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Pink Eye: What You Should Know

Conjunctivitis, also known as pink eye, is an inflammation of the conjunctiva -- the thin, clear tissue that lies over the white part of the eye and lines the inside of the eyelid.

Pink eye can be contagious and is often associated with children, but anyone can get it. Treatment will depend on whether your pink eye is due to a virus, bacteria, allergies, or an irritating substance. (Photo Credit: iStock/Getty Images)

Pink eye causes redness, itching, pain, burning, discharge, and swelling in and around the eyes. It might make your vision blurry and make you sensitive to light, but you'll still be able to see. 

Pink eye can happen to anyone, regardless of age, but it's common in children. It can be highly contagious, spreading rapidly in schools and day-care centers, but it's rarely serious. It's unlikely to damage your vision, especially if you find and treat it quickly. When you take care to prevent its spread and do everything your doctor suggests, pink eye clears up with no long-term problems.

What does pink eye look like?

Pink eye looks like the whites of one or both eyes are pink or red. You may have swelling around your eyes and could see white, yellow, or green discharge.

Pink eye vs. Stye

Stye and pink eye are eye infections with similar symptoms. Like pink eye, symptoms of a stye include itchy, sore, and watery eyes and sensitivity to light. But unlike conjunctivitis, a stye causes a small pus-filled bump in the upper or lower eyelid. It also happens due to a bacterial infection, most commonly Staphylococcus aureus and Staphylococcus epidermidis.

Several things could be to blame, but the most common causes of pink eye are:

Viruses, including the kind that causes the common cold

Bacteria

Allergens such as pollen, dust, or smoke. It could also be due to a special type of allergy that affects some people who wear contact lenses.

Other causes include:

Irritants such as shampoos, dirt, smoke, and pool chlorine

A reaction to eye drops

A reaction to wearing contact lens

Fungi, amoebas, and parasites

Conjunctivitis sometimes results from an STD. Gonorrhea can bring on a rare but dangerous form of bacterial conjunctivitis. It can lead to vision loss if you don't treat it. Chlamydia can cause conjunctivitis in adults. If you have chlamydia, gonorrhea, or other bacteria in your body when you give birth, you can pass pink eye to your baby through your birth canal.

Pink eye, caused by some bacteria and viruses, can spread quickly from person to person. But it isn't a serious health risk if diagnosed promptly. However, if it happens in a newborn, tell a doctor immediately, as it might be an infection that can affect the baby's eyesight.

Who is at risk for pink eye?

Though pink eye can happen to anyone, newborn babies are at a higher risk of having it. You also may be more at risk if:

You interact with someone who has pink eye.

You just had a cough, cold, or other respiratory infection.

You wear contact lenses.

You've been exposed to an allergen.

Pink eye and COVID-19

Pink eye may be the only symptom of COVID when the virus infects the eyes, according to a 2020 case report. But more research is needed, as it's rarely the sole COVID symptom. Most people with COVID show symptoms such as fever or chills, cough, tiredness, difficulty breathing, loss of taste or smell, sore throat, runny nose, vomiting, and body aches.

Is pink eye contagious?

Pink eye may be contagious, depending on the type. Cases caused by a viral or bacterial infection can spread to other people, but those caused by allergies or irritants don't.

Pink eye symptoms may be the same regardless of their cause. It's hard to know which type of conjunctivitis you have without your doctor testing it. So, regularly wash your hands and avoid touching your eyes to prevent spreading or catching it.

Viral pink eye

Viral pink eye is the most common and may be the most contagious form. It's usually caused by the virus that causes the common cold. It tends to start in one eye, causing lots of tears and a watery discharge. Within 24-48 hours, it affects the other eye, too. You might feel a swollen lymph node in front of your ear or under your jawbone.

You may also have cold symptoms such as a fever, sore throat, and runny nose.

Viral pink eye has no cure but will go away on its own. Your symptoms may worsen in the first 3-5 days, but you'll get better within 1-3 weeks.

