How to tell if pink eye is bacterial or viral

Infectious conjunctivitis (pink eye) is the most frequently diagnosed eye infection in the US, with up to 6 million cases every year.

Conjunctivitis can also occur from allergies and chemical irritants, so it is best to have your eyes examined by an eye doctor for an accurate diagnosis and treatment plan. 

What is conjunctivitis?

The conjunctiva is the thin membrane that covers the white part of the eye. When bacteria or viruses enter the eye, it causes inflammation of the tiny blood vessels in the conjunctiva, giving a pink or red appearance to the eyes.

While bacterial and viral conjunctivitis are both referred to as ‘pink eye’, each present with different symptoms and require different treatment methods.

Since infectious conjunctivitis is highly contagious, it is important to have your eyes examined by an eye doctor as soon as symptoms appear to receive an effective treatment plan.

What is bacterial conjunctivitis?

Bacterial conjunctivitis accounts for over 1 million primary care visits in the US each year.

Bacterial conjunctivitis is most commonly caused by staphylococcal, streptococcus or hemophilic bacteria. This type of conjunctivitis usually affects only one eye, but can be present in both eyes.

Common symptoms of bacterial eye infection include:

  • Whites of the eyes appear pink or red
  • Swollen eyelids
  • Burning in the eyes
  • Scratchy feeling in the eye
  • Excessive tearing
  • Yellow or green discharge from the eye
  • Crusting on the eyelashes, especially in the morning

Treatment of bacterial conjunctivitis generally involves antibiotic eye drops or ointments to eliminate the infection.

SEE RELATED: Why Do My Eyes Feel Sore?

If you have ‘pink eye’, schedule an eye appointment with an eye doctor near you as soon as possible.

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What is viral conjunctivitis?

Viral conjunctivitis is the most common type of pink eye, accounting for over 80% of all conjunctivitis infections, and almost 5 million annual cases in the US alone.

Viral conjunctivitis typically affects both eyes and usually accompanies a cold, sore throat, runny nose or fever.

Common symptoms include:

  • Whites of the eyes appear light pink or salmon color
  • Itchy eyes
  • Excessive tearing
  • No presence of discharge

Viral conjunctivitis generally resolves on its own within three to seven days, without any treatment. Placing cold compresses on your eyes and applying artificial tears eye drops can help to alleviate your symptoms as the virus makes its way out of your system.

Once the eyes have stopped tearing, you are no longer contagious. Be sure to inform your eye doctor if symptoms persist after a few days.  

Is it safe to wear contact lenses with conjunctivitis?

No. 

It is not safe to wear contact lenses with any type of conjunctivitis, as germs can remain on the surfaces of your lenses and reinfect your eyes.

If you wore disposable contact lenses while your eyes were infected, resume contact lens wear with a fresh pair— but only after you have completed your antibiotics or have been given approval by your eye doctor.

How can I prevent pink eye from spreading to other family members?

Being careful with personal hygiene is the best way to protect your family members.

Wash your hands frequently, avoid sharing pillows and sheets and refrain from touching your eyes as much as possible!

LEARN MORE: Guide to Eye Conditions

‘Pink eye’ can be highly contagious, schedule an appointment with an eye doctor near you as soon as you notice any symptoms.

Bacterial and viral conjunctivitis are both referred to as ‘pink eye’, but each present with different symptoms and require different treatment methods.

Infectious conjunctivitis is highly contagious, so have your eyes examined by an eye doctor as soon as symptoms appear to receive an accurate diagnosis and effective treatment plan.

How to tell if pink eye is bacterial or viral

Key facts

  • Conjunctivitis is sometimes known as ‘pink eye’ or ‘sticky eye’.
  • Conjunctivitis is a common condition where the white part of the eye becomes pink or red. One or both eyes may be watery, sore or itchy, sometimes with sticky white or yellow discharge.
  • Conjunctivitis can be caused by bacterial or viral infection, allergy, or irritants such as dust or chemicals.
  • Your doctor or optometrist can tell you the likely cause of your conjunctivitis, if it’s contagious, and the best treatment for your type of conjunctivitis.

On this page

  • What is conjunctivitis?
  • What are the symptoms of conjunctivitis?
  • What causes conjunctivitis?
  • How did I catch conjunctivitis?
  • When should I see my doctor?
  • How is conjunctivitis diagnosed?
  • How do I treat conjunctivitis?
  • Can conjunctivitis be prevented?
  • Related information on Australian websites

What is conjunctivitis?

Conjunctivitis, sometimes known as ‘pink eye’ or ‘sticky eye’, is a common condition where the white part of the eye becomes pink or red. One or both eyes may be watery, sore or itchy, sometimes with sticky white or yellow discharge. This is due to inflammation of the eye’s clear outer layer (known as the conjuctiva) and the inside of the eyelid.

