Can I Go to Work with Pink Eye?

Reviewed on 1/13/2022

Man in a paper face mask covering his right eye
Pink eye is highly contagious and can be transmitted by touching or shaking hands, coughing, sneezing, and touching infected surfaces. You should be able to return to work if you have been treating the infection with antibiotics for 24 hours or more and/or are not experiencing any symptoms.

Pink eye (conjunctivitis) is an inflammation of the conjunctiva, the thin membrane that lines the inner surface of the eyelids and the whites of the eyes (called the sclera). 

There are five main types of conjunctivitis

  • Viral
  • Bacterial
  • Allergic
  • Toxic (also called toxic keratoconjunctivitis)
  • Nonspecific

How Contagious Is Pink Eye?

Viral and bacterial conjunctivitis can be very contagious and easily spread from person to person by:

  • Close personal contact, such as touching or shaking hands
  • Coughing and sneezing
  • Touching an object or surface with germs on it, then touching your eyes before washing hands
  • Viral conjunctivitis is usually contagious for two weeks after the symptoms first appear, for as long as the eyes are red. A general rule of thumb for viral conjunctivitis is: if the eyes are red, it can spread. 

Bacterial conjunctivitis is considered no longer contagious after 24 hours of antibiotic treatment.

If you have pink eye but do not have fever or other symptoms, you may be allowed to go to work with a doctor’s approval. People who have symptoms and whose work involves close contact with other people should not go to work. 

What Are Symptoms of Pink Eye?

Symptoms of pink eye (conjunctivitis) include: 

  • Eye redness
  • Eye irritation
  • Discharge
    • May be watery or thick
    • May be yellow, white, or green, and usually continues to drain throughout the day
    • Affected eye often is crusty and stuck shut in the morning
  • Burning, sandy, or gritty feeling in one eye
  • Cold symptoms (viral conjunctivitis)
  • Itchy eyes (allergic conjunctivitis)

When to See a Doctor

See an eye specialist (ophthalmologist or optometrist) if you suspect pink eye and have the following symptoms that may be signs of a more serious condition: 

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What Causes Pink Eye?

Causes of pink eye (conjunctivitis) include: 

  • Viral infections 
    • Highly contagious
    • Most often caused by a virus that can cause the common cold
    • Most cases of infectious conjunctivitis are caused by viruses
    • Spread by contact, usually after an infected person touches their eye and then touches an object 
  • Bacterial infections
    • Highly contagious
    • More common in children than in adults
    • Spread by contact, usually with objects which have come into contact with the infected person's eye secretions
    • Frequently affects multiple people in a classroom or household
  • Allergies
    • Caused by airborne allergens that come in contact with the eye
  • Toxic 
    • Chronic inflammation of the surface of the eye from an offending agent, usually a preservative or a medication
  • Nonspecific conditions
    • Foreign body irritation (e.g., dust, eyelash) 
    • Dry eye
    • Irrigation after a chemical splash

How Is Pink Eye Diagnosed?

Pink eye (conjunctivitis) is diagnosed with a physical examination of the eye. A diagnosis of pink eye is usually made based on the presence of symptoms such as eye redness and discharge, and the patient’s vision being normal with no evidence of other eye conditions such as keratitis, iritis, or angle-closure glaucoma.

  • Swabbing the eye for a culture, stains, and direct antibody or polymerase chain reaction (PCR) testing is generally only used in uncommon or chronic cases that do not get better on their own or respond to treatment.
  • There is a rapid (10-minute) test for conjunctivitis caused by adenoviruses but it often is not covered by insurance so it is not widely used. 

What Is the Treatment for Pink Eye?

Treatment for pink eye (conjunctivitis) depends on the cause. 

Viral conjunctivitis treatment: 

  • Viral conjunctivitis is usually contagious for two weeks after the symptoms first appear, for as long as the eyes are red
  • Topical antihistamine/decongestant eye drop to relieve eye irritation 
    • Available without a prescription in most pharmacies
    • Take care to avoid spreading the viral infection from one eye to the other
    • Apply to the affected eye only and wash hands thoroughly after application
  • Warm or cool compresses may be used as needed

Bacterial conjunctivitis treatment: 

  • Bacterial conjunctivitis is considered no longer contagious after 24 hours of antibiotic treatment
  • Antibiotic eye drops or ointment
    • Ointment is generally preferred for young children
  • Treatment can help shorten the duration of symptoms when started early
  • Redness, irritation, and eye discharge should begin to improve within 24 to 48 hours 
  • Most cases go away on their own even if no treatment is used
  • Contact lens wearers should not wear lenses the first 24 hours of treatment, or until the eye is no longer red
  • Contact case should be discarded and contacts disinfected overnight or replaced (if disposable)

Allergic conjunctivitis treatment:

  • Eye drops that contain naphazoline-pheniramine, ketotifen, olopatadine, and others

Toxic conjunctivitis treatment:

  • Removal of the offending agent
  • Stop use of any topical eye medications 
    • Don’t stop taking any prescribed eye medications without first talking to your doctor, especially glaucoma drops, because an increase in eye pressure may cause irreversible vision loss

Nonspecific conjunctivitis treatment:

  • This type of pink eye usually goes away within a few days without treatment
  • Lubricant drops or ointments may help the eye feel better as it heals
  • Antibiotic or steroid eye drops/ointments are not recommended unless there is an accompanying bacterial infection or inflammation

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Reviewed on 1/13/2022
References
Image Source: iStock Images

https://www.uptodate.com/contents/conjunctivitis-pink-eye-beyond-the-basics?search=Pink%20Eye&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2

https://www.southerncross.co.nz/group/medical-library/conjunctivitis-pink-eye-symptoms-treatment-prevention

https://www.uptodate.com/contents/conjunctivitis?search=Pink%20Eye&source=search_result&selectedTitle=4~150&usage_type=default&display_rank=4#H25

https://www.cdc.gov/conjunctivitis/about/transmission.html