported along sensory nerves to the nerve cell bodies, where they reside lifelong. Causes of recurrence may include: decreased immune function, stress, and sunlight exposure.
Oral and genital herpes is usually diagnosed based on the presenting symptoms. The diagnosis may be confirmed by viral culture or detecting herpes DNA in fluid from blisters. Testing the blood for antibodies against the virus can confirm a previous infection but will be negative in new infections.
Daily antiviral medication taken by someone who has the infection can reduce spread. There is no available vaccine and once infected, there is no cure. Paracetamol (acetaminophen) and topical lidocaine may be used to help with the symptoms. Treatments with antiviral medication such as aciclovir or valaciclovir can lessen the severity of symptomatic episodes.
Worldwide rates of either HSV-1 or HSV-2 are between 60% and 95% in adults. HSV-1 is usually acquired during childhood. Rates of both increase as people age. Rates of HSV-1 are between 70% and 80% in populations of low socioeconomic status and 40% to 60% in populations of improved socioeconomic status.
The name is from Greek: ἕρπης herpēs, which is related to the meaning "to creep", referring to spreading blisters. The name does not refer to latency.
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