Allergic conjunctivitis may be seasonal, or triggered by specific allergens, for example, pollen or animal dander. Viral and bacterial conjunctivitis can be highly contagious and it is important that a doctor, optometrist or pharmacist diagnoses the exact cause to ensure you get the right treatment.

What are the symptoms of conjunctivitis?

The main symptom of conjunctivitis is red or pink eyes, often with itching, watering or discomfort.

If you have bacterial conjunctivitis, you may have yellow or green sticky discharge from the eyes, which can make the eyelids stick closed together, especially when you wake up from sleep.

If you have viral conjunctivitis, one or both eyes might be affected, and the discharge is likely to be clear.

If you have allergic conjunctivitis, both eyes are usually affected with a clear discharge, and you might also have hay-fever symptoms, such as an itchy nose, watery eyes and sneezing.

If you have conjunctivitis, you might also:

  • have tears
  • have puffy eyes
  • have a gritty sensation in one or both eyes
  • have itchy or burning eyes
  • be sensitive to light
  • have some vision loss or pain (if this is the case, see a doctor or optometrist straight away)

CHECK YOUR SYMPTOMS — Use our eye problems Symptom Checker and find out if you need to seek medical help.

What causes conjunctivitis?

Conjunctivitis can be caused by:

  • bacterial infection
  • viral infection
  • allergy
  • irritants such as dust or chemicals

How did I catch conjunctivitis?

You can catch viral and bacterial conjunctivitis from direct contact with eye discharge from a person with conjunctivitis. You can also catch it from contact with objects that were contaminated with infectious eye secretions, such as towels, face washers and tissues.

Allergic conjunctivitis is caused by exposure to allergens such as dust mite, pollen, animal dander, mould spoors and occasionally foods or food additives. It isn’t contagious so it can’t spread from person to person.

When should I see my doctor?

If you have symptoms of conjunctivitis, you should see your doctor to find the cause of your conjunctivitis, and the best treatment for your type of conjunctivitis.

FIND A HEALTH SERVICE — Our Service Finder can help you find doctors, pharmacies, hospitals and other health services.

How is conjunctivitis diagnosed?

Your doctor will talk to you about your symptoms and will examine you, especially your eyes.

They might also take a sample of the discharge from your eye.

ASK YOUR DOCTOR — Preparing for an appointment? Use our Question Builder for general tips on what to ask your GP or specialist.

How do I treat conjunctivitis?

The treatment for conjunctivitis depends on the cause. For all types of conjunctivitis, it’s helpful to wash the eye gently several times a day with clean cotton wool soaked in warm tap water.

Viral infections improve without other special treatment.

Bacterial infections may require antibiotic eye drops or ointment. It’s important to keep applying the medicine for several days after your symptoms have improved.

If you wear disposable contact lenses and have bacterial or viral conjunctivitis, you should throw away any lenses you have been using and replace you contact lens case.

If you wear ‘extended-wear’ contact lenses, clean them according to the package directions, You should avoid using contact lenses for at least a week after your symptoms have resolved.

Replace any eye makeup or eyelash extensions used right before or during an infection.

Allergic conjunctivitis is treated with antihistamine drops or tablets. Sometimes your doctor might suggest tests to help you find the allergic trigger.

Can conjunctivitis be prevented?

People with conjunctivitis should try not to touch their eyes and should wash their hands regularly with soap and warm water and use a separate towel. This will reduce the risk of spreading conjunctivitis from one eye to the other, and between people.

People who use contact lenses should change them regularly and avoid wearing them while bathing or swimming.

Those who work with an irritant or in a dusty environment should wear eye protection. Learn more about eye care.

While adults can develop conjunctivitis, it is much more common among children. Conjunctivitis is often contagious, so if you are affected, don’t share towels or face cloths, and stay away from preschool, school or work until the discharge from the eyes has completely stopped.

Should I keep my child home from school?

Keep your child home from school until the discharge (pus) from their eyes has stopped — unless otherwise advised by your doctor.

Read more about common childhood illnesses, including conjunctivitis, and their recommended exclusion periods.

Is bacterial pink eye more contagious than viral?

Pinkeye that's caused by bacteria can spread to others as soon as symptoms appear and for as long as there's discharge from the eye — or until 24 hours after antibiotics are started. Conjunctivitis that's caused by a virus is generally contagious before symptoms appear and can remain so as long as the symptoms last.

What does bacterial pink eye look like?

Redness in the white of the eye or inner eyelid. Swollen conjunctiva. More tears than usual. Thick yellow discharge that crusts over the eyelashes, especially after sleep.

What is the difference between pink eye and bacterial conjunctivitis?

Conjunctivitis is most often caused by germs such as viruses and bacteria. "Pink eye" most often refers to a highly contagious viral infection that spreads easily among children. Conjunctivitis can be found in people with COVID-19 before they have other typical symptoms.

What color is viral pink eye?

People often call conjunctivitis “pink eye” because it can cause the white of the eye to take on a pink or red color. Symptoms of pink eye can vary but typically include redness or swelling of the white of the eye.