How Do You Know When Pink Eye Is No Longer Contagious?

What Is Pink Eye (Conjunctivitis)?

Bacterial pinkeye stops being contagious shortly after you start antibiotics, but viral pinkeye may be contagious for up to two weeks.
Bacterial pinkeye stops being contagious shortly after you start antibiotics, but viral pinkeye may be contagious for up to two weeks.

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

What Are Symptoms of Pink Eye (Conjunctivitis)?

Symptoms of pink eye (conjunctivitis) include: 

  • Eye redness
  • 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
  • Eye irritation
  • Burning, sandy, or gritty feeling in one eye
  • Cold symptoms (viral conjunctivitis)
  • Swollen lymph nodes (glands)
  • Fever
  • Sore throat
  • Runny nose
  • Itching of both eyes (allergic conjunctivitis)

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

What Causes Pink Eye (Conjunctivitis)?

Causes of pink eye (conjunctivitis) include: 

  • Viral infections 
    • Most cases of infectious conjunctivitis are viral in adults and children
    • Highly contagious
    • Typically caused by a virus that can cause the common cold
    • Spread by contact, usually after an infected person touches their eye and then touches an object 
  • Bacterial infections
    • Highly contagious
    • Bacterial conjunctivitis is 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
    • Often affects multiple people in a classroom or household
  • Allergies
    • Caused by airborne allergens that come in contact with the eye
  • Toxic 
    • A chronic inflammation of the surface of the eye from an offending agent, usually a preservative or a medication
  • Nonspecific conditions
    • Dry eye
    • Irrigation after a chemical splash
    • Foreign body irritation (e.g., dust, eyelash) 

How Is Pink Eye (Conjunctivitis) Diagnosed?

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

Swabbing the eye for culture, stains, and direct antibody or polymerase chain reaction (PCR) testing is usually 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 (Conjunctivitis)?

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
  • A general rule of thumb is: if the eyes are red, it can spread
  • Irritation and discharge worsen for three to five days before improving, and symptoms can persist for two to three weeks
  • Topical antihistamine/decongestant eye drop to relieve eye irritation 
  • Drops are available without a prescription in most pharmacies
  • Patients should be careful to avoid spreading the viral infection from one eye to the other
  • Drops should be applied to the affected eye only and hands should be washed 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
  • The contact case should be discarded and the 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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