Conjunctivitis
Your health expert: Mr Ali Mearza, Consultant Ophthalmic Surgeon
Content editor review by Rachael Mayfield-Blake, December 2022
Next review due December 2025
Conjunctivitis is a condition that affects your eyes – it can make them look red, feel gritty and they may be watery or sticky. Conjunctivitis is sometimes called pink eye and can affect people of all ages.
About conjunctivitis
Conjunctivitis is inflammation and swelling of the thin, clear layer that covers the white of your eye and lines your eyelid (the conjunctiva).
Conjunctivitis is common, especially in children, and usually gets better on its own within a week or so. There are things you can do to ease your symptoms, often with treatments you can get from your pharmacist. You don’t usually need to see a GP for conjunctivitis, but there are some occasions when it’s important to seek medical advice.
Types of conjunctivitis
There are two main types of conjunctivitis. These are:
- infective conjunctivitis, which may be caused by viruses or bacteria
- non-infective conjunctivitis, which includes:
- allergic conjunctivitis, such as an allergic reaction to pollen
- irritant (chemical) conjunctivitis, when your eyes come into contact with something that irritates them (for example, chlorine in swimming pools)
Causes of conjunctivitis
Different things can cause the inflammation and swelling in conjunctivitis.
Viral conjunctivitis
Viruses are a common cause of conjunctivitis, especially in adults. The virus that most commonly causes conjunctivitis also causes the common cold. You might get viral conjunctivitis if you have a cold or come into contact with somebody who’s coughing or sneezing. Or you may get conjunctivitis from using contaminated eye make-up. Viral conjunctivitis is very contagious.
Bacterial conjunctivitis
In children and older people, bacterial conjunctivitis is more common than viral conjunctivitis. Lots of different bacteria can cause conjunctivitis. Most often it’s bacteria from your own skin or respiratory system (nose and throat) that causes it. You can also get bacterial conjunctivitis by:
- coming into contact with somebody who has conjunctivitis
- wearing contact lenses that are infected
- touching your eyes with unwashed hands
Conjunctivitis in babies
Neonatal (newborn) conjunctivitis affects babies in their first month. One of the most common causes is an infection passed on at birth by a mother with chlamydia or less often, gonorrhoea. Neonatal conjunctivitis can cause permanent eye damage if it isn’t treated quickly.
Allergic conjunctivitis
If you’re allergic to plant pollens released at the same time each year, you may get seasonal allergic conjunctivitis. All-year-round (perennial) allergic conjunctivitis can be caused by house dust mites and animal fur. These are the most common causes of allergic conjunctivitis.
Another type of allergic conjunctivitis is called giant papillary conjunctivitis (GPC). Doctors don’t fully understand what causes it, but it seems to be a type of allergic reaction to contact lenses. If you develop GPC, you may need to change the type of lenses you wear, the solutions you use to clean them, or possibly stop wearing them altogether.
You may have an allergic reaction to eye drops and eye make-up, which can cause inflammation of your eyelids. This form of conjunctivitis is called contact dermatoconjunctivitis.
Irritant conjunctivitis
Sometimes, conjunctivitis is caused by an irritating or toxic substance coming into contact with your eye. These may include chemicals found in:
- eye medicines with preservatives (if you use them for a long time)
- swimming pools that contain chlorine
- air pollution, including smoke and fumes
You may also get conjunctivitis if something rubs or scratches your eye (for example, a foreign body that gets caught under your eyelid).
Symptoms of conjunctivitis
Conjunctivitis can affect one or both of your eyes. Symptoms of conjunctivitis include:
- redness of the white of your eye
- a watery or thick and sticky, yellow or green discharge from your eyes; they may be stuck together when you wake in the morning
- blurry vision, which can be caused by discharge in and around your eye, or if the clear part at the front of your eye (cornea) is also affected
- a gritty feeling in your eye that can feel itchy or burn
- swollen eyelids
If you have allergic conjunctivitis, both of your eyes will feel really itchy. You may have hay fever or asthma symptoms too.
