Conjunctivitis

Also called Pink eye, Red eye

Usually harmless and self-limiting. The point of this entry is the red eyes that are not.

What it is

Conjunctivitis is inflammation of the membrane covering the white of the eye. Most cases are viral, resolve on their own within a week or two, and need no antibiotics.

This entry exists mainly to draw the line between the red eye that will settle and the red eye that threatens sight.

The dangerous ones are: acute glaucoma, uveitis, corneal ulcer, and infection in a contact lens wearer. Each of those causes pain and visual change, and each needs same-day specialist assessment.

The distinguishing question is simple. Conjunctivitis is gritty and uncomfortable with normal vision. A serious red eye is painful, light-sensitive, and vision is affected.

Signs you might notice

Conjunctivitis: redness, grittiness, watering or discharge, eyelids stuck together in the morning, and normal vision.

Bacterial tends to have sticky yellow discharge; viral tends to be watery and often follows a cold; allergic is itchy and both eyes are affected.

Red flags that mean something else: significant pain rather than discomfort, sensitivity to light, reduced or blurred vision, a pupil that looks different, or contact lens wear.

In a newborn under 28 days, any conjunctivitis needs urgent assessment.

How it can affect day-to-day life

Antibiotic drops are prescribed for the majority of conjunctivitis in the UK and are unnecessary in most cases, which drives resistance without shortening the illness.

Contact lens wearers with a red eye are the group most at risk of a sight-threatening corneal ulcer, and they need to stop wearing lenses and be seen the same day.

In care settings and nurseries, conjunctivitis spreads through shared towels and poor hand hygiene, and outbreaks are avoidable.

Supporting someone well

Learn the red flags and act on them: pain, light sensitivity, visual change, or contact lenses.

Bathe the eye with cooled boiled water and clean cotton wool, one wipe per swipe, and wash hands afterwards.

Do not share towels, flannels or pillows.

Do not wear contact lenses until it has fully settled, and replace lenses and case.

Most viral conjunctivitis needs no treatment at all; give it a fortnight.

For allergic conjunctivitis, antihistamine drops help and the cause is worth identifying.

Where to get help

A pharmacist can advise and treat under Pharmacy First in many areas.

Same-day optometrist, eye casualty or A and E for pain, light sensitivity, visual change, or a red eye in a contact lens wearer.

Any conjunctivitis in a newborn is urgent.