Pink eye (conjunctivitis): symptoms and complications


Sometimes red eyes are one thing. Conjunctivitis , a condition caused by an infection or inflammation of the clear membrane that covers the eyeball or inner eyelid, is another matter. Pink eye , often known as pink eye, is characterized by redness, itching, burning, tearing, and discharge that can cause scabs around the eye. Because it can be contagious and have complications, it is important to recognize its signs and symptoms, get tested, and, if necessary, receive treatment.

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Frequent symptoms

When some people hear the term conjunctivitis, they often mistake it for a highly contagious viral form known as epidemic keratoconjunctivitis (EKC) . EKC is related to the common cold virus and can be spread at school, kindergarten, or the office when infected people cough, sneeze, and pass the virus to their peers.

However, other bacteria and viruses can also cause pink eye, as well as allergies or chemical pollutants .

The symptoms of EKC correspond to those common to all forms of conjunctivitis, including :

  • Change the color of one or both eyes to pink
  • Gritty sensation in the affected eye.
  • Itchy or burning eyes ( itchy eyes )
  • Excessive tearing ( epiphora )
  • Swollen eyelids
  • Blurry vision
  • Hypersensitivity to light (photophobia).
  • Discharge from the eye, which may crust over at night

Although EKC is generally limited to those listed above, other forms can include these and additional symptoms.


Conjunctivitis can be contagious or non-contagious. If you suspect you have the condition, your doctor can evaluate your symptoms to determine both the cause and appropriate treatment.

Conjunctivitis can be roughly divided into three groups: infectious conjunctivitis, allergic conjunctivitis, and chemical conjunctivitis.

Although they all tend to have symptoms of redness, discomfort and watery eyes, there may be slight differences that differentiate them from each other.

Viral conjunctivitis

Viral conjunctivitis is associated with upper respiratory infections and colds. It usually affects only one eye, but it can affect both if you rub your eyes.

Viral conjunctivitis can often cause a watery discharge that can be clear, sticky, or slightly milky. Because it is closely associated with respiratory infections, pink eye can be accompanied by coughing, sneezing, a runny nose, and a sore throat. Enlarged lymph nodes are also common.

Generally, if you have viral conjunctivitis, the worst days are the third to fifth day of infection. After that, the eyes will start to improve on their own.

Besides EKC, other viral causes include the herpes simplex virus (HSV) , which can affect children and cause recurrent infections in adults. Although less common than EKC, it can be more of a problem if it travels towards the center of the cornea (the clear layer of the colored part of the eye).

Bacterial conjunctivitis

Unlike the viral form of bacterial conjunctivitis, bacterial conjunctivitis usually affects both eyes and causes a thick, yellow-green discharge. The types of bacteria affected include staph, streptococci, The most common species are Corynebacterium, Haemophilus, Pseudomonas, and Moraxella .

Because the purulent discharge can be profuse, the crust around the eyes is usually thicker and may even "stick" the eyelids closed in the morning. Swollen lymph nodes are less common, but can occur with severe gonorrheal infections .

Gonorrhea or chlamydia can also cause a form of conjunctivitis known as newborn ophthalmia , in which the bacteria are transferred to the newborn's eyes as it travels through the mother's birth canal. Although most of these infections can be avoided with the routine use of antibiotics after delivery, untreated infections can cause eye pain, swelling, and purulent discharge during the first month of life.

Allergic conjunctivitis

Allergic conjunctivitis can be caused by a number of reasons, including seasonal allergies or food allergies .

Allergic conjunctivitis usually affects both eyes and can be accompanied by classic allergic symptoms such as hives, itching, or allergic rhinitis (sneezing, nasal congestion, puffy eyes).

Although excessively watery eyes are common, eye discharge is less common. In severe cases, the rash can appear on the conjunctiva itself.

Another form of allergic conjunctivitis, known as giant papillary conjunctivitis (GPC) , occurs when a persistent foreign object in the eye (such as contact lenses or stitches) causes pimple-like papules to develop on the inner eyelid .

Chemical conjunctivitis

Chemical conjunctivitis, also known as toxic conjunctivitis, is characterized by severe redness, watery eyes, and pain in response to smoke, fumes, or liquids. Mild cases, such as those associated with chlorine or smoke, usually resolve within a day.

More aggressive chemicals may take longer. These injuries can cause an overproduction of eye mucus (an immune response designed to protect the eye) or cause proteins in the conjunctiva to break down to form a protective barrier over the cornea. Vision loss can be temporary or permanent, depending on the degree of corneal damage.


Most cases of conjunctivitis are relatively mild and do not cause any damage to the eyes. In rare cases, complications can develop that can be serious and even life-threatening.

Among the most common complications of conjunctivitis:

  • Perforated epithelial keratitis : characterized by an infection of the cornea (keratitis), accompanied by the formation of small holes in the conjunctiva. Recurrence of herpes infection is a common cause. In addition to eye pain, excessive sensitivity to light can occur, as small perforations cause the light to scatter incorrectly. While the symptoms are bothersome, they usually resolve within a few weeks with topical antiviral medications.
  • Newborn Ophthalmia : Today this is generally avoided due to routine screening for sexually transmitted infections in mothers and the use of neonatal antibiotics in newborns. Babies who do not receive treatment are at risk for vision loss and blindness. Also, about 20 percent of children with chlamydial conjunctivitis develop pneumonia , a life-threatening complication in newborns .

When to contact a healthcare provider

Because certain types of pink eye are contagious, you should see your doctor if your symptoms are accompanied by swollen lymph nodes or any signs of a respiratory infection . This is especially true for school-age children, who are often victims of community-borne viruses.

Even if there are no other obvious symptoms, you should see a doctor or ophthalmologist if your pink eye persists for more than two weeks.

On the other hand, you should call your doctor immediately if you experience any of the following symptoms:

  • High temperature (more than 100.4 degrees)
  • Thick yellow or green discharge from the eye
  • Severe pain when looking at a bright light.
  • Blurred vision, double vision, loss of vision, or bright halos around objects.

These are signs of a serious infection that may require more aggressive treatment.

Frequently asked questions

  • Conjunctivitis caused by a virus or bacteria is very contagious and can be transmitted in several ways:

    • Direct (skin-to-skin) contact with another person (such as shaking hands)
    • Through the air, in the form of droplets that are released by coughing or sneezing .
    • By touching an object with germs and then touching one or both eyes before washing your hands .

  • Yes, if it is caused by a virus, conjunctivitis can be spread to other people before the infected person develops symptoms. Bacterial conjunctivitis is usually contagious after symptoms appear and within 48 hours after starting antibiotic treatment . Allergic and chemical conjunctivitis is not contagious.

  • It depends on the reason. Antibiotic eye drops can help clear bacterial conjunctivitis. For allergic conjunctivitis, avoiding allergy triggers and using antihistamines or anti-inflammatory eye drops can help (although symptoms are more likely to return if exposed to the allergen). With viral conjunctivitis, you may not be able to speed up your recovery, but while you wait for it to go away, you can ease symptoms by taking over-the-counter pain relievers, applying warm compresses to your eyes, and using tears to relieve dryness.

  • Conjunctivitis caused by a virus or bacteria usually clears up within a week or two. Bacterial conjunctivitis may clear up more quickly with antibiotic eye drops , although it may not always need to be treated.

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