Bacterial pink eye 

Bacteria that cause pink eye include:

Staphylococcus aureus

Streptococcus pneumoniae

Haemophilus influenzae

Moraxella catarrhalis

Chlamydia trachomatis

Neisseria gonorrhoeae

Bacterial strains affect children more often than adults. These infections spread easily and are typically seen from December through April. Bacterial pink eye usually infects one eye but can show up in both. Your eye will release a lot of yellow, white, or green pus and mucus. If treated with antibiotic eye drops or ointment, it goes away quickly without causing eye problems. 

Allergic conjunctivitis

Allergic pink eye may occur when allergens in the air, such as dust mites, cat dander, and pollen, enter the eye. It often occurs in people with allergic conditions such as hay fever and asthma. Symptoms such as tearing, itching, and redness in the eyes may happen suddenly, seasonally, or all year round. You might also have an itchy, runny nose and sneezing.

It doesn't spread from person to person, and symptoms usually go away once you're no longer exposed to the allergen.

You can manage allergic conjunctivitis with allergy eye drops.

Pink eye in newborns

Pink eye in newborns is called neonatal conjunctivitis or ophthalmia neonatorum. It can be caused by a bacterial or viral infection, a blocked tear duct, or irritation from topical medicines given to the baby at birth. 

It's a serious form of pink eye, so get medical help immediately if your baby has discharge in their eye or if their eyelids look puffy and tender. Quick treatment can prevent permanent eye damage or blindness. A doctor might treat it with antibiotics.

Giant papillary conjunctivitis

Giant papillary conjunctivitis (GPC) is linked to long-term contact lens use, but it can also happen around surgery stitches near the eyelid. Doctors think it's an allergic reaction to a chronic foreign body in the eyes.

See a doctor immediately if you notice pink eye symptoms, especially if you wear contacts, an artificial eye, or have stitches around your eyes. Left untreated, GPC can cause serious eye problems.

Your doctor may recommend eye drops or ointments and advise you to change your contact lenses or reduce the number of times you wear them. You could feel better within a week of starting treatment but may need to stop wearing contact lenses for a month to fully heal.

You can also reduce your risk of GPC by using lens solutions with unpreserved salt solution and removing your contact lenses before bed.

Conjunctivitis symptoms depend on the cause of the inflammation, but may include:

More tears than usual

Green or white discharge from the eye

Burning eyes

Blurred vision

Light sensitivity

Swollen lymph nodes (often from a viral infection)

Early-stage pink eye symptoms

The earliest signs of pink eye include:

Redness in the white of the eye or inner eyelid

Swollen conjunctiva

Thick discharge that crusts over the eyelashes, especially after sleep. It can make your eyelids stick shut when you wake up.

Itchy eyes

Call your doctor if:

There's a lot of yellow or green discharge from your eye, or if your eyelids are stuck together in the morning

You have severe pain in your eye when you look into a bright light

Your vision is affected by pink eye

You have a high fever, shaking chills, face pain, or vision loss (very unlikely symptoms)

Call your doctor right away if your newborn has pink eye, as it could permanently harm their vision.

Your eye doctor may tell you to come into the office immediately. If you're an adult with a mild case of pink eye and can't reach your eye doctor, call your primary care doctor. 

If your symptoms remain mild but the redness doesn't improve within 2 weeks, you need to consult your eye doctor.

Your eye doctor will ask you questions about your symptoms, such as: 

When did you start having your eye symptoms?

Does anyone else living with you have the same symptoms?

Does your eye release any discharge?

Is the discharge watery, thin, thick, sticky, or mucus-like?

Are your eyes very itchy?

Have you ever had seasonal allergies?

They may also give you an eye exam and use a cotton swab to remove fluid from your eyelid to test in a lab. Test results will show bacteria or viruses that may have caused conjunctivitis, including those that can cause an STD. Then, your doctor can prescribe the right treatment.

If your doctor tells you that you have pink eye, you may want to ask these questions:

Is my pink eye contagious?

If it's contagious, how do I avoid spreading it?

