Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at February 16, 2016

Conjunctivitis, also called pinkeye, is a highly contagious infection of the eye. It is a common and easily treatable condition that can impact anyone at any age, but it’s especially common in young children.


Definition & Facts

Conjunctivitis, commonly known as pinkeye, is an inflammation of the conjunctiva which is the clear membrane that covers the white part of the eye and the interior of the eyelids. This causes the whites of the eyes to appear pink. It is a very common eye disease, especially in children.

It can affect one or both eyes or start in one eye and spread to the other. Viral and bacterial forms of conjunctivitis are highly contagious. They spread through schools and at home quite easily. While pinkeye is usually an easily treatable, minor eye infection, it can sometimes develop into a more serious problem.

Symptoms & Complaints

Pink eye can occur in one or both eyes. Sign and symptoms one may encounter include:


There are four main causes of pinkeye. One is viral conjunctivitis, which is caused by a virus, upper respiratory tract infection, or the common cold. It is very contagious. It usually starts in one eye, but rapidly spreads to the other, and it spreads easily to others.

Another cause of pinkeye is allergic conjunctivitis which is caused by eye allergens such as pollen, dust, or animal dander. Allergic conjunctivitis may be seasonal or flare ups can occur sporadically year-round. It can also be caused from wearing contacts too long, from reactions to medications, or from cosmetics. Once the allergen or cause is removed, the pinkeye can clear up.

The third is bacterial conjunctivitis which is caused by a bacterial infection due to bacteria such as Staphyloccocus aureus and Streptococcus pneumoniae. It is the most common cause of pinkeye. The cases are mild, start in one eye, and sometimes progress to the other. They can last anywhere from two days to three weeks. The fourth cause is from chemicals caused by irritants like air pollution, swimming pool chlorine, or exposure to other environmental toxicants.

Diagnosis & Tests

If symptoms of pinkeye appear, call a doctor and set up an appointment. In order for a doctor to diagnose pinkeye they will ask about the symptoms such as eye discharge, burning, itchy eyes, and excessive tearing. Usually the doctor can determine from the symptoms and seeing the patient whether or not it is pinkeye. The doctor may ask whether the pinkeye symptoms came on slowly or appeared suddenly. They may also ask if the patient has been exposed to anyone else with pinkeye symptoms. For instance, some daycares will send home notification when pinkeye is discovered in their facilities.

In some serious cases, the doctor may want swabs of the eye discharge to send to a lab to determine the cause, bacterial or viral. Treatment can start during the appointment while lab results are pending, and it can be modified based on lab test results. If the pinkeye is the result of allergens and the patient has never been allergy tested, the doctor may recommend allergy testing to prevent future occurrences.

Treatment & Therapy

Treatment for pinkeye depends on its cause. The first step to treat pinkeye caused by allergens is to remove or avoid the irritant. Cold compresses, over-the-counter artificial tears, and allergy eye drops can alleviate discomfort. If the eye drops are refrigerated, they may bring even more relief.

If the case is severe, a doctor will prescribe nonsteroidal anti-inflammatory drugs and antihistamines. If the patient has persistent cases of allergy induced pinkeye, it may require topical steroid eye drops to treat it. Bacterial pinkeye is commonly treated with antibiotic eye drops or ointments. After three or four days of treatment there should be significant improvement. Even though the symptoms may subside, the entire course of antibiotics must be carried out or the pinkeye may return.

Viral pinkeye is harder to treat, and it usually is not treated. Since there are no medications to cure viruses, there are drops or ointments that are effective for viral pinkeye. Like all viruses, this one must run its course. For symptom relief, cool compresses and over the counter tear solutions can be effective. For severe cases there are prescription topical steroid drops, but they do not shorten the virus’s course, just alleviate symptoms. Also for severe cases, doctors can perform a newer treatment called an iodine eye wash. Its effectiveness has not been well researched yet.

Treatment for chemical pinkeye requires gentle flushing of the eyes with a saline solution. They sometimes require topical steroids which must be prescribed by a doctor. Severe chemical damage is considered a medical emergency. This chemical damage can lead to scarring, eye damage, or even complete vision loss.

Prevention & Prophylaxis

Pinkeye is spread through contact with the infected eye drainage. The drainage holds the virus or bacteria that caused the pinkeye. Touching the eye and then touching anything else leaves that object tainted. The next person that comes into contact with the tainted object and touches their eye gets the virus or bacteria.

The best way to avoid contracting pinkeye is to avoid contact with infected people. Good hygiene such as avoiding rubbing or touching the eyes, washing hands often, avoiding reusing towels, washing pillowcases frequently, and cleansing contacts thoroughly can also prevent this form of pinkeye from spreading.