Conjunctivitis or pink eye
The conjunctiva is a clear layer of tissue lining the eyelids and covering the white of the eye. Conjunctivitis occurs when the conjunctiva becomes swollen or inflamed.
Conjunctiva
The conjunctiva is a thin, clear membrane that covers the inner surface of the eyelid and the white part of the eyeball (the sclera). It contains ma...

This swelling can be due to an infection, an irritant, dry eyes, or an allergy.
Let's talk about pink eye - Animation
Let's talk about pink eye. I'm Dr. Alan Greene. Pink eye is a very common problem especially among children. And first off, yes it is contagious - very contagious. Whenever they touch their eyes, and it is common to rub eyes when you have pink eye, the hands are then infected and contagious. Then they touch other objects. They touch your hands. You have an infected hand and you touch your own nose or mouth or eye and you can get pink eye that way. So the best way to break that chain of infection is frequent hand washing spread by the hands. Now, often schools will recommend that kids have some kind of eye drops and antibiotic eye drops before they go back to school. This is often done. Most pink eye in general pink eye is defined as viral conjunctivitis. It's a virus where the antibiotics don't make a big difference. But if you do need to give eye drops for whatever reason for the eye, let me talk about how to get them in because with children, it can be kind of tough. And the best thing is you get them to lie down on their back, and when they're lying on their back, it's okay if they close their eyes or open their eyes - don't worry about trying to hold the eyes open. But just put 3, 4, or 5 drops right in the corner of the eye while they're lying flat and then when they do blink, their eyes open it will slip right in there. Take care of it that way. But be sure and wash your hands afterwards.
Causes
Tears most often protect the eyes by washing away germs and irritants. Tears contain proteins and antibodies that kill germs. If your eyes are dry, germs and irritants are more likely to cause problems.
Antibodies
An antibody is a protein produced by the body's immune system when it detects harmful substances, called antigens. Examples of antigens include micr...

Conjunctivitis is most often caused by germs such as viruses and bacteria.
- "Pink eye" most often refers to a highly contagious viral infection that spreads easily among children.
- Conjunctivitis can be found in people with COVID-19 before they have other typical symptoms.
- In newborns, an eye infection may be caused by bacteria in the birth canal. This must be treated at once to preserve eyesight.
- Allergic conjunctivitis occurs when the conjunctiva becomes inflamed due to a reaction to pollen, dander, mold, or other allergy-causing substances.
Allergic conjunctivitis
The conjunctiva is a clear layer of tissue lining the eyelids and covering the white of the eye. Allergic conjunctivitis occurs when the conjunctiva...
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A type of long-term allergic conjunctivitis may occur in people who have chronic allergies or asthma. This condition is called vernal conjunctivitis. It most commonly occurs in young men and boys in the spring and summer months. A similar condition can occur in long-time contact lens wearers. It may make it difficult to continue to wear contact lenses.
Vernal conjunctivitis
Vernal conjunctivitis is long-term (chronic) swelling (inflammation) of the outer lining of the eyes. It is due to an allergic reaction.

