You wake up with a red, gritty eye and maybe some crust on your lashes. Your first question is probably whether this is pink eye, and your second is whether you really need to see a doctor or can just wait it out.
The honest answer is that many cases of pink eye are mild and get better on their own, but some red eyes need prompt care, and a few are emergencies. This guide will help you sort out which is which.
The Short Answer
You don’t always need to see a doctor for pink eye. Mild cases with redness, watery discharge and no pain or vision changes often improve on their own within one to two weeks. You should see an eye doctor promptly if you have eye pain, blurred vision, light sensitivity, thick yellow or green discharge, symptoms that are getting worse or not improving after a few days, a weakened immune system, or if you wear contact lenses. Pink eye in a newborn always needs medical care right away.
What Is Pink Eye?
Pink eye, or conjunctivitis, is inflammation of the conjunctiva, the thin clear tissue covering the white of the eye and the inside of the eyelids. When it’s inflamed, its tiny blood vessels swell and the eye looks pink or red. Typical symptoms include redness, watering, itching or a gritty feeling, discharge, crusting along the lashes in the morning, and puffy eyelids. It can affect one eye or both.
It’s important to know that many other conditions look like pink eye, from dry eye and eyelid inflammation to corneal infections and inflammation inside the eye. Our posts on why your eyes are red and what is commonly misdiagnosed as pink eye cover these look-alikes.
Do I Need to See a Doctor for Pink Eye? A Quick Decision Guide
Home care is usually reasonable if:
- You have redness, watering, mild itching or a gritty feeling
- Discharge is mostly watery or slightly sticky
- Your vision is normal (it may blur briefly from discharge but clears when you blink)
- You have no real eye pain or light sensitivity
- You don’t wear contact lenses
- You’re otherwise healthy, and symptoms are steady or improving
See an eye doctor promptly (within a day or so) if:
- You wear contact lenses
- You have thick yellow or green discharge, or your eyelids are glued shut in the morning
- Symptoms are getting worse, or not improving after a few days
- Symptoms last longer than about a week
- You have a weakened immune system, diabetes, or an existing eye condition
- You’ve had recent eye surgery
- The person with symptoms is a young child who seems unwell, or has a fever or eyelid swelling
Get care right away (same day or emergency) if:
- You have moderate to severe eye pain
- Your vision is blurry and doesn’t clear with blinking, or you have vision loss
- Light hurts your eyes
- You see halos around lights, or have a severe headache with nausea
- The eye was injured, or splashed with a chemical (rinse with clean water for several minutes first)
- The skin around the eye is red, swollen, hot or painful, or it hurts to move your eye
- A newborn has red eyes or discharge
These signs can point to a corneal infection, inflammation inside the eye, or a pressure problem, which are not ordinary pink eye and can threaten your vision without timely treatment. Call us at (800) 500-4667, or go to the nearest emergency department if we’re closed.
Viral vs. Bacterial vs. Allergic Pink Eye
The three main types often look similar, and there’s overlap, so these are typical patterns rather than hard rules.
Viral Pink Eye
Viral conjunctivitis is the most common type in adults. It often comes with or after a cold, sore throat or runny nose. It usually causes watery discharge, redness and a gritty or burning feeling, often starting in one eye and spreading to the other within a few days. It’s very contagious. Antibiotic drops don’t help viral infections; most cases run their course in one to two weeks, sometimes longer.
Adenovirus conjunctivitis is the most common form of viral pink eye. It spreads easily in homes, schools and workplaces and can be uncomfortable for a week or more. In some people it also affects the cornea, causing light sensitivity or blurry vision that lingers, which is a reason to be seen.
Bacterial Pink Eye
Bacterial conjunctivitis more often causes thick yellow or green discharge that keeps coming back during the day and can glue the eyelids together. It’s more common in children but happens in adults too. Mild cases sometimes clear on their own, but antibiotic drops or ointment prescribed by a doctor can shorten the illness and how long it’s contagious.
Allergic Pink Eye
Allergic conjunctivitis usually affects both eyes and causes intense itching, watering and puffy eyelids, often along with sneezing or a runny nose. It isn’t contagious. It tends to flare during pollen seasons, which can be long in East Tennessee; see when East Tennessee allergies attack your eyes for relief tips.
Adult Pink Eye: Is It Different?
Adults get pink eye for the same reasons children do, though in adults it’s more often viral than bacterial. Adults are also more likely to wear contact lenses or have other conditions, like dry eye or eyelid inflammation, that can look like pink eye or make it worse. If you’re an adult with a red eye that isn’t behaving like a typical mild case, or keeps coming back, have it examined.
Contact Lens Wearers Should Always Be Seen
If you wear contacts and develop a red, irritated eye, take your lenses out and see an eye doctor. A red eye in a contact lens wearer can be a corneal infection rather than simple pink eye, and some of these infections progress quickly. Wear glasses until your doctor says it’s safe to go back to lenses, and replace the lenses and case you were using. Good habits help prevent problems; see how to take care of your contact lenses.
What Helps at Home?
For mild cases:
- Cool or warm compresses on closed eyes for a few minutes, several times a day (use a clean cloth each time, and a separate one for each eye)
- Preservative-free artificial tears to soothe irritation
- Gently clean discharge from the lashes with a clean, damp cloth
- Skip eye makeup until it clears, and throw out eye makeup you used while infected
- For allergies, avoid triggers and try over-the-counter antihistamine eye drops
- Avoid “redness relief” whitening drops, which can make irritation worse with regular use
Don’t use leftover prescription drops or someone else’s medication. Some eye drops can make certain infections worse.
How Long Is Pink Eye Contagious?
Viral and bacterial pink eye spread through hands, shared towels, pillowcases and makeup, and contact with eye discharge. In general, viral pink eye can be contagious for as long as you have symptoms, and bacterial pink eye is usually much less contagious once you’ve been on antibiotic treatment for about a day. Allergic pink eye isn’t contagious at all.
To protect others:
- Wash your hands often, especially after touching your eyes or applying drops
- Don’t share towels, washcloths, pillows or makeup
- Change pillowcases and towels frequently
- Avoid touching or rubbing your eyes
When Can I Go Back to Work or School?
There’s no single rule. Many people can return once symptoms are improving and they can keep their hands clean, especially adults who don’t work in close contact with others. Many schools and child care centers have their own policies, and some ask that a child with bacterial pink eye start treatment first. If you work in health care, food service or child care, check with your employer. Your doctor can give you advice for your specific situation.
Getting Seen for Pink Eye in East Tennessee
If you aren’t sure whether your red eye is simple pink eye or something more, it’s always reasonable to have it checked. Our eye doctors diagnose and treat eye infections, allergies and other red-eye problems as part of our medical eye care services, at clinics in Harriman, Knoxville, Lenoir City, Morristown and Powell. Find the nearest location and schedule a visit.