How to tell if you have pink eye and what to do

True conjunctivitis can be either viral or bacterial, but inflamed eyes can also mean something else.
Girl holding tissue to her pink eye
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By Maxine Lipner

Waking up to a red, inflamed eye that might even be hard to open can be terrifying. Is it a temporary infection or a virus? Maybe it’s the dreaded pink eye, the common name for conjunctivitis, which can be contagious. No need to panic, there are ways to clear up that irritated eye fast.

The first thing is to look at any other symptoms, especially pain and vision problems, to figure out whether it’s time to visit a doctor right away.

“If it’s something serious, that means there’s associated pain or vision symptoms: your vision is blurry, there’s pain, there’s sensitivity to light and other things that are occurring,” Dr. William B. Trattler, cornea specialist, Center for Excellence in Eye Care, Miami, told TODAY. “That’s not something you want to self-treat.”

If the eye is simply red and watery, it could be something more benign masquerading as conjunctivitis, like dry eye from staring at the computer all day or irritation from a windy environment, Trattler said. Moisturizing eye drops, also called “artificial tears,” or a redness reliever can help.

Spotting true pink eye

Centers for Disease Control and Prevention

Genuine conjunctivitis occurs when the transparent membrane that covers the white part of the eye becomes irritated and small blood vessels in the tissue are more easily seen. The condition can be caused by a virus, bacteria or even allergies, Trattler said.

Hallmarks of pink eye include:

  • Redness
  • Discharge in one eye or the other, which may become crusty
  • Itching
  • Tearing
  • A gritty sensation

If it’s allergy season when pollen and other irritants abound, the body can release histamine as part of an allergic reaction. If this is the case and the eye is itchy and watery, over-the-counter anti-allergy medication can help, Trattler noted. Cold compresses can also help to soothe the inflamed eye.

The situation that is more worrisome is when the conjunctivitis is viral, which is the contagious form, or bacterial.

“Healthy people don’t typically get bacterial pink eye,” Trattler said. One of the signs that someone may be dealing with a bacterial pink eye is the fact that there’s significant goopy discharge.

“The viral is mainly just an itchy pink and red eye,” he said. “It doesn’t get much discharge.”

People with weaker immune systems including infants, children, the elderly, and those in nursing homes, are more prone to this form of the condition. When it’s bacterial, pink eye can be treated with antibiotics.

“So, it does make sense in that situation to see your eye care provider, whether it’s an optometrist or an ophthalmologist, to see if there’s a treatment for the condition,” Trattler said. Cold compresses can also be used to soothe the eyes.

Viral pink eye

Having viral pink eye is like having a cold in the eye and, unfortunately, there is no magic bullet. The same methods can be used to soothe discomfort, but the added concern with the viral form is that it could be contagious – both from one eye to another and to other people.

Use a separate towel for the affected eye and be careful not to inadvertently touch the tip of an eye drops bottle to one eye and then to the other. Also, avoid sharing towels or pillowcases with others and wash hands often.

“If you have a viral cause of pink eye, you want to make sure you limit activities and don’t get any infection on your hands that you can transmit to other people,” Trattler said.

It can be difficult at first look to tell whether someone has the bacterial or conjunctival form, Trattler noted. Doctors can test a tear sample to see if someone has the adenovirus, he said, which would indicate the viral form.

Pink eye can clear up quickly and be nothing but a distant memory. However, if things don’t improve after a few days, or there are any signs of blurred vision, sensitivity to light or eye pain, Trattler said it’s time to seek medical attention.