Do I need to stay home from work or school?

What is commonly misdiagnosed as pink eye?

Don't assume that all red, irritated, or swollen eyes are pink eye (viral conjunctivitis). Your symptoms could also be caused by seasonal allergies, a stye, iritis, chalazion (an inflammation of the gland along the eyelid), or blepharitis (an inflammation or infection of the skin along the eyelid). These conditions aren't contagious.

Conjunctivitis treatment depends on the cause:

Viruses. Viruses that cause the common cold can also cause pink eye. Just as a cold must run its course, the same is true for this form of conjunctivitis, which usually lasts 4-7 days. Remember, it can be very contagious, so do everything you can to prevent its spread. Antibiotics won't help anything caused by a virus. Pink eye caused by the herpes virus can be serious, however, and may need prescription antiviral eye drops, ointment, or pills.

Bacteria.  If bacteria, including those related to STDs, cause your pink eye, you'll take antibiotics. You may need to apply eye drops or ointments to the inside of your eyelid three to four times a day for 5-7 days. For more stubborn infections or rare cases of pink eye caused by gonorrhea or chlamydia, you might get an oral antibiotic. You'll need to take pills for several days. The infection should improve within a week. Take or use the medicines as instructed by your doctor, even after the symptoms go away.

Irritants.  For pink eye caused by an irritating substance, use water to wash the substance from the eye for 5 minutes. Your eyes should begin to improve within 4 hours. If your conjunctivitis is caused by acid or alkaline material such as bleach, immediately rinse the eyes with lots of water and call your doctor immediately.

Allergies.  Conjunctivitis tied to allergies should improve once you get your allergy treated and avoid your allergy triggers. Antihistamines (either oral or drops) can give relief in the meantime. Remember that taking antihistamines by mouth can make your eyes even drier if you have dry eyes. See your doctor if you think your pink eye is due to an allergy.

Your eye doctor may have you return in several days to ensure your pink eye improves with the medication prescribed.

How long is pink eye contagious after starting drops?

Pink eye is contagious until your eyes stop tearing and releasing a discharge, whether or not you've started eye drops. About 24 hours after starting antibiotic drops, you should see improvement in symptoms.

How long does pink eye last?

Pink eye may last 2-5 days for mild bacterial infections without treatment. But sometimes, it may last up to 2 weeks. Antibiotics can shorten the duration of bacterial conjunctivitis.

Pink eye lasts 7-14 days for most viral infections. However, some cases of viral conjunctivitis may need 2-3 weeks to completely clear.

A lot of it comes down to cleanliness:

Wash your hands often with soap and warm water, especially before eating.

Keep your eyes clean. Wash any discharge from your eyes several times a day using a fresh cotton ball or paper towel. Afterward, discard the cotton ball or paper towel and wash your hands with soap and warm water.

Wash or change your pillowcase every day until the infection goes away. Clean your bed linens, pillowcases, and towels in hot water and detergent when you do the laundry. Keep your towels, washcloths, and pillows separate from those of others, or use paper towels.

Don't touch or rub your infected eye with your fingers. Use tissues to wipe.

While treating pink eye, don't wear -- and never share -- eye makeup, eye drops, or contact lenses. Wear glasses until your eye heals. Throw away disposable lenses, or be sure to clean extended-wear lenses and all eyewear cases.

Use a warm compress, such as a washcloth soaked in warm water. Put it on your eye for a few minutes, three to four times a day. This will ease your pain and help break up some of the crust that may form on your eyelashes.

Don't put a patch over your eye. It may worsen the infection.

Protect your eyes from dirt and other things that irritate them.

Limit eye drops. Don't use them for more than a few days unless your eye doctor tells you to. Nonprescription "artificial tears," a type of eye drops, may help ease itching and burning from the irritants causing your pink eye. But you shouldn't use other types of eye drops because they may irritate the eyes, including those promoted to treat eye redness. Don't use the same bottle of drops for an uninfected eye.

