Pink eye, or conjunctivitis, causes redness, discharge, and irritation in one or both eyes. The specific symptoms depend on whether the cause is viral, bacterial, or allergic, and knowing the differences helps you figure out what you’re dealing with and how long it will last.
Symptoms All Types Share
Regardless of the cause, pink eye produces a core set of symptoms: redness across the white of the eye, a gritty or burning sensation, tearing, and some degree of discharge. The redness comes from tiny blood vessels in the clear membrane covering the eye (the conjunctiva) becoming inflamed and dilated, which is why the eye looks pink or red rather than its normal white.
Swelling of the eyelids is common across all types, and many people notice their eyes feel “scratchy,” as if something small is stuck in them. These shared symptoms are what make pink eye easy to recognize but harder to pin down without looking at the specific details of the discharge, the pattern of which eyes are affected, and whether itching is a major feature.
Viral Pink Eye Symptoms
Viral conjunctivitis is the most common type. The discharge is watery and thin, not thick or sticky. It typically starts in one eye and then spreads to the other within a day or two. You may also have cold-like symptoms at the same time, such as a runny nose, sore throat, or mild congestion, since the same viruses that cause upper respiratory infections often cause viral pink eye.
The eyes water constantly, and you might notice mild sensitivity to light. Viral infections typically last up to two weeks, though some cases stretch longer. There’s no antibiotic treatment for viral pink eye because antibiotics don’t work on viruses. It resolves on its own, similar to a common cold.
Bacterial Pink Eye Symptoms
Bacterial conjunctivitis produces a noticeably different discharge: thick pus that is yellow or greenish. This discharge is heavy enough to cause the eyelids to stick together, especially after sleeping. Waking up with your eyes sealed shut and crusted over is one of the hallmarks of a bacterial infection.
Bacterial pink eye can affect one or both eyes and tends to feel more “goopy” than watery throughout the day. It usually lasts up to 10 days and often improves faster with antibiotic eye drops, though mild cases can clear without treatment.
Allergic Pink Eye Symptoms
The defining feature of allergic conjunctivitis is intense itching. While viral and bacterial types can cause mild itching, the severe, persistent urge to rub your eyes is a symptom only associated with eye allergies. Both eyes are almost always affected at the same time, unlike viral pink eye, which tends to start in one eye first.
The discharge in allergic pink eye is watery or slightly stringy, and you’ll often have other allergy symptoms alongside it: sneezing, a stuffy nose, or an itchy throat. The eyes may also appear puffy and swollen rather than just red. Allergic pink eye lasts as long as you’re around the allergen causing the reaction, whether that’s pollen, pet dander, or dust mites. It’s not contagious.
Quick Comparison by Type
- Viral: Watery discharge, starts in one eye, lasts up to two weeks, often accompanies a cold.
- Bacterial: Thick yellow or green pus, eyelids stuck together in the morning, lasts up to 10 days.
- Allergic: Intense itching, both eyes at once, watery discharge, lasts as long as the allergen exposure continues.
Contact Lens Wearers
If you wear contact lenses, you’re at risk for a specific form called giant papillary conjunctivitis. This causes red, itchy, sore eyes along with thick, stringy mucus and a persistent feeling that something is stuck in your eye. Over time, small bumps called papillae develop on the inside of the eyelids, and your lenses become increasingly uncomfortable or impossible to wear. Blurred vision and droopy eyelids can also develop. If your contacts suddenly feel intolerable and you’re producing unusual mucus, this is likely the cause.
How Long You’re Contagious
Viral and bacterial pink eye are both contagious. The general rule is that you remain contagious as long as you have tearing and matted eyes. For children, returning to school may be appropriate if there’s no fever and they can avoid touching their eyes and sharing items with others. Children who can’t reliably practice good hygiene should stay home until the symptoms have cleared.
Allergic pink eye is never contagious since it’s an immune response, not an infection. You can’t pass it to anyone.
Symptoms That Need Prompt Attention
Most pink eye is mild and self-limiting, but certain symptoms signal something more serious. Significant eye pain (not just irritation), sensitivity to light that makes it hard to keep your eyes open, blurred vision that doesn’t clear after blinking away discharge, or symptoms that worsen after several days instead of improving all warrant a prompt visit to a healthcare provider. These can indicate a deeper infection, a corneal ulcer, or a condition that isn’t actually pink eye at all.
Pink Eye in Newborns
Pink eye in newborns is a separate and more serious concern. Babies can develop conjunctivitis within days to weeks after birth, with puffy, red, tender eyelids and drainage from the eyes. The challenge is that different causes, including bacterial infections picked up during delivery, produce very similar symptoms in newborns, making the specific cause hard to identify by appearance alone.
Some newborn infections carry significant risks. Gonorrheal conjunctivitis produces thick pus and, if untreated, can lead to corneal ulcers and even blindness. Chlamydial conjunctivitis can spread beyond the eyes to the lungs. Herpes-related eye infections can cause severe eye damage. Any eye discharge or redness in a newborn in the first month of life needs immediate medical evaluation, since early treatment prevents these complications.