What Should I Do If I Have Pink Eye?

Most cases of pink eye clear up on their own within one to two weeks, so the first thing to do is take a breath and resist the urge to panic. What you should do next depends on which type of conjunctivitis you have, because viral, bacterial, and allergic pink eye each call for different responses. The right home care can cut your discomfort significantly, but certain warning signs mean you should get to a doctor quickly rather than toughing it out.

Figure Out Which Type You’re Dealing With

Pink eye is a catch-all term for inflammation of the conjunctiva, the clear membrane over the white of your eye and the inside of your eyelids. The three main flavors are viral, bacterial, and allergic, and they look and feel different enough that you can often narrow it down at home.

Viral conjunctivitis is the most common infectious type by a wide margin. Adenoviruses alone account for up to 65 to 90 percent of viral cases.¹ It usually starts in one eye and spreads to the other within a day or two. Your eye will be red and watery, often with a thin, clear discharge. Many people notice it shows up alongside a cold, sore throat, or swollen lymph node near the ear. There is no antibiotic that will help because it’s caused by a virus.

Bacterial conjunctivitis tends to produce thicker, yellow or greenish discharge. You might wake up with your eyelids crusted shut. The most common culprits in adults and children are Haemophilus influenzae and Streptococcus pneumoniae.² In kids, Moraxella catarrhalis is another frequent cause. If you wear contact lenses, gram-negative bacteria become more likely players.

Allergic conjunctivitis is the one that makes both eyes itch intensely and simultaneously. It’s usually seasonal, showing up when pollen counts spike, or it flares around dust, pet dander, or other triggers you already know about. The discharge, if any, is watery and clear. Unlike the infectious forms, allergic conjunctivitis is not contagious.

Sometimes it’s genuinely hard to tell the types apart just by looking. Research into point-of-care testing suggests that combining a few clinical signs, particularly how red the eye is, how swollen the eyelid feels, and your overall level of discomfort, does a reasonable job predicting adenoviral infection, and adding a rapid antigen test improves accuracy further.³ But these rapid tests aren’t widely available in every clinic. If you’re unsure which type you have, that’s one good reason to see a doctor.

Home Care That Actually Helps

Regardless of the type, a few basic steps will make you more comfortable while your body deals with the infection or irritation.

Cool compresses: A clean cloth soaked in cool water and placed gently over the closed eye for five to ten minutes can ease swelling and soothe irritation, especially with viral or allergic pink eye. Warm compresses work better for bacterial cases with heavy crusting, as they help soften and loosen the gunk.
Artificial tears: Preservative-free lubricating eye drops can flush irritants and provide temporary relief. Use them as often as you need to. These are available over the counter and are safe for all three types.
Stop wearing contacts: If you wear contact lenses, take them out immediately and switch to glasses until the infection is completely gone. Toss any disposable lenses you were wearing when symptoms started, and disinfect your lens case thoroughly. Continuing to wear contacts traps bacteria and debris against the eye surface and risks a much more serious corneal infection.
Hands off: Rubbing your eyes feels instinctively right but makes everything worse. It pushes infectious material deeper, irritates the inflamed tissue, and transfers germs to your hands and then to everything you touch.

For allergic pink eye specifically, over-the-counter antihistamine eye drops can be a real game-changer. Olopatadine, available as an OTC drop, blocks histamine receptors and tamps down the allergic response. Clinical testing showed it reduced both itching and redness more effectively than an older antihistamine drop and caused less stinging on application.⁴ If you already know your pink eye is allergy-driven, reaching for antihistamine drops before anything else is usually the fastest route to relief.

When You Need Prescription Treatment

Viral pink eye has no targeted treatment. Antibiotics don’t work against viruses, and no antiviral eye drop has shown clear benefit during the acute phase of adenoviral conjunctivitis.⁵ The infection runs its course, and your job is to manage symptoms and avoid spreading it.