If your child has bacterial or viral pink eye, keep them home from school or day care until their eyes no longer tear up or produce discharge. Once symptoms have cleared up, it's safe to go back to school or work, but everyone should continue to maintain good hygiene practices.

Usually, pink eye clears up on its own or after you take any medicines your doctor prescribes, with no lasting problems. Mild pink eye is almost always harmless and will get better without treatment.

But some forms of conjunctivitis can become serious and may affect your ability to see because they can scar your cornea, the clear protective covering at the front of your eye. They include conjunctivitis caused by gonorrhea, chlamydia, or certain strains of the adenovirus.

If caused by a virus, pink eye gets better in 2-3 weeks. If caused by bacteria, antibiotics may speed up the healing process.

See a doctor immediately if you have symptoms, including:

Eye pain

Blurry vision

Light sensitivity

Feeling something in your eyes

You can take steps to prevent pink eye:

Keep your hands clean. Wash them thoroughly and often, especially if you touch your eye or the area around it.

Don't overshare. Infection can also enter the body through your nose and mouth. So, don't share washcloths, bath towels, pillowcases, or handkerchiefs with others, even with family. Don't use other people's eyedrops or cosmetics, especially eyeliner pencils and mascara.

Avoid allergy triggers. If allergies cause your pink eye, avoid the allergens that trigger your symptoms. Don't rub your eyes, which may make it worse. Splash your face and eyes with cold water, or use a cool compress. Use aqueous-based "artificial tears." Stick with your allergy treatment.

Clean contact lenses carefully. Sometimes, chemicals used to clean contact lenses can irritate your eyes. You may find relief if you change how you clean your contacts, but be sure to disinfect them before you put them back in your eyes.

Throw away infected items.To avoid another infection, throw away makeup tools, contact lenses, and the contact lens solution and cases you used when you had pink eye.

Pink eye causes red, itchy, watery eyes that produce discharge. Mild cases of conjunctivitis may go away on their own, but it's best to see a doctor for diagnosis and proper treatment. Pink eye doesn't usually have major complications. But if a newborn has red, puffy eyes, they should receive treatment immediately to avoid damage to their vision. Maintain good personal hygiene and avoid touching your eyes, even after your pink eye clears.

Should I stay home if I have pink eye?

Stay at home if you have pink eye symptoms such as tearing and discharge, because you could spread it to others. Talk to your doctor to confirm if your form of pink eye isn't contagious.

How long do you stay contagious with pink eye?

You're contagious with pink eye as long as you have eye tearing and discharge.

What kills the pink eye-causing germs on surfaces?

An antimicrobial cleaner such as bleach can kill the bacteria or viruses that cause pink eye on most surfaces.

How To Handle Running With Allergies

Running with allergies can bring on unexpected challenges that ultimately effect your performance or halt your run entirely. The reason: "Running increases your breathing rate, which makes you more likely to inhale more allergens," explains Vijay Jotwani, M.D., a primary care sports medicine physician at Houston Methodist.

That means you'll not only be dealing with spring-induced wheezing, but also common symptoms of seasonal allergies such as congestion, runny nose, a scratchy throat, and eye irritation—basically, everything that would make you swear off nature and embrace treadmill training for the foreseeable future.

But just because the slightest tinge of yellow dust in the air makes you sneeze doesn't mean you need to give up outdoor miles. Rather, it's all about knowing what you're getting yourself into and properly preparing for it.

Related Stories How to Manage Running With Allergies Pinpoint Your Allergens

First, if your seasonal allergies are bad enough that they're affecting your run, you may want to get tested by an allergist to find out what you're allergic to (tree pollen? Grass pollen? Other outdoor allergens?) and how sensitive you are, says Stanley Fineman, M.D., a spokesperson for the American College of Allergy, Asthma and Immunology. "Know what conditions will make your symptoms flare can help you avoid a lot of grief," he says.

