Pink eye in adults typically causes redness in the white of one or both eyes, a gritty or irritated feeling, discharge that can range from watery to thick and yellowish, and crusting that may seal your eyelids shut overnight. These core symptoms show up across all types of conjunctivitis, but the specific pattern of discharge, itching, and which eyes are affected can tell you a lot about what’s causing it.
Core Symptoms Across All Types
Regardless of the cause, pink eye shares a recognizable set of symptoms. You’ll notice a pink or red tint in the white of your eye from inflamed blood vessels, along with swelling of the eyelid or the thin membrane covering the eye’s surface. Most people describe a gritty sensation, like something is stuck in the eye, paired with an urge to rub it. Tearing is common, and many people develop sensitivity to light.
One of the most distinctive signs is morning crusting. Discharge accumulates overnight and dries along your lash line, sometimes forming a crust thick enough that you need a warm, damp cloth to open your eyes. The color and consistency of that discharge is one of the best clues to what type of pink eye you’re dealing with.
Viral Pink Eye Symptoms
Viral conjunctivitis is the most common form in adults. It often starts in one eye and spreads to the other within a day or two. The hallmark is a watery, thin discharge rather than anything thick or colored. Your eyes will look red and feel irritated, and you may notice swollen lymph nodes near your ear on the affected side. It frequently shows up alongside or right after a cold, sore throat, or upper respiratory infection.
Viral pink eye typically lasts up to two weeks. It stays contagious as long as you have tearing and discharge, so the full duration can overlap with your contagious window. There’s no antibiotic treatment for it since antibiotics only work on bacteria. Cool compresses and artificial tears are the main ways to manage discomfort while it resolves on its own.
Bacterial Pink Eye Symptoms
Bacterial conjunctivitis also tends to start in one eye before spreading to the other, but the discharge looks noticeably different. Instead of clear or watery, it’s thick, sticky, and yellow or greenish. This is the type most likely to glue your eyelids together in the morning. The redness and irritation feel similar to the viral form, but the heavy, colored discharge is the giveaway.
Bacterial infections usually last up to 10 days. Antibiotic eye drops can shorten that timeline and reduce how long you’re contagious. If you wear contact lenses and develop these symptoms, remove them immediately. Contact lenses can trap bacteria against the eye’s surface and make the infection worse.
Allergic Pink Eye Symptoms
Allergic conjunctivitis looks and feels different in a few key ways. The most obvious: intense itching. While all forms of pink eye can itch somewhat, allergic conjunctivitis makes itching the dominant symptom. The discharge is watery rather than thick, and both eyes are almost always affected at the same time, since both are exposed to the same allergen.
Swelling tends to be more prominent, and you’ll often have other allergy symptoms like sneezing or a runny nose. Allergic pink eye isn’t contagious, and it responds to antihistamine eye drops rather than antibiotics. It commonly flares during pollen seasons or after exposure to pet dander, dust, or other environmental triggers.
Contact Lens-Related Pink Eye
If you wear contacts, you’re susceptible to a specific form called giant papillary conjunctivitis. Symptoms usually affect both eyes and include redness, itching or soreness, blurred vision from thick or stringy mucus, and a persistent foreign body sensation. Your lenses may feel like they won’t stay in place or are suddenly uncomfortable despite fitting fine before.
In some cases, your eyelid may appear slightly droopy or inflamed. A doctor can confirm this type by flipping your upper eyelid to check for small raised bumps on the inner surface. Switching to daily disposable lenses or taking a break from contacts altogether is typically part of the treatment.
Sexually Transmitted Infections and Pink Eye
Chlamydia and gonorrhea can both cause conjunctivitis in adults, usually through hand-to-eye transmission after contact with infected genital secretions. Chlamydial conjunctivitis has a distinct pattern: it typically affects one eye, produces a mucus-like discharge, and persists for weeks or even months without improving. If you’ve been using antibiotic eye drops and the infection isn’t clearing up after three weeks, this is one of the possibilities your doctor will consider.
Swollen lymph nodes near the ear on the affected side are common. Left untreated, it can eventually cause clouding and blood vessel growth on the cornea, which threatens your vision. This form requires oral antibiotics, not just topical drops, and sexual partners need treatment as well.
How to Tell What Type You Have
A few quick distinctions can help you narrow it down:
- Watery discharge, one eye first: likely viral
- Thick yellow or green discharge, one eye first: likely bacterial
- Intense itching, both eyes, watery discharge: likely allergic
- Persistent symptoms for weeks, not responding to drops: possible STI-related cause
- Blurry vision with stringy mucus, contact lens wearer: possible giant papillary conjunctivitis
Symptoms That Signal Something More Serious
Most pink eye is uncomfortable but harmless. A few symptoms, however, suggest something beyond routine conjunctivitis. Significant eye pain (not just irritation), sudden changes in vision or persistent blurriness, severe light sensitivity, or symptoms that keep getting worse after several days all warrant prompt attention. These can point to conditions like keratitis, uveitis, or acute glaucoma, which require different and more urgent treatment than standard pink eye.
If you wear contact lenses and develop redness with pain, take them out and get evaluated quickly. Contact lens wearers have a higher risk of corneal infections, which can escalate fast if mistaken for simple conjunctivitis.