Conjunctivitis
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https://www.cdc.gov/conjunctivitis/treatment/index.html
Conjunctivitis ("pink eye") is inflammation of the conjunctiva, the thin membrane over the white of the eye and inside the eyelids.
Common patterns
| Type | Typical clues | Usual approach |
|---|---|---|
| Viral | Watery discharge, burning/gritty feeling, often begins in one eye then spreads, may occur with a cold | Often resolves on its own in 7-14 days. Antibiotics do not work. |
| Bacterial | Thick yellow or green discharge, eyelids stuck together on waking | May resolve without antibiotics, but prescribed antibiotic drops/ointment can shorten illness in selected cases. |
| Allergic | Itching is prominent, usually affects both eyes, watery/stringy discharge, sneezing or allergy symptoms | Avoid trigger, cool compresses, artificial tears; antihistamine eye drops may help. |
| Irritant | After smoke, chlorine, cosmetics, dust, or chemical exposure | Rinse the eye and avoid the irritant. |
Self-care
- Wash hands often and avoid touching or rubbing the eyes.
- Use a clean cool compress and preservative-free artificial tears.
- Do not share towels, pillowcases, cosmetics, or eye drops.
- Stop contact lenses until symptoms are fully gone and an eye clinician says it is safe to restart. A painful red eye in a contact-lens wearer needs prompt assessment because of risk of corneal infection.
- Do not use leftover antibiotic or steroid eye drops. Steroid drops can worsen certain infections.
Seek urgent medical assessment today if you have
- Moderate or severe eye pain
- Light sensitivity, blurred/reduced vision, or difficulty keeping the eye open
- Marked eyelid swelling, injury, chemical exposure, or a foreign body
- Contact lens use with a red eye
- Copious pus-like discharge
- Symptoms that worsen or do not improve
- A newborn with eye redness or discharge
Viral and bacterial conjunctivitis can spread easily. The CDC advises hygiene measures and notes that antibiotics do not help viral conjunctivitis; bacterial cases may or may not need topical antibiotics depending on severity and clinical assessment (CDC treatment guidance). Textbook of Family Medicine also notes that a red eye in a contact-lens wearer needs prompt evaluation for a corneal ulcer (p. 350).
Recent review evidence suggests antibiotics have benefit in acute bacterial conjunctivitis, but routine use should be individualized rather than assumed for every red eye (PMID 37482371).
Viral conjunctivitis treatment
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CDC viral conjunctivitis treatment 7 to 14 days antibiotics not effective warning signs
Viral conjunctivitis treatment
Most cases are self-limiting and improve in 7-14 days, though some last 2-3 weeks. There is no routine antiviral treatment for typical adenoviral conjunctivitis. CDC guidance states that antibiotic drops do not help viral conjunctivitis.
Relieve symptoms
- Cold clean compresses several times daily.
- Preservative-free artificial tears for grittiness or dryness.
- Oral analgesics such as acetaminophen or ibuprofen if safe for you.
- Avoid rubbing the eyes.
Prevent spread
- Wash hands frequently, especially after touching the face or applying drops.
- Do not share towels, washcloths, pillowcases, cosmetics, or eye drops.
- Discard eye makeup used during infection.
- Do not wear contact lenses until symptoms have completely resolved and an eye clinician says it is safe to resume.
Do not self-start
- Antibiotic eye drops, unless bacterial infection is diagnosed.
- Steroid eye drops. They can aggravate herpes eye disease and should only be used under ophthalmology supervision.
Get urgent same-day eye assessment for eye pain, significant light sensitivity, blurred/decreased vision, a red eye while using contact lenses, marked swelling, or symptoms worsening rather than improving. Herpes simplex or shingles-related conjunctivitis can require prescribed antiviral therapy, unlike ordinary adenoviral pink eye (CDC clinical overview).
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