Conjunctivitis is inflammation of the inner clear layer of the eye called the conjunctiva and can affect one or both of the eyes. It is commonly called “pink eye” because it can cause the whites of the eye to turn red or pink due to inflammation and irritation. Pink eye has several different causes and often resolves on its own without medications in one to two weeks, but in some cases, medications may be needed. Pink eye can be caused by bacteria, viruses, allergens or irritants such as chemical fumes, contact lens wear, or foreign objects in the eye. Bacterial and viral pink eye are both contagious, and precautions should be taken to prevent the spread to others. It can be difficult to tell what has caused pink eye as symptoms of different types of pink eye can be similar. A healthcare provider can help determine what type of pink eye you have and discuss with you the appropriate treatments for infection and symptom relief.

Some of the most common symptoms of pink eye include eye redness, swelling, watery eyes, itching and discomfort. These symptoms can affect one or both eyes. Depending on the cause of pink eye, you may experience additional symptoms.

• Bacterial pink eye symptoms can also include:
  • Eye discharge, which is usually thick and can cause crusty eyes, sometimes leading to eyelids being stuck together upon waking
  • Ear infection can also be present, with ear pain and drainage
• Viral pink eye symptoms can also include:
  • Thin, watery eye discharge
  • Usually begins in one eye and spreads to the other within several days
  • Upper respiratory infections such as the cold or flu can also be present, along with their associated symptoms
• Allergic pink eye symptoms typically include:
  • Eyes that are teary and swollen
  • Intense eye itching
  • Both eyes are typically affected
  • May experience other allergic symptoms such as sneezing, congestion or itchy nose
• Irritant pink eye symptoms typically include:
  • Watery eyes
  • Eye discomfort
  • Mucus discharge can occur, depending on the irritant

It may be difficult to differentiate the specific cause of pink eye, as symptoms of viral, bacterial, allergic and irritant pink eye may be very similar or overlap. Seeking medical care is important to determine the cause of your symptoms and if treatment is necessary.

Pink eye that is caused by viruses or bacteria is very contagious. To help prevent the spread to others, it is important to wash your hands with soap and water often, avoid touching or rubbing your eyes, wash sheets and towels with hot water after use, and do not share any items such as towels, pillowcases or eye makeup.

Treatment for pink eye varies, depending on the cause:

• Most cases of bacterial pink eye are mild and get better without any medication. Mild cases may resolve in 2 to 5 days without treatment but could take up to 2 weeks to completely go away. However, if your symptoms are more severe or persist, a provider may prescribe antibiotic eye drops or eye ointments for bacterial pink eye. Antibiotics may help to shorten the length and severity of the infection. Bacterial pink eye is very contagious, and antibiotics help prevent the spread to others, which can be helpful when in daycare, school or work environments.
  Antibiotics may be prescribed if:
  • Eye irritation occurs with pus
  • You have a weakened immune system
  • Certain bacteria are suspected
  • You are a contact lens wearer
• When pink eye is caused by a virus, it can often be treated at home by applying a cool compress and using artificial tears to help relieve some of the inflammation and dry eye feelings. Viral pink eye will usually resolve on its own without treatment in one to two weeks. For symptom relief, over-the-counter (OTC) eye drops containing antihistamines or mast cell stabilizers (a group of medications that reduce allergy symptoms) may be recommended. In rare cases, an antiviral medication may be prescribed, for example when caused by the herpes simplex virus.
• When pink eye is caused by an allergen such as pet dander or pollen, it usually improves when the allergen is removed from your environment. At-home remedies such as applying a cool compress can also help. Sometimes, prescription and OTC eye drops and ointments can be used. Medications such as vasoconstrictors (which help reduce eye redness and inflammation), antihistamines and mast cell stabilizers can help relieve symptoms that occur from allergic pink eye. In some cases, your provider may recommend other allergy medications to improve symptoms.
• If an irritant such as chemical fumes or foreign objects like an eyelash is the cause of pink eye, removing the irritant is the first step in treatment. If it is a chemical, it is often recommended to flush the eyes with water and seek medical attention. Always seek medical attention if vision is affected.

When using any eye medication, be very careful not to touch the tip of the eye dropper or ointment tube to any surface, especially your hands or your eye to ensure the medication inside the container stays sterile. Discard the eye medication after completing your course of therapy to avoid spreading the germs to yourself or others. If you wear contact lenses, you should not wear them until your treatment is complete, symptoms have fully resolved, or until your eye doctor indicates it is safe to use again. Also, replace any eye makeup that you used before pink eye occurred, to prevent potential re-infection.

All medications have potential side effects, including eye drops and ointments for pink eye. Side effects are different depending on the type of medication you are using.

• Common side effects of prescription antibiotic eye drops and ointments used to treat bacterial pink eye include minor eye irritations such as redness, burning, stinging, discomfort or itching. This may occur as soon as drops are placed in the eye or at any time with extended use and typically resolve when the eye drops are discontinued. Eye ointments can cause temporary blurred vision as the ointment slowly absorbs. As with all antibiotic medications, extended use may result in overgrowth of organisms that can no longer be killed by the antibiotic (called antibiotic resistance), including fungi. To prevent this and other complications, only use antibiotic eye drops and ointments as directed by your provider and for the duration instructed.
• Viral pink eye typically resolves on its own without the need for medication. However, in the rare case of viral pink eye due to herpes simplex virus or shingles, prescription eye drops or ointments may be recommended. Side effects of these medications may include temporary blurred vision (ointment or gel formulations), eye irritation, redness of the eye, mild temporary burning or stinging when first applying the medication, swelling of the eyelid and a rare eye condition called punctate keratitis (a condition of the eye caused by the death of small groups of cells on the surface of the eye, with symptoms of red watery eyes, sensitivity to light, possible bluffed vision; often a feeling as if a foreign object is in the eye).
• Prescription medications used to treat the symptoms of allergic pink eye include antihistamines and mast cell stabilizers. Mast cell stabilizers are medications that help reduce allergy eye symptoms such as itchy, watery and swollen red eyes. Common side effects from these medications include temporary eye burning, stinging and irritation, headaches, bitter taste and viral upper respiratory tract infection. These side effects are usually mild and resolve once medication is stopped.

More serious but rare side effects of any prescription eye drop or ointment can include hypersensitivity or allergic reactions, inflammation of the cornea, swelling of the area around the eye or face, sensation that a foreign object is in your eye, sensitivity to light, blurred vision, tearing, dryness, eye pain, nausea and dizziness. Seek medical help immediately if any of these symptoms occur.

Some prescription eye drops and ointments are safe for children. However, every medication has its own FDA approved indication, including age of patient, safety profile and clinical studies conducted at certain pediatric ages. Speak with your child’s healthcare provider about which medication is safe for them to use.

During your Walgreens Virtual Healthcare visit, you will start by completing an online questionnaire. In this intake form you will answer questions about your current symptoms and provide details regarding your medication and health history. You will also be asked to provide close-up photos of each eye. A doctor or nurse practitioner will connect with you via secure online chat, and if appropriate, prescribe medication. A virtual visit is not appropriate if you wear contact lenses, have sudden onset vision loss, severe eye pain or recent trauma to the eye or are currently pregnant or breastfeeding, and you should seek an in-person provider instead.