Anything which irritates the eye may also cause conjunctivitis. These include:
- Chemicals.
- Smoke.
- Dust.
- Over-use of contact lenses (often extended-wear lenses) can lead to conjunctivitis.
Symptoms
Symptoms include:
- Blurred vision
Blurred vision
There are many types of eye problems and vision disturbances, such as: Halos Blurred vision (the loss of sharpness of vision and the inability to see...
ImageRead Article Now Book Mark Article - Crusts that form on the eyelid overnight (most often caused by bacteria)
- Eye pain
Eye pain
Pain in the eye may be described as a burning, throbbing, aching, or stabbing sensation in or around the eye. It may also feel like you have a forei...
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Gritty feeling in the eyes
Eye burning with discharge is burning, itching, or drainage from the eye of any substance other than tears.
ImageRead Article Now Book Mark Article - Increased tearing
- Itching of the eye
Itching of the eye
Eye burning with discharge is burning, itching, or drainage from the eye of any substance other than tears.
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Redness in the eyes
Eye redness is most often due to swollen or dilated blood vessels. This makes the surface of the eye look red or bloodshot.
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Sensitivity to light
Photophobia is eye discomfort in bright light.
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Exams and Tests
Your health care provider will:
- Examine your eyes
- Swab the conjunctiva to get a sample for analysis
There are tests that can sometimes be done in the office to look for a specific type of virus as the cause.
Treatment
Treatment of conjunctivitis depends on the cause.
Allergic conjunctivitis may improve when allergies are treated. It may go away on its own when you avoid your allergy triggers. Cool compresses may help soothe allergic conjunctivitis. Eye drops that contain antihistamines for the eye or drops containing steroids, may be necessary in more severe cases.
How to use eye drops - Animation
I'm Dr. Alan Greene and let's talk about how to put eye drops in. The problem people often have is when you tilt your head back and you see that dropper looming up there and the drops start falling down, it's a natural response to blink. You can send that drop spraying where you don't want it to go. And it can be a little uncomfortable to have that drop come down and strike your eye. If you can keep your eyes open, that's great and it works very well. But if you can't like many people, if not most people, not to worry. There's another way that works very, very well. And what you do is you'll simply tilt your head back hold the dropper right above your eyes with your eyes closed. You don't want the dropper to actually touch the eye because you can contaminate the dropper or your eye, one or the other if there's an infection involved somewhere. Just do like this - couple drops right in the corner and then blink while you're head is still up. And when you do that it will slip right in very comfortably and you'll get the whole dosage in and it works very well.
Antibiotic medicines work well to treat conjunctivitis caused by bacteria. These are most often given in the form of eye drops. Most cases of viral conjunctivitis will go away on its own without antibiotic eye drops. Mild steroid eye drops may help ease discomfort.
If your eyes are dry, if may help to use artificial tears in conjunction with any other drops you may be using. Be sure to allow about 10 minutes in between using different types of eye drops. Crustiness of the eyelids can be helped by applying warm compresses. Gently press clean cloth soaked in warm water to your closed eyes.
Other helpful steps include:
- Do not smoke and avoid secondhand smoke, direct wind, and air conditioning.
- Use a humidifier, especially in the winter.
- Limit medicines that may dry you out and worsen your symptoms.
- Clean eyelashes regularly and apply warm compresses.
Outlook (Prognosis)
The outcome for bacterial infections is most often good with early antibiotic treatment. Pinkeye (viral conjunctivitis) can easily spread through entire households or classrooms, but a full recovery is expected.
When to Contact a Medical Professional
Contact your provider if:
- Your symptoms last longer than 3 or 4 days.
- Your vision is affected.
- You have light sensitivity.
- You develop eye pain that is severe or becoming worse.
- Your eyelids or the skin around your eyes becomes swollen or red.
- You have a headache in addition to your other symptom.
Prevention
Good hygiene can help prevent the spread of conjunctivitis. Things you can do include:
- Change pillowcases daily.
- Do not share eye makeup and replace it regularly.
- Do not share towels or handkerchiefs.
- Handle and clean contact lenses properly.
- Keep hands away from the eye.
- Wash your hands often.
Reviewed By
Audrey Tai, DO, MS, Athena Eye Care, Mission Viejo, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Centers for Disease Control and Prevention website. Conjunctivitis (pink eye). How to prevent pink eye. www.cdc.gov/conjunctivitis/prevention/index.html. Updated April 15, 2024. Accessed August 16, 2024.
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Khavandi S, Tabibzadeh E, Naderan M, Shoar S. Corona virus disease-19 (COVID-19) presenting as conjunctivitis: atypically high-risk during a pandemic. Cont Lens Anterior Eye. 2020;43(3):211-212. PMID: 32354654 pubmed.ncbi.nlm.nih.gov/32354654/.
Kumar NM, Barnes SD, Pavan-Langston D, Azar DT. Microbial conjunctivitis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 112.
Rubenstein JB, Kelly E. Infectious conjunctivitis.. In: Yanoff M, Duker JS, eds. Ophthalmology. 6th ed. Philadelphia, PA: Elsevier; 2023:chap 4.6.