Conjunctivitis (Pink Eye)

About This Disease

Conjunctivitis or pink eye is an inflammation of the outer lining of the eye. Conjunctivitis is frequently caused by infectious agents, either viruses or bacteria. Conjunctivitis can also be caused by an allergy or by exposure to chemicals that irritate the eye. Anyone can get conjunctivitis, but family members and close friends of someone with infectious conjunctivitis (caused by virus or bacteria) are at increased risk.      

Signs and Symptoms

Symptoms can vary but typically include the white of the eye taking on a pink or red color with swelling of the eyelid(s). Other symptoms of conjunctivitis may include some or all of the following: blurred vision, sensitivity to light, a scratchy or painful sensation in one or both eyes, heavy tearing in the eyes, discharge from the eye(s), crusting of eyelids or lashes and itchy eyelids. For bacterial conjunctivitis, the symptoms usually begin 24 to 72 hours after exposure to the infection. For viral conjunctivitis, the onset of symptoms can range from 12 hours to 12 days after infection. The symptoms can persist for several days, or rarely, for 2 to 3 weeks.

Transmission

In infectious conjunctivitis, the fluids from an infected person’s eyes are highly contagious. Therefore, it can be passed from person-to-person via contaminated fingers, clothes, towels, and through items such as eye makeup and sunglasses. Children younger than 5 are most often affected. It is best to limit contact with infected persons until the symptoms go away. Children with conjunctivitis should be kept out of school to prevent the disease from spreading to other students. Infected persons can go back to school or work when the itching, pain, and tearing have stopped.

Diagnosis

Diagnosis is made through examination of the eye(s), symptoms and patient history. Rarely, the physician may collect exudate or discharge from the eye for laboratory analysis.

Treatment

The treatment varies depending on the cause of the conjunctivitis. Severe or chronic conjunctivitis should be treated by a doctor. Newborns with symptoms of conjunctivitis should see a doctor right away. Allergic conjunctivitis may improve when allergies are treated. It may go away on its own when you avoid allergy triggers. Allergy medications and certain eye drops (topical antihistamine and vasoconstrictors), including some prescription eye drops, can also provide relief from allergic conjunctivitis. In some cases, a combination of drugs may be needed to improve symptoms. Cool compresses may help soothe allergic conjunctivitis. Antibiotic medicines work well to treat pink eye caused by bacteria. These are most often given in the form of eye drops. Viral pink eye will go away on its own without antibiotics. Mild steroid eye drops may help ease discomfort.

Immunity

Conjunctivitis can come back if you do not take steps to prevent it from spreading. Pink eye caused by viruses or bacteria can spread through contact. These have been known to spread through entire households or classrooms.

Risk in Hawaii

Widespread and common worldwide, particularly in warmer climates.

Prevention

You can greatly reduce the risk of getting conjunctivitis or spreading it to someone else by following some simple good-hygiene steps, such as:
  • Wash your hands often with soap and warm water.
  • Make sure your hands are clean before and after applying eye drops or ointment to the infected eye.
  • Avoid touching or rubbing your eyes.
  • Follow physician’s recommendations on caring for the infected eye.
  • Seek medical attention if symptoms worsen.
  • Do not use the same eye drop dispenser/bottle for your infected and non-infected eyes.
  • Do not share your towels, washcloths, or handkerchiefs with others.
  • Change pillowcases often.
  • Handle and clean contact lenses properly.
  • If diagnosed with conjunctivitis, you should also stop wearing contact lenses until your eye doctor says it’s okay to start wearing them again.
  • Do not share sunglasses, eye makeup, eye drops, eye medicine, or anything else that touches the eyes.
  • Do not use swimming pools.
In addition, if you have conjunctivitis, there are steps you can take to avoid re-infection once the infection goes away:
  • Throw away and replace any eye or face makeup you used while infected.
  • Throw away contact lens solutions that you used while your eyes were infected.
  • Throw away disposable contact lenses and cases that you used while your eyes were infected.
  • Clean extended wear lenses as directed.
  • Clean eyeglasses and cases that you used while infected.
There is no vaccine that prevents all types of conjunctivitis. However, there are vaccines to protect against some viral and bacterial diseases that are associated with conjunctivitis.

Additional Resources

Information for Clinicians

CDC - Conjunctivitis information for clinicians   Last Reviewed September 2018