What are the treatment options for conjunctivitis (pink eye) at home?

Home Treatment for Pink Eye (Conjunctivitis)

For most cases of pink eye, supportive care at home is sufficient, with specific treatments depending on whether the cause is viral, bacterial, or allergic.

Initial Assessment at Home

Before starting treatment, identify the likely cause based on these key features:

• Bacterial conjunctivitis: Yellow or green mucopurulent discharge with eyelids matted shut upon waking, typically no itching 1, 2, 3
• Viral conjunctivitis: Watery discharge, burning or gritty sensation, often highly contagious 3, 4
• Allergic conjunctivitis: Bilateral itching as the predominant symptom, watery discharge, often seasonal 3, 5, 4

Home Treatment by Type

Viral Conjunctivitis (Most Common in Adults)

Viral conjunctivitis requires only supportive care and will resolve on its own in 1-2 weeks 3, 4:

• Apply cold compresses to the affected eye(s) multiple times daily 3
• Use artificial tears (lubricating eye drops) frequently for comfort 3
• Consider over-the-counter antihistamine eye drops for symptom relief 3
• Practice strict hand hygiene and avoid touching the eyes to prevent spread 3
• Avoid sharing towels, pillowcases, or personal items 3

Bacterial Conjunctivitis

Most uncomplicated bacterial conjunctivitis is self-limiting and resolves in 1-2 weeks without antibiotics 4:

• Clean eyelids and lashes with warm water and gentle soap to remove crusts before any treatment 1
• Warm compresses can help loosen crusted discharge 1
• If symptoms are mild, watchful waiting is appropriate 4

However, topical antibiotics can shorten duration and allow earlier return to work/school 4:

• Over-the-counter options like bacitracin ophthalmic ointment applied 1-3 times daily into the conjunctival sac for 5-7 days 2, 6
• Erythromycin ophthalmic ointment is another option for superficial bacterial infections 7

Allergic Conjunctivitis

Topical antihistamines with mast cell-stabilizing activity are the treatment of choice 3:

• Over-the-counter antihistamine/mast cell stabilizer eye drops (such as ketotifen) applied as directed 3, 4
• Oral antihistamines can provide additional relief 5
• Cold compresses for symptomatic relief 3
• Avoid known allergens when possible 5

When to Seek Medical Care Immediately

Do not attempt home treatment if any of these red flags are present 2, 8:

• Severe pain not relieved by over-the-counter pain medication 2, 8
• Decreased vision or visual changes 2, 8
• Moderate to severe purulent discharge 2
• Corneal involvement (cloudy appearance of the normally clear front part of the eye) 2, 8
• History of recent eye surgery 2, 8
• Vesicular rash on eyelids or nose (suggesting herpes) 2, 3
• Immunocompromised state 2, 8
• Contact lens wearer with conjunctivitis (risk of corneal ulcer) 5, 4
• Newborn with conjunctivitis (requires immediate evaluation) 3, 5

Follow-Up Considerations

• If no improvement after 3-4 days of home treatment, seek medical evaluation 1
• If symptoms persist beyond 7-10 days, medical evaluation is needed 1, 2
• Recurrent episodes warrant ophthalmology referral 2

Critical Pitfalls to Avoid

• Never use topical corticosteroids without ophthalmology supervision as they require monitoring for glaucoma and cataracts 9
• Never use topical anesthetics for home treatment 10
• Do not share eye medications between family members 1
• Bacterial conjunctivitis caused by gonorrhea or chlamydia requires systemic antibiotics, not just topical treatment 2, 4