Check Pollen Counts

Once you know your triggers, you can check local pollen counts on sites such as pollen.Com. Pollen concentrations are usually highest from 5 a.M. To 10 a.M., according to the American Academy of Allergy, Asthma, and Immunology. "Waiting until the afternoon and evening may be more helpful to reduce exposure and make your run feel easier," says David Erstein, M.D., a New York-based allergist and immunologist.

Take Meds as Prevention

Knowing what sets off your symptoms can also help you take preventative measures before heading outside. "If your symptoms aren't too bad and only warrant an 'as needed approach,' taking an oral antihistamine like Allegra, Zyrtec, or Claritin at least one to two hours before a run may be a good enough strategy for you," says Erstein.

Otherwise, an allergist may recommend a nasal steroid spray or additional prescription meds to make the run more bearable, adds Fineman. If you're dealing with itchy eyes, over-the-counter antihistamine eye drops like Zaditor can provide serious relief on the run.

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Zaditor Zaditor Eye Drops Take Precautions

When you are outside, you should take some precautions to limit your exposure to pollen. "I recommend wearing a hat with a brim and wrap-around sunglasses to keep the pollen out of your eyes, because that's a very sensitive area," says Fineman. Plus, "wearing a neck gaiter or bandana to cover your nose and mouth can limit the amount of pollen that gets into your respiratory passages," says Erstein.

It may also be worth decreasing your intensity and pace, says Jotwani. Remember, the heavier you're breathing, the more allergens you're inhaling, so if the pollen count is super high, you may be better off taking your interval run into the gym.

Pay Attention to Practices After a Run

What you do after your run is just as important as how you protect yourself during it. "Get out of those workout clothes ASAP and shower as soon as you get home," says Erstein. "Pollens can stick to you, and changing and showering will minimize residual and continuous exposure." That doesn't mean you're completely in the clear, though. "Once you trigger the body's immune response, it can take some time for allergy symptoms to resolve," says Jotwani.

Related Story Stay Inside When Necessary

There are a few times where you'd be better off skipping your outdoor run completely.

Warm fronts tend to cause a rise in pollen counts, says Jotwani, while windy days whisk the pollen around, which can cause more suffering. And during allergy season, you'll also want to avoid running when you're super tired or sick; "a lowered and overworked immune system can make you more sensitive to allergens that may not have otherwise bothered you," says Erstein.

Meanwhile, a great time to pound the pavement is immediately after a storm. "A good rain shower helps wash away the pollens suspended in the air," he adds.

The good news? It's pretty easy to run allergy symptom-free (most days, at least!). The bad news: There goes one of your excuses for flaking on that tough workout.

Related Story

Ashley Mateo is a writer, editor, and UESCA- and RRCA-certified running coach who has contributed to Runner's World, Bicycling, Women's Health, Health, Shape, Self, and more. She'll go anywhere in the world once—even if it's just for a good story. Also into: good pizza, good beer, and good photos.

The Evolution Of A Big, Ugly Cry

April 17, 2024

4 min read

The Evolution of a Big, Ugly Cry

Uncontrollable sobbing is uniquely human, and it may be our emotions running out of our faces, a way to connect us with other people

By Bethany Brookshire

MTStock Studio/Getty Images

I cry on a lot of planes, and often for no good reason. I did it just the other day, deep in the throes of a romance novel at 30,000 feet. I'm never a pretty, feminine weeper. Emily Henry's Book Lovers didn't leave my eyes delicately swimming with tears. My entire body twisted as I tried to hide gasping, gut-wrenching sobs.

The humiliation of asking a flight attendant for more tissues after blowing through your pathetic supply, trapped in a tiny public space, is compounded by the fact that a good, healthy cry is never simply picturesque droplets coursing down your shining cheeks.

No. Your eyes are red and sore, and your nose will just not stop running. Not the thick gobbets of mucus from the tail end of a cold, but thin, pale streams that trickle obscenely into your mouth. But while that stream is gross, it's also wondrous. Because when you sob, your nose is sobbing with you. And when you cry at a Hallmark commercial, you're doing something uniquely human. Whether in joy or sorrow, your tears, visible signs of emotion, can't be contained by your eyes. Your feelings are running out of your face through every available orifice.