Bacterial pink eye is where antibiotics make a difference. A Cochrane review found that antibiotic eye drops modestly speed up both symptom resolution and the clearance of bacteria, compared to waiting it out.⁶ Beyond helping you feel better sooner, topical antibiotics also reduce how contagious you are, which matters if you’re around other people all day. Your doctor will typically prescribe broad-spectrum antibiotic drops or ointment. Ointment can blur vision temporarily but stays in the eye longer, which makes it a practical choice at bedtime or for young children who resist drops.

That said, some doctors and researchers support a “watchful waiting” approach for mild bacterial cases, since many resolve without treatment. The choice often depends on the severity of symptoms, the patient’s age, and whether they need to return to school or work quickly.

When to See a Doctor Right Away

Most pink eye is annoying but harmless. A few signs, though, suggest something more serious is going on and warrant prompt medical attention.

Significant eye pain: Ordinary pink eye causes irritation and a gritty feeling, not intense pain. Pain that goes deeper than the surface or worsens with light could signal corneal involvement or another condition entirely.
Vision changes: If your eyesight becomes blurry and does not improve after blinking away any discharge, get seen quickly. Pink eye alone rarely affects vision; when it does, it can indicate corneal inflammation.
Symptoms in only one eye with severe redness: The distinction between one-sided and two-sided symptoms, the intensity of pain, and how long things have been going on are among the main criteria that separate everyday conjunctivitis from conditions that need specialist care.⁷
No improvement after a week: Viral pink eye sometimes lingers, but if your symptoms are worsening rather than plateauing, see a doctor.
A weakened immune system: If you’re on immunosuppressive medications or have a condition that compromises your immune defenses, treat any eye infection as more urgent than you otherwise would.

When a doctor is uncertain about the diagnosis, or when any of those red flags are present, referral to an ophthalmologist is warranted.⁷ The stakes go up quickly when a corneal infection enters the picture, and that situation calls for specialized evaluation rather than general care.

Contact Lens Wearers Face Higher Stakes

If you wear contacts and develop pink eye, the standard advice to switch to glasses isn’t just a suggestion. Contact lenses create a warm, moist environment between the lens and the cornea. Coatings accumulate on the lens surface, debris gets trapped underneath, and bacteria that would normally be flushed away by blinking and tears get a foothold. Pseudomonas aeruginosa is the most common bacterium behind serious corneal infections in contact lens wearers, and it’s especially associated with extended-wear lenses that stay in the eye overnight.⁸

A corneal infection, or keratitis, is a fundamentally different beast from conjunctivitis. It can cause scarring, permanent vision loss, and in severe cases may require surgical intervention. If you wear contacts and your pink eye comes with pain, light sensitivity, or any reduction in vision, don’t wait. See an eye doctor the same day if possible.

Stopping the Spread

Viral and bacterial pink eye are both highly contagious. Adenovirus, the most common viral cause, spreads through direct contact with eye secretions, contaminated surfaces, and respiratory droplets.¹ The virus can survive on doorknobs, countertops, and shared towels long enough to infect someone else. A few practical steps go a long way:

Wash your hands constantly: Every time you touch your face, rub your eye, or apply drops, wash with soap and water for at least twenty seconds. Hand sanitizer is a reasonable backup but isn’t as effective against adenovirus as proper handwashing.
Don’t share personal items: Towels, pillowcases, eye makeup, and eye drops should be strictly yours until you’re no longer symptomatic.
Clean surfaces: Wipe down anything you touch frequently, including your phone screen, keyboard, and bathroom faucet handles.
Replace eye cosmetics: Mascara, eyeliner, and any applicator that touched your eye area during the infection should be thrown away. Reusing them risks reinfection.

You remain contagious as long as your eyes are red and producing discharge, which with adenovirus can be up to two weeks. Some of the more aggressive strains, particularly the ones responsible for epidemic keratoconjunctivitis, are contagious enough to sweep through households, schools, and medical offices if hygiene slips.

