Pink eye (conjunctivitis) has three leading causes that require different treatments: viral infections, bacterial infections, and allergic reactions. Distinguishing between them helps determine appropriate care.
Viral pink eye characteristics: Watery discharge is the hallmark of viral conjunctivitis. The eyes produce clear, thin tears rather than thick, colored discharge.
In most cases, both eyes are affected, though one eye may start first and spread to the other within 1-2 days.
Cold symptoms often accompany viral pink eye, including a runny nose, sore throat, or cough.
Duration: Typically resolves within 7-10 days without treatment.
Bacterial pink eye characteristics: Thick, colored discharge (yellow, green, or white) that may cause eyelids to stick together, especially after sleeping.
One eye affected initially, though the infection can spread to the other eye.
No cold symptoms are typically present with isolated bacterial conjunctivitis.
Rapid onset with symptoms developing quickly over 24-48 hours.
Duration: Usually improves within 2-3 days with antibiotic treatment.
Allergic pink eye characteristics: Itching is the dominant symptom, often severe and persistent.
Both eyes affected simultaneously with similar symptoms.
Clear, watery discharge similar to viral pink eye but with more prominent itching.
Seasonal patterns or trigger exposure (pets, pollen, dust) coinciding with symptoms.
Other allergy symptoms include sneezing, a runny nose, or skin reactions.
Duration: Continues as long as allergen exposure persists.
Key differentiating factors: Discharge type is the most reliable indicator – thick and colored suggests bacterial, watery suggests viral or allergic.
Itching intensity helps distinguish allergic conjunctivitis from infectious causes.
Associated symptoms provide context – cold symptoms suggest viral, allergy symptoms suggest allergic causes.
Treatment implications:
- Viral: Supportive care, no antibiotics needed
- Bacterial: Antibiotic eye drops required
- Allergic: Antihistamines and allergen avoidance
When to seek care:
- Severe pain or vision changes
- Thick, persistent discharge
- Symptoms worsening after 2-3 days
- Newborn with any eye discharge
If you’re experiencing pink eye symptoms, ChatRx can help determine the likely cause and recommend appropriate treatment based on your specific symptoms.
