What is "pink eye"?

Pink eye, or conjunctivitis, is redness and inflammation of the membranes (conjunctiva) covering the whites of the eyes and the membranes on the inner part of the eyelids. These membranes react to a wide range of bacteria, viruses, allergy-provoking agents, irritants, and toxic agents, as well as to underlying diseases within the body. Viral and bacterial forms of conjunctivitis are common in childhood, but they can occur in people of any age. Overall, however, there are many causes of pink eye. These can be classified as either infectious or noninfectious. Pink eye does not cause any changes in vision.

What infections cause pink eye, what are infectious pink eye symptoms, and how are they treated?

Viral pink eye

The leading cause of a red, inflamed eye is virus infection. Adenoviruses are the type of virus that are most commonly responsible for the infection. Viral pink eye symptoms are usually associated with more of a watery discharge that is not green or yellow in color. Often, viral "cold-like" symptoms, such as sinus congestion and runny nose, are also present. The eyelids may be swollen. Sometimes looking at bright lights is painful. While viral pink eye may not require an antibiotic, those affected should see a doctor, as occasionally this form of pink eye can be associated with infection of the cornea (the clear portion of the front of the eyeball). This infection must be correctly detected and treated. Viral pink eye is highly contagious. The symptoms of viral pink eye are pronounced for the first three to five days after symptoms appear, with slow resolution over the following one to two weeks.

Bacterial pink eye

Staphylococci and Streptococci, among others, are types of bacteria that commonly cause pink eye. Symptoms of bacterial pink eye include

• eye pain,



• swelling,



• redness, and



• a moderate to large amount of discharge, usually yellow or greenish in color.

The discharge commonly accumulates after sleeping. Affected children may awaken most unhappy that their "eyes are stuck shut," requiring a warm washcloth applied to the eyes to remove the discharge. Bacterial pink eye is treated by repeated warm washcloths applied to the eyes (try applying these to your child's eye one eye at a time during a favorite video) and requires antibiotic eyedrops or ointment prescribed by the doctor.

What does pink eye look like?

Be careful not to use medication prescribed for someone else, or from an old infection, as these may be inappropriate for your current infection or may have been contaminated from other infections by accidentally touching the medicine bottle to infected areas. A safe, effective, and potentially less frightening method of putting drops into the eyes involves asking your child to lie down flat, with instructions to merely "close your eyes," and placing the recommended number of drops in the inner corner of the eye, next to the bridge of the nose, and letting them make a little "lake" there. When your child relaxes and opens the eyes, the medicine will flow gently into the infected mucous membranes without the need to "force open" the eyes.

When you feel that you or your child might have bacterial pink eye, it is very important to see your doctor immediately for several reasons. First, if the cause is a bacterial infection, an antibiotic will be needed to help the infection-fighting immune system to kill this infection. Secondly, if you are experiencing other symptoms such as a runny nose, cough, earache, etc., there is a good chance that these symptoms are caused by the same bacteria, and an oral antibiotic may also be needed to treat this infection along with the antibiotic drops or ointment for the eyes. Finally, your doctor will want to exclude the possibility that the infection has spread to areas where the symptoms may not yet be recognizable.

Chlamydia pink eye

Pink eye due to infection with Chlamydia is an uncommon form of bacterial pink eye in the U.S., but it is very common in Africa and Middle Eastern countries. Chlamydia can cause pink eye in adults and neonates. It is a cause of pink eye in adolescents and adults that can be sexually transmitted. Chlamydia pink eye is typically treated with erythromycin (E-Mycin, Eryc, Ery-Tab, PCE, Pediazole, Ilosone) or oral tetracycline (Sumycin), except in children less than 8 years of age, because of possible discoloration of the teeth.

What noninfectious conditions cause pink eye, what are noninfectious pink eye symptoms, and how are they treated?

Allergic pink eye

Allergic pink eye symptoms and signs are usually accompanied by intense itching, tearing, and swelling of the eye membranes. Frequent causes include seasonal pollens, animal dander, and dust. It is frequently seasonal and accompanied by other typical allergy symptoms such as sneezing, itchy nose, or scratchy throat. Cold, moist washcloths applied to the eyes and over-the-counter decongestant eyedrops can provide relief. Your doctor can prescribe stronger medications if these remedies are not adequate.

Chemical pink eye

Chemical pink eye can result when any irritating substance enters the eyes. Common offending irritants are

• household cleaners,



• sprays of any kind,



• smoke,



• foreign objects in the eye,



• smog, and



• industrial pollutants.

Prompt, thorough washing of the eyes with very large amounts of water is very important if an irritating substance enters the eye. Your doctor or your local poison control center should be contacted at once, even if you think the irritant or chemical is safe, as some of the most common household products like bleach and furniture polish can be very damaging.

Underlying diseases

Persistent pink eye (conjunctivitis) can be a sign of an underlying illness in the body. Most often these are rheumatic diseases, such as rheumatoid arthritis and systemic lupus erythematosus. Conjunctivitis is also seen in Kawasaki's disease (a rare disease associated with fever in infants and young children) and certain inflammatory bowel diseases such as ulcerative colitis and Crohn's disease.

Subconjuctival hemorrhage

Bright redness of the whites of the eyes can also occur when the tiny blood vessels covering the whites of the eyes rupture from trauma or changes in pressure within the head (for example, after forceful laughing or vomiting, when diving under water, or even bending upside down). This condition is called subconjunctival hemorrhage, and while it can appear frightening, it is generally harmless. It causes a local area of the white portion of the eye (the sclera) to become brilliantly reddened. It does not typically involve the colored portion of the eye (the iris) and does not affect vision.

How can I prevent the spread of pink eye?

Infectious forms of pink eye are highly contagious and are spread by direct contact with infected people. If you or your child has infectious pink eye, avoid touching the eye area and wash your hands frequently, particularly after applying medications to the eye area. Never share towels or handkerchiefs, and throw away tissues after each use. Disinfecting surfaces like countertops, sinks, and doorknobs can also help prevent the spread of infectious pink eye.

Pink Eye At A Glance

• Pink eye (conjunctivitis) can be due to infectious or noninfectious causes.
• Infectious pink eye is highly contagious.
• Infectious pink eye can be caused by bacteria or viruses.
• Avoiding contact with infected people, disinfection of household surfaces, and good hygienic practices can help prevent the spread of infectious pink eye.
• Noninfectious pink eye can be caused by allergy, chemical irritation, underlying inflammatory diseases, or trauma.

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