closeup of a person putting an eye drop in their eye

pink eye symptoms:

important things to know, with advice from Dr. Cynthia E. Collins.

If you’ve ever woken up with red, itchy eyes or, worse, crusted over eyelids, you know pink eye can look and feel pretty icky. And it can be especially worrying if you don’t know what’s causing the symptoms. Pink eye, or conjunctivitis, is one of the most common eye infections in children and adults.1

There are four main reasons pink eye symptoms can develop. Conjunctivitis is one of the most common conditions MDLIVE doctors care for, so we asked Dr. Cynthia Collins, MDLIVE Clinical Medical Director, to share her advice on what causes pink eye and how to treat symptoms properly.

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Get the facts on pink eye:

Dr. Collins gives us the facts about how you contract pink eye, common symptoms, and how to treat it. If you develop symptoms, talk to an MDLIVE board-certified doctor in minutes.

What causes pink eye?

Pink eye is an infection or inflammation of the transparent membrane (conjunctiva) that lines your eyelid and the whites of your eyes. It causes the small blood vessels in your eyes to become inflamed, giving your eyes that telltale red or pink color.2 Pink eye has several causes, including:

  • Viruses
  • Bacteria
  • Chemicals or irritants
  • Allergies

Although pink eye is irritating, it’s rarely serious or likely to affect your vision. But certain types of pink eye are highly contagious. A proper diagnosis and early treatment can help prevent spreading it to others.

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Common symptoms of pink eye.

Pink eye can affect one or both eyes. Depending on the cause (most often viruses or bacteria), symptoms can include:


Red or pink color in the whites of the eyes

scratchy eye

A gritty or scratchy feeling

watery, tearing eye

Watery, teary eyes

eye pain

Blurred vision or increased sensitivity to light

burning eye

Itchy or burning eyes

swollen eye

Swollen eyelids


Thick white, yellow, or green discharge that crusts over the eyelashes during the night, often preventing you from opening your eyes in the morning

Dr. Collins’ perspective

“From allergies to infections, your eyes can look red, pink, or irritated for many reasons that aren’t always obvious. The good news is that most cases of conjunctivitis don’t require an office visit. They can be reliably diagnosed during a telehealth appointment. Because certain types of pink eye are infectious, you should talk to a doctor when you notice symptoms. Your doctor will help determine the root cause and provide a treatment plan so you can feel better faster.”

Is your pink eye contagious?

Some types of pink eye are highly contagious and can be spread for up to two weeks while symptoms are present.


a red, watery eye suffering from a viral infection
  • Often caused by the same viruses that cause the common cold or respiratory infections.
  • Commonly spread from the nose to the eyes or by an infected person sneezing or coughing near you.
  • Most common. Highly contagious.


A red, crusty eye suffering from a bacterial eye infection
  • Often caused by bacteria present on the skin or in the respiratory system, occurring with an ear infection or strep throat infections.
  • Commonly spread from touching the eye with unwashed hands or contaminated objects like makeup or contact lenses.
  • Less common than viral infections. Highly contagious.

Chemicals or irritants

A red, watery eye irritated from exposure to chemicals
  • Often caused by foreign objects or chemical splashes, including chlorine, air pollution, or car fumes.
  • Spread through swimming and exposure to chemicals, smog, or accidental contact.
  • Not contagious.

Allergies (allergic conjunctivitis)

A red, watery eye irritated by allergens
  • Often caused by allergens like pollen, cosmetics, shampoo, pet dander, or dust.
  • Histamines cause inflammation in the body and eyes, resulting in intensely itchy, pink, or red eyes. Allergic pink eye is not an infection.
  • Not contagious (unless a secondary viral or bacterial infection develops).

Is it pink eye or allergies?

When your eyes are inflamed, watery, and itchy, it can be hard to tell if it’s an infectious type of pink eye or an allergy, which is an autoimmune reaction and not contagious.3 There are a few slight differences that can help your MDLIVE doctor determine whether the inflammation is contagious or not:

  • Viral pink eye – eyes tend to be more watery than crusty.
  • Bacterial pink eye – discharge tends to be thick and makes the eyes stick together.
  • Allergies – eyes tend to be extremely itchy and watery.

Symptoms can, however, look the same for any type of pink eye, so it’s essential to get treatment early. Allergic conjunctivitis is more common if you already suffer from hay fever. In that case, your doctor may recommend tips like these for easing allergy symptoms.

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What treatments are available for pink eye?

Your doctor can recommend different treatments4 depending on which type of pink eye or allergic conjunctivitis you have:

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Likely needs antiviral eye drops, steroids, cold or warm compresses, or artificial tears. Antibiotic medications won’t work for this type.



Likely needs antibiotic eye drops, ointments, or pills.

Chemical or irritant

wash your face

Wash the affected eye with water for at least five minutes. If the irritant is chlorine or bleach, see a doctor right away. You can have an appointment with an MDLIVE doctor in 15 minutes or less.


blister packet of pills

Allergic conjunctivitis can go away on its own once the underlying allergy is treated with antihistamines or the allergen is removed. Or, your doctor may prescribe lubricating, decongestant, or antihistamine eye drops to ease symptoms.

How can you get help without going to a doctor’s office?

If your pink eye is contagious, early treatment helps prevent spreading it to others. MDLIVE offers fast, 24/7/365 appointments by phone or video. If you’re having severe symptoms5 or need relief fast, talk to a board-certified doctor who can send a prescription to the pharmacy of your choice. Your MDLIVE doctor can also help determine if something else is causing your pink eye.6

  • 5If you have a medical emergency, call 911. If you are experiencing severe eye pain, vision changes, or a severe headache, go to your local ER. Seek immediate medical attention if you experience a life-threatening condition or acute or severe symptoms.
  • 6Your MDLIVE doctor can help determine if other causes are present, such as corneal abrasion, herpes in the eye, scleritis, or subconjunctival hemorrhage.

Dr. Collins’ perspective

“Since viral or bacterial conjunctivitis is easily spread, I recommend these hygiene tips for limiting your exposure:

  1. Wash your hands often for at least 20 seconds.

  2. Don’t touch your eyes or face with your hands.

  3. Wash your face every day with a clean washcloth (this can also help prevent allergic conjunctivitis).

  4. Don’t share cosmetics, makeup, washcloths, or other personal eye and face care items.

  5. Change your pillowcases and sheets often.

  6. Wipe away mucus from an infected eye with a fresh, wet cotton ball or pad, and throw that away. Use another clean one for each swipe. Wash your hands afterward.

  7. Throw away makeup, cosmetics, or brushes you used while infected.

  8. Remove contact lenses immediately and throw them out. Use a new set after your symptoms clear up.

If you or family members develop pink eye symptoms, schedule an appointment with an MDLIVE doctor in minutes to get care fast and learn how to ease symptoms. Returning to work, school, or sports is generally acceptable when eye redness or discharge is no longer present for at least 24 hours.”

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