Children, Schools, and Daycare Policies

Pink eye in kids is incredibly common, and the rules around when a child can return to school or daycare vary wildly depending on where you live. Many schools still enforce a blanket “no pink eye” exclusion policy that requires either 24 hours on antibiotics or complete resolution of redness before a child is allowed back. The problem is that these policies often don’t distinguish between viral and bacterial cases. Since viral pink eye doesn’t respond to antibiotics, a child with viral conjunctivitis can end up staying home for a week or more despite antibiotic drops doing nothing useful.

Researchers who study how pediatric conjunctivitis decisions get made have found that school and daycare exclusion policies are a major driver of unnecessary antibiotic prescriptions. Parents understandably want their child back in school, and doctors sometimes prescribe antibiotics just to satisfy a school’s requirement rather than because the child’s infection would benefit from them. There are calls to update these policies so that exclusion is based on evidence rather than tradition.⁹

If your child’s school demands a doctor’s note or a prescription before readmission, it’s worth having a direct conversation with your pediatrician about what’s genuinely needed versus what’s being driven by institutional policy. Many pediatricians will write a return-to-school note confirming that the child’s conjunctivitis is viral and does not require antibiotics.

Complications That Can Linger After the Redness Clears

For most people, pink eye is a temporary nuisance. But the most severe form of adenoviral conjunctivitis, epidemic keratoconjunctivitis, can leave a calling card. Some patients develop small cloudy spots on the cornea called subepithelial infiltrates, or SEIs. These are an immune response in the corneal tissue, and they can cause blurry vision, glare, and light sensitivity that persists for months after the infection itself has resolved.¹⁰

The acute phase of epidemic keratoconjunctivitis has no treatment with proven benefit across clinical trials. No antiviral, steroid, or disinfectant tested to date has reliably shortened the acute illness.⁵ Where treatment does help is the chronic phase. If those subepithelial infiltrates stick around and interfere with vision, cyclosporine A eye drops can speed their resolution.⁵ This is a prescription immunosuppressive drop that calms the localized immune reaction in the cornea.

Recent research into what these infiltrates actually are has found something interesting at the cellular level. Tissue analysis from a patient with persistent SEIs revealed that the cloudy spots corresponded to abnormal cells with characteristics of myofibroblasts sitting just beneath the corneal surface, showing signs of cellular stress.¹¹ That’s the first structural evidence explaining why SEIs persist and recur, and it may eventually lead to more targeted treatments. For now, if you had a bad case of pink eye and your vision still feels off weeks later, the infiltrates are likely why, and you should see an ophthalmologist for evaluation.

Why Steroid Eye Drops Are Not a Simple Fix

Steroid eye drops are powerful anti-inflammatory agents, and some doctors use them for severe viral or allergic conjunctivitis. They can significantly improve short-term comfort. In one trial comparing standard treatment with and without a topical steroid in severe viral conjunctivitis, the steroid group had noticeably less discomfort in the first few days. By two weeks, however, both groups felt about the same, suggesting steroids provided symptomatic relief without changing the overall course of the disease.¹²

The catch is that steroids carry real risks when used on the eye. They can raise intraocular pressure, potentially triggering or worsening glaucoma. Long-term use increases the risk of cataracts. And they can actually prolong adenoviral infections or cause a herpes simplex virus infection in the eye to flare badly.¹³ This is why steroid drops should never be self-prescribed or borrowed from someone else’s leftover prescription. If a doctor decides steroids are warranted for your case, they’ll typically keep you on them briefly and monitor your eye pressure. Using them without medical oversight, especially if you happen to have an undiagnosed herpes infection of the eye, can make things dramatically worse.

