How to Tell—and What to Do About It

Your eyes are red. They’re itchy. There’s goop in the corners.

You Google: “red itchy eye” and everything says pink eye.

But is it really pink eye? And does it even need treatment?

Here’s what you need to know.

Not All Red Eyes Are Pink Eye

“Pink eye” (conjunctivitis) is inflammation of the conjunctiva – the clear membrane covering the white part of your eye.

But red eyes can also be:

• Dry eyes (from screen time, dry air, aging)
• Stye (infected eyelash follicle – bump on eyelid)
• Subconjunctival hemorrhage (broken blood vessel – bright red patch, not painful)
• Corneal abrasion (scratch on eye surface – painful)
• Foreign object (something in your eye)

How to tell if it’s actually pink eye:

• Discharge – Pink eye produces discharge. Dry eyes don’t.
• Crusting – Waking up with eyes sealed shut = pink eye
• Contagious spread – If others around you are getting it, likely pink eye

👀 The Three Types—How to Tell Them Apart

VIRAL Pink Eye

Symptoms:

• Watery, clear discharge
• Very itchy, very red
• Usually starts in one eye, spreads to other within 1-2 days
• Often accompanies cold symptoms

Caused by:

Adenovirus (same family as common cold)

Contagious?

EXTREMELY. Can spread for up to 2 weeks.

Treatment:

No antibiotics (it’s a virus). Supportive care—cool compresses, artificial tears. Runs its course in 7-14 days.

BACTERIAL Pink Eye

Symptoms:

• Thick, yellow or green discharge
• Eyes glued shut with crusty goop in morning
• More painful than viral
• Can affect one or both eyes

Caused by:

Bacteria (Staph, Strep, Haemophilus)

Contagious?

Yes, until treated with antibiotics.

Treatment:

Antibiotic eye drops. Usually clears in 3-5 days. Contagious until 24 hours after starting drops.

ALLERGIC Pink Eye

Symptoms:

• Both eyes affected at same time
• VERY itchy
• Watery discharge
• Other allergy symptoms (sneezing, runny nose)

Caused by:

Allergens (pollen, dust, pet dander, mold)

Contagious?

No.

Treatment:

Antihistamine eye drops, avoid allergen. Usually improves quickly.

When You Need to Come In

• Thick, colored discharge (likely bacterial = needs antibiotics)
• Eye pain or vision changes
• Sensitivity to light
• You wear contact lenses (higher infection risk)
• Symptoms not improving after 3-4 days
• You need a work note
• Newborn or infant with pink eye (always needs evaluation)

What We Do at Night Watch

• Examine eyes to determine type
• Rule out other causes (corneal abrasion, foreign object, etc.)
• Prescribe treatment (antibiotic drops for bacterial, supportive care for viral, antihistamines for allergic)
• Provide work/school notes
• Educate on preventing spread

🧼 Preventing Pink Eye

• Wash hands frequently – especially before touching eyes
• Don’t touch or rub eyes
• Don’t share towels, pillows, eye makeup, contact lens cases
• Replace eye makeup every 3 months, immediately after pink eye
• Clean contact lenses properly or use daily disposables
• Disinfect shared surfaces if someone in household has pink eye

❌ Common Mistakes

• Using old antibiotic drops from last time – they may be expired or contaminated
• Stopping antibiotics early – finish entire course
• Sharing drops between family members – spreads infection
• Wearing contacts during infection – can worsen and prolong infection
• Going to work/school before cleared – spreads to others

👁️ Red eyes? Goopy discharge? We can tell you what it is. Get the right diagnosis. Get the right treatment.