What to Do if You Think You Have Pinkeye

Every day, I, as an ophthalmologist (a medical doctor who specializes in medical and surgical treatment of eye diseases) receive at least one telephone call from a patient who says, "I think I have pinkeye." When I ask him or her what the symptoms are, he usually will tell me that one or both eyes are red, tearing, itching, and uncomfortable. I will then ask him to come in for an examination that day.

Pinkeye is a nonmedical term which is commonly used by patients to describe conjunctivitis, an inflammation of the conjunctiva (the transparent covering of the white of the eye and inside of the eyelids). I consider pinkeye as synonymous with viral conjunctivitis, an infection caused by a variety of viruses in the eye. Most of these viruses reside in the respiratory tract and are spread through the air or by hand to eye contact.

When I speak with a patient such as this in the office, I ask whether he or she also has symptoms of light sensitivity, lids stuck together in the morning upon awakening, discharge, or a sensation of having something in the eye, all of which are common with pinkeye. The patient may have or have had a recent cold. Recent antibiotic usage also increases the risk of pinkeye. Family members may have or have had the same symptoms, indicative of an infection is being passed from one person to another.

When I examine this patient, the vision is usually not affected. There may be a tender pea-sized lymph node in front of the ear on one or both sides. The eyelids may be swollen and one or both eyes will be red and tearing. There usually is thin drainage from the affected eye(s). Viral conjunctivitis usually affects both eyes, although the severity or onset of signs and symptoms may be different between the two eyes. The other eye structures will be normal.

As I examine the eye, I am looking for signs of other common causes of a red eye, such as allergy or dry eye. I am also making certain that there are no more serious problems, such as herpes infection, bacterial infection, fungal or amebic infection, corneal ulceration, or evidence of deeper involvement of the eye.

When I tell this patient that he indeed has pinkeye (viral conjunctivitis), I also inform her that this is contagious and she should try to prevent spreading the infection to the other eye (if only one is involved) and to other people. I instruct her to carefully wash her hands every time she touches around the eye, not to share towels with others, not to wear contact lenses and not to use or share eye makeup. If the patient is a child, I advise staying home from school for two or three days until the risk of spread is diminished.

I will treat this patient with drops and ointment to decrease the symptoms, although pink eye is a self-limited condition which will usually improve on its own. I advise placing a warm compress, such as a washcloth soaked in warm water, on the eyes for a few minutes, three to four times a day. This eases the discomfort and helps break up some of the crust that may form on the eyelashes. An eye patch should not be worn.

Most people will have pinkeye at least once in their lifetime. Prevention is important. Pinkeye can spread in areas where people live, work, and play closely together. If you are around someone with pinkeye, wash your hands thoroughly and often. People who share computer keyboards with others at work must be careful to wash their hands before they touch anywhere around their faces, especially during cold season.