Viral Conjunctivitis, Also Known as “Pink Eye”: Symptoms, Treatment, and When to See an Eye Doctor

Pink eye is one of the most common reasons patients call the eye doctor with a red, irritated eye. The medical term is conjunctivitis, which means inflammation of the conjunctiva — the thin, clear tissue that covers the white part of the eye and the inside of the eyelids.

There are several types of conjunctivitis, including viral, bacterial, and allergic. Viral conjunctivitis is the type most people think of when they hear “pink eye.” It is usually very contagious and is often caused by the same types of viruses associated with colds and upper respiratory infections. The CDC notes that viral and bacterial pink eye can spread easily from person to person.

Eye clinic scene with doctor pointing to Viral Conjunctivitis screen while patient uses slit lamp; pink eye poster and chart visible

What Causes Viral Pink Eye?

Viral conjunctivitis is commonly caused by viruses such as adenovirus. It may happen by itself or along with cold-like symptoms such as a sore throat, cough, congestion, or swollen lymph nodes.

It often starts in one eye and may spread to the other eye within a few days. The infection can spread through contact with infected tears, eye discharge, respiratory droplets, contaminated hands, towels, pillowcases, makeup, or shared personal items. The CDC advises frequent handwashing, separate towels, and avoiding close contact to reduce spread.

Infographic on viral conjunctivitis aka pink eye, showing an eye exam with a doctor checking a woman’s eye and symptoms, spread, care tips.

Common Symptoms of Viral Conjunctivitis

Viral pink eye may cause:

• Redness in one or both eyes

• Watery tearing

• Burning, gritty, or sandy sensation

• Mild eyelid swelling

• Light sensitivity

• Crusting in the morning

• Irritation that feels worse than it looks

• Recent cold, sore throat, or upper respiratory symptoms

Unlike many bacterial infections, viral conjunctivitis usually causes more watery discharge than thick yellow or green mucus.

Pink eye symptoms infographic with woman checking a red eye, and icons for redness, watery tears, irritation, plus OPT-ISM Eye Care.

Is Pink Eye Contagious?

Yes, viral conjunctivitis can be very contagious. It spreads easily through hand-to-eye contact, shared towels, pillowcases, cosmetics, eye drops, contact lenses, and contaminated surfaces.

To reduce the risk of spreading pink eye:

• Wash your hands often.

• Avoid touching or rubbing your eyes.

• Do not share towels, washcloths, makeup, or eye drops.

• Wash pillowcases, sheets, and towels.

• Avoid swimming pools while infected.

• Throw away disposable contact lenses and old lens cases used during the infection.

• Stay out of contact lenses until your eye doctor says it is safe.

The CDC specifically recommends stopping contact lens wear until symptoms are gone or an eye doctor clears you to restart.

Eye care poster: mother and child washing hands at sink, with tips on pink eye spread, towels, makeup, and contacts.

How Is Viral Pink Eye Treated?

Most viral conjunctivitis does not require antibiotics. Because it is caused by a virus, antibiotic eye drops usually do not help. The American Academy of Ophthalmology notes that antibiotic drops are ineffective for conjunctivitis caused by a virus.

Treatment is usually focused on comfort and preventing spread.

Supportive treatment may include:

Artificial tears

Preservative-free artificial tears can help soothe burning, dryness, and irritation.

Cold compresses

A clean, cool compress can reduce eyelid swelling and discomfort. The CDC recommends cold compresses and artificial tears for symptom relief.

Good hygiene

Handwashing and avoiding shared personal items are one of the most important parts of treatment.

Avoiding contact lenses

Contact lenses should be stopped until the infection has resolved and your eye doctor confirms it is safe to resume wear.

Cleaning or replacing eye products

Patients may need to replace contaminated makeup, lens cases, contact lenses, or eye drops used during the infection.

Infographic on treating viral conjunctivitis, with woman holding a cold cloth to one eye and tips: cold compresses, artificial tears, no antibiotics.

Do Steroid Drops Help?

Sometimes, but they should only be used under the direction of an eye doctor. Steroid drops may reduce inflammation in select cases, but they can also make certain infections worse, especially herpes-related eye disease. They can also raise eye pressure in some patients.

This is one reason it is important not to self-treat a red eye with leftover prescription drops.

When Should You See an Eye Doctor?

You should schedule an eye exam if you have a red eye and are unsure what is causing it. Many conditions can look like pink eye, including dry eye, allergies, corneal abrasions, contact lens complications, iritis, herpes eye disease, or even more serious infections.

Seek prompt care if you have:

• Eye pain

• Light sensitivity

• Blurry vision

• A red eye in a contact lens wearer

• Symptoms lasting more than several days without improvement

• Thick discharge

• Significant eyelid swelling

• A history of eye surgery or eye disease

• Only one very red, painful eye

• Recurrent episodes of “pink eye”

Contact lens wearers should be especially careful because redness, pain, or discharge may be related to a corneal infection rather than simple conjunctivitis.

Viral vs. Bacterial vs. Allergic Pink Eye

Not all pink eye is treated the same way.

Viral pink eye is usually watery, contagious, and often associated with cold symptoms. Treatment is usually supportive.

Bacterial pink eye may cause thicker yellow or green discharge and may sometimes require antibiotic drops.

Allergic conjunctivitis usually causes itching, tearing, and redness in both eyes. It is not contagious and is often treated with allergy eye drops.

Because the symptoms can overlap, an eye exam is the best way to determine the cause and avoid unnecessary or incorrect treatment.

Can Kids Go to School With Pink Eye?

This depends on symptoms, school policy, and the doctor’s recommendation. In general, viral pink eye spreads easily, especially when children are rubbing their eyes or unable to practice good hygiene. The CDC says patients with viral or bacterial conjunctivitis and systemic signs of illness should remain home if they cannot avoid close contact with others.

Poster titled When to See an Eye Doctor: optometrist examines a woman; red-eye symptoms and OPT-ISM Eye Care listed.

The Bottom Line

Viral conjunctivitis, or pink eye, is common, uncomfortable, and highly contagious, but it often improves with supportive care. Antibiotics are usually not helpful for viral pink eye. The most important steps are reducing irritation, avoiding contact lenses, practicing good hygiene, and seeing an eye doctor if symptoms are painful, worsening, affecting vision, or not improving.

At OPT-ISM, we evaluate red eyes to determine whether symptoms are due to viral pink eye, allergies, bacterial infection, contact lens problems, dry eye, or another eye condition. The right diagnosis helps patients get the right treatment and avoid unnecessary medications.