Gonococcal Conjunctivitis Is a Medical Emergency

One form of pink eye deserves its own warning because it behaves nothing like the common types. Gonococcal conjunctivitis, caused by the sexually transmitted bacterium Neisseria gonorrhoeae, produces explosive, copious purulent discharge, often with significant pain and eyelid swelling. It can progress rapidly, and in a case series of thirteen patients diagnosed with the condition, three required hospital admission and one developed a lasting complication affecting the eyelid.¹⁴

Gonococcal conjunctivitis can perforate the cornea within 24 to 48 hours if untreated, so any pink eye that produces heavy purulent discharge in a sexually active adult should be treated as urgent. Treatment typically requires systemic antibiotics, most commonly intramuscular ceftriaxone, because topical drops alone are not enough. In that same case series, all strains were susceptible to ceftriaxone, though over half were resistant to ciprofloxacin, reflecting broader trends in gonorrhea resistance.¹⁴ If you suspect this is what you’re dealing with, go to an emergency room rather than waiting for a primary care appointment.

Folk Remedies and Breast Milk

In many cultures, applying breast milk to an infant’s eye is a traditional treatment for newborn conjunctivitis. Breast milk does contain antibodies and antimicrobial proteins, and the logic behind the practice is understandable. However, breast milk also carries bacteria from the skin and milk ducts, and its use directly in a newborn’s eye is not supported by controlled evidence. A review of the practice found that it introduces potential microbial risks and recommended culturally sensitive messaging that encourages breastfeeding’s proven benefits while discouraging unverified ocular applications.¹⁵

The same skepticism applies to other home remedies you’ll find online, including chamomile tea bags, colloidal silver drops, and honey solutions. None of these have been tested rigorously enough to recommend, and some, particularly colloidal silver, carry documented risks of their own. Sticking with artificial tears, cool compresses, and appropriate over-the-counter antihistamine drops for allergic cases is a safer and better-supported approach. Save the folk remedies for conditions where the worst-case outcome of an ineffective treatment isn’t damage to your eyesight.

Telehealth and Getting Diagnosed Remotely

If getting to a doctor’s office quickly is impractical, a virtual visit can be surprisingly useful for pink eye. A study that tested remote evaluation for red-eye patients in a primary care setting found that tele-examination correctly identified the cause in all cases evaluated.¹⁶ That’s a small study, and not every telehealth platform handles eye complaints equally well, but it suggests that a video visit with a good-quality camera and adequate lighting can give a clinician enough visual information to make a reasonable diagnosis and prescribe treatment if needed. If you’re weighing whether to drag yourself to an office with a contagious eye, a telehealth visit is worth considering first, both for your convenience and to avoid spreading the infection in a waiting room.

1
PubMed Central. Adenovirus: ocular manifestations
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PubMed Central. Bacterial conjunctivitis
3
PubMed Central. Diagnostic accuracy of clinical signs, symptoms and point-of-care testing for early adenoviral conjunctivitis
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PubMed Central. Treatment of allergic conjunctivitis with olopatadine hydrochloride eye drops
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PubMed Central. Epidemic keratoconjunctivitis: the current situation and recommendations for prevention and treatment
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Recent Patents on Inflammation & Allergy Drug Discovery. Bacterial Conjunctivitis in Childhood: Etiology, Clinical Manifestations, Diagnosis, and Management
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PubMed Central. Red Eye: A Guide for Non-specialists
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PubMed. Pseudomonas keratitis and contact lens wear: the lens/eye is at fault
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PubMed Central. A qualitative evaluation of pediatric conjunctivitis medical decision making and opportunities to improve care
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PubMed Central. Management of Adenoviral Keratoconjunctivitis: Challenges and Solutions
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PubMed. New insights into persistent corneal subepithelial infiltrates following epidemic keratoconjunctivitis: The first case report with ultrastructural and immunohistochemical investigations
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Indian Journal of Applied Research. Efficacy of Topical Steroids in Treating Severe Viral Conjunctivitis: A Randomized Control Trial
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PubMed. Use of Topical Steroids in Conjunctivitis: A Review of the Evidence
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PubMed. Adult gonococcal conjunctivitis: Prevalence, clinical features and complications
15
The Journal of Perinatal & Neonatal Nursing. Neonatal Eye Infections: Microbial Risks, Transmission Routes, and the Paradox of Traditional Human Milk Applications
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PubMed Central. Virtual Consultation for Red Eye: Accuracy Assessment in a Primary Care Center