Symptoms of Pink Eye (Conjunctivitis)
Pink eye (conjunctivitis) typically presents with redness, discharge, and discomfort, with specific symptoms varying by type (viral, bacterial, or allergic). 1, 2
Common Symptoms Across All Types of Conjunctivitis
- Red or pink appearance of the eye (conjunctival injection)
- Swelling of the conjunctiva (chemosis)
- Eyelid swelling and erythema
- Eye discharge (varies by type)
- Discomfort or irritation
Symptoms by Type of Conjunctivitis
Viral Conjunctivitis
- Abrupt onset
- Unilateral initially, often becoming sequentially bilateral
- Watery discharge
- Follicular reaction of inferior tarsal conjunctiva
- Distinctive signs:
- Preauricular lymphadenopathy
- Petechial and subconjunctival hemorrhage
- Eyelid ecchymosis (bruising)
- Possible membrane/pseudomembrane formation 1
Bacterial Conjunctivitis
- Unilateral or bilateral presentation
- Purulent or mucopurulent discharge (thicker, yellow-green)
- Mattering and adherence of eyelids upon waking (eyelids "stuck shut")
- Absence of itching
- Less commonly: preauricular lymphadenopathy 1, 3
Allergic Conjunctivitis
- Bilateral presentation
- Intense itching (most consistent and characteristic symptom)
- Watery discharge
- Chemosis (conjunctival swelling)
- Papillary reaction of the conjunctiva
- Often accompanied by other allergic symptoms (sneezing, nasal congestion) 2, 4
Important Distinguishing Features
- Discharge type: Watery in viral and allergic; purulent/mucopurulent in bacterial 2, 5
- Itching: Prominent in allergic, minimal or absent in viral and bacterial 3
- Eyelid matting: Most prominent in bacterial conjunctivitis 5
- Preauricular lymph nodes: More common in viral conjunctivitis 1, 6
Warning Signs Requiring Immediate Medical Attention
- Severe eye pain
- Vision changes or decreased visual acuity
- Light sensitivity (photophobia)
- Corneal involvement
- No improvement after 7-10 days
- Increased eye discharge after initial improvement 2
Special Considerations
- In neonates, conjunctivitis requires immediate attention as it may indicate serious infection
- Contact lens wearers with conjunctivitis should be evaluated for possible corneal involvement
- Herpes simplex or varicella zoster conjunctivitis may present with distinctive vesicular skin lesions or specific corneal findings 1, 2
Pink eye is typically self-limiting, with viral cases resolving in 5-14 days and bacterial cases in 1-2 weeks without treatment. However, proper identification of symptoms helps determine appropriate management and when medical attention is necessary 2, 3.