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Writers may say "her eyes were brimming with tears," but a healthy eye is brimming at all times. There are, in fact, three types of tears. The subtle basal tear—which is different from the ones I sob— comes from tiny glands under your eyelids, called the accessory lacrimal glands. These tears may taste like salty water, but really they are triple-layered complexes of water, salts, proteins, fats and hormones that produce a minorly-disgusting film that keeps the eye moist.

Basal tears sluice constantly over the eye, and pool in a place called the lacrimal lake, in the inside corner next to your nose. That lake has two tiny outlets, the lacrimal puncta, which you can see on the inside corners of your bottom and top eyelid. Those tiny holes drain through small channels to the nasolacrimal duct. As you can probably guess from the name, this duct drains right down into the nose. Basal tears usually go unnoticed, trickling down the back of the nose, swallowed at random.

The drama arrives with our other two types of tears, reflex tears and psychoemotional tears. These are the ones we notice, the ones that come pouring out of our eyes, and are produced by the main lacrimal gland (lacrima is the Latin word for tear), located on the upper, outside edge of the eye. Reflex tears help rid the eye of irritants—from the chemicals released when you chop onions to bits of sand or grit. Psychoemotional tears are the ones that emerge in response to emotion, from grief to shame to joy. In these cases, the lacrimal gland kicks into high gear, producing lots of watery tears, and leaving it to the nose to deal with the overflow.

Many animals have a reflex tear response. Yet emotional tears—even the ones dribbling out of your nose—are more than disgusting mixes of salt, water, proteins and hormones, formed into a slurry with your mucus. They are something that only humans seem to do.

People spend a lot of time asking what it is that makes us something "more" or "different" from other animals. Scientists have proposed many ideas that might have been the key to our world takeover, from bipedalism to language to tool use. But the more scientists learn about the world, the more our "superiorities" are shown to be false. Bipedalism and thumbs aren't unique. Crows and primates make and use tools. Elephants and other highly social creatures take on long-term parental care. Animals exhibit social learning and complex social structures. Language may be one area where people are set apart, but whales, elephants, birds and other animals communicate in sophisticated ways. Even reflex tears are easily spotted in dogs or cats—as their remnants form the gross gunk doting pet parents wipe from their eyes.

Scientists love to float those reasons, but what about this one: Humans are the only species that weeps. Babies of many species have distress cries. But only humans pair those cries with tears and keep the skill as adults. We are the only species that has a big, open, gushing, response to emotion—whether our own or someone else's. (Adult dogs can make distress cries, and a 2022 study suggested that they might well up a little when ecstatically reuniting with their owners, but other experts were skeptical about the results.)

No one truly knows why it is that humans cry with emotion, but one hypothesis is that our tears help us connect to each other. One study showed that adding tears to any emotional face made other people see the face as sadder. People are more likely to offer help when they see tears. Tears, flowing from our eyes and noses alike are displays of our emotions. They are also invitations. Invitations to other people to come and help. Invitations to join with us, to feel what we feel.

Tears are inherently vulnerable, which is part of what makes them an attachment behavior. They signal that we are feeling something strongly—that we might need something. Comfort, understanding, the simple presence of another person. They're a reminder that we are intensely social creatures—that we derive our biggest strength from our emotional attachments to each other.

Perhaps previous generations of scientists clung on to tool use and thumbs to explain humanity because they appeared solid. Unemotional. There's nothing vulnerable about tools. It can be uncomfortable to think that crying might be important—especially when most scientists are men, and women cry five times more often. Most of us have been told that crying is weak. For children. Illogical. But as I again sit on an airplane, bawling through the film Crazy Rich Asians, I might be at my most human. I'm dripping out of every hole in my face, and it's because I'm emotionally connected to the people on my screen, feeling a tiny bit of what they feel. There is nothing more human than that.

This is an opinion and analysis article, and the views expressed by the author or authors are not necessarily those of Scientific American.

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