If you have symptoms of conjunctivitis, speak to your pharmacist. They can offer you help and advice about what might help ease your symptoms.
When to see a doctor for conjunctivitis
If conjunctivitis doesn’t get better after two weeks with treatment from your pharmacist or your symptoms get worse, contact your GP.
Contact your GP straightaway or get an urgent appointment with an optician if:
- you have pain inside your eyes
- you become sensitive to light
- you have sudden changes to your vision
- your vision is consistently blurred
These may be signs of a more serious problem with your eyes.
If you have a baby under a month old and think they may have conjunctivitis, contact your midwife or GP straightaway. Conjunctivitis in a newborn baby can sometimes be serious. If your GP surgery is closed, go to the accident and emergency department at your local hospital.
Diagnosis of conjunctivitis
If you seek medical attention for conjunctivitis, a GP or nurse will ask about your symptoms and medical history, and will examine you. They may take a swab of your eye and send it to a laboratory to be tested to help identify what’s causing your conjunctivitis. A GP may refer you to an ophthalmologist (a doctor who specialises in eye health), although this isn’t usually necessary.
Self-help for conjunctivitis
Try not to scratch or rub your eyes as you may make your symptoms worse.
To help ease the discomfort of conjunctivitis, you may find it helps to put a cool facecloth soaked in water on your eyes to soothe them. Wipe away any discharge from your eyelids and lashes with cotton wool soaked in cooled boiled water. Use a separate piece of cotton wool for each eye.
You can buy lubricant eye drops for conjunctivitis over the counter from a pharmacist. These may help to relieve discomfort too.
If you use contact lenses, don’t wear them until your conjunctivitis has completely cleared up and wear glasses until it does. If you’re taking a treatment for conjunctivitis, wait a further three days after you’ve finished it and are completely symptom-free before you wear contact lenses again.
If you have allergic conjunctivitis, the best thing you can do is try to avoid what you’re allergic to. For instance, if you’re allergic to house dust mites, it might help reduce your symptoms if you change your bedding regularly and use synthetic pillows and acrylic duvets. If your conjunctivitis is caused by an allergy to pollen, there are ways to ease the symptoms of hay fever.
Treatment of conjunctivitis
Conjunctivitis usually gets better within a week or two without any treatment, but it can last longer and you may need specialist help. Allergic conjunctivitis will usually get better within a few hours once you’re away from the source of your reaction.
You can ask your pharmacist for advice on what might help ease your symptoms. They’ll advise you about any over-the-counter treatments such as eye drops or antihistamines that might help. The type of treatment you may need will vary depending on what’s causing your conjunctivitis.
Medicines
You may need to try several combinations of medicines until you find the one that suits you best.
Medicines for viral conjunctivitis
There aren’t any antiviral medicines that work on the viruses that cause conjunctivitis so try the self-help measures while it clears up.
If your eyes are feeling very irritated, lubricating eye drops may help to soothe them. Sometimes, the cornea (the clear part at the front of your eye) is also affected and this, in turn, may affect your vision. If this happens, it’s important to see a specialist who may prescribe you a course of steroid eye drops.
Antibiotics for bacterial conjunctivitis
Conjunctivitis usually gets better on its own, and you won’t need antibiotics. If your conjunctivitis is caused by a virus, which is often the case, antibiotics are no use at all. If your symptoms don’t improve, and you have tried over-the-counter medicines, a GP may suggest you use antibiotic eye drops (or ointment) for conjunctivitis.
You can buy an antibiotic called chloramphenicol from a pharmacy, so you can treat yourself without needing to go through a GP. Your pharmacist will advise whether it’s suitable for you.
If you have an eye infection caused by the bacteria Chlamydia, or wear contact lenses, your GP may prescribe you antibiotic tablets and eye drops. If they think antibiotics are the best option for you, they’ll explain why.
Medicines for allergic conjunctivitis
Antihistamine medicines or eye drops may help if you have allergic conjunctivitis. These should work quickly to give you some relief from your symptoms.
Allergic conjunctivitis can also be treated with a type of medicine called mast cell stabilisers. These come as eye drops. Some types of mast cell stabiliser are available over the counter from a pharmacy.
Mast cell stabilisers are more effective for long-term relief of allergic conjunctivitis but may take a few weeks to start working. You can take antihistamines at the same time as mast cell stabilisers. These will give you some relief while you wait for the mast cell stabilisers to work.
If your inflammation is severe and the treatments above aren’t working, a specialist may prescribe you a short course of steroid eye drops.
Always read the patient information that comes with your medicine and, if you have any questions about your medicines, ask your pharmacist or doctor.
Prevention of conjunctivitis
Infective conjunctivitis is contagious, so you might decide to take time off work. You don't necessarily need to keep your child at home if they have conjunctivitis, unless they’re feeling very unwell. Check with their school or nursery if you aren’t sure. They might tell you to keep your child at home if they have their own rules.
If you have infective conjunctivitis, wherever possible, it’s best to try to avoid close contact with others for a week or two. This is especially important if you’re a healthcare worker, or work with children. Here are some other tips on how you can prevent spreading conjunctivitis.
- Wash your hands regularly and try not to touch your eyes.
- Use clean towels and pillows and don’t share them with anybody.
- Don’t share make-up with anybody else.
If you wear contact lenses, it’s very important to follow all the instructions your optician gives you about cleaning and caring for them. It’s best not to wear contact lenses while you have symptoms of conjunctivitis due to the risk of other problems that can affect your vision, for example, a corneal infection (an infection that affects the clear part at the front of your eye). This could potentially cause you to lose your sight.
You may be contagious for a week or two if you have infective conjunctivitis, so avoid close contact with other people during this time. This is especially important if you work with children, or in a hospital or care home. If you have viral conjunctivitis, a rough guide is that it’s contagious until your eye is no longer red and the watery discharge has stopped.
See our section: Prevention of conjunctivitis above for more information.
Conjunctivitis usually gets better within a couple of weeks without treatment, but it can last longer, and you may need specialist help. Allergic conjunctivitis will usually get better within a few hours once you’re away from the source of your reaction (unless it’s caused by something seasonal like hay fever).
See our section: Treatment of conjunctivitis above for more information.
You can catch bacterial or viral conjunctivitis by coming into contact with a person with the condition, or if you share towels or make-up with them. But you can’t catch allergic conjunctivitis or irritant conjunctivitis. Babies can get conjunctivitis from an infection passed on at birth by a mother with chlamydia or less often, gonorrhoea.
See our section: Causes of conjunctivitis above for more information.
If you wear contact lenses and don’t keep the lenses or lens cases clean, you may be more likely to get bacterial conjunctivitis. There’s also a type of conjunctivitis linked to wearing contact lenses, called giant papillary conjunctivitis. If your contact lenses are irritating you and you’re getting symptoms, contact an optician as soon as possible for advice.
In adults, viruses usually cause conjunctivitis, whereas in children and older people, bacteria are a more common cause. There are other causes of conjunctivitis too, such as allergies to things like pollen and animal fur. You can also get conjunctivitis if an irritating or toxic substance comes into contact with your eye, such as chlorine in a swimming pool.
See our section: Causes of conjunctivitis above for more information.
A GP or nurse will be able to tell you if conjunctivitis is viral or bacterial if they take a swab of your eye and send it to a laboratory to be tested. This will help identify what’s causing your conjunctivitis. But you don’t usually need to see a GP for conjunctivitis, although there are some occasions when it’s important to seek medical advice.
See our section: Causes of conjunctivitis above for more information.
Antihistamines
Antibiotics
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