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4 types of conjunctivitis

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Viral conjunctivitisBacterial conjunctivitisAllergic conjunctivitisChemical conjunctivitisSpeaking with a doctorSummary
There are several types of conjunctivitis, each with different causes and treatment options. It’s advisable to speak with a healthcare professional to get an accurate diagnosis.
Medically reviewed by Grace Zhang, MD
Written by Rashida Ruwa, RN
Updated on March 1, 2024

Conjunctivitis, commonly known as pink eye, is an inflammation of the conjunctiva. The conjunctiva is a thin tissue that lines the inner surface of the eyelids. Conjunctivitis can lead to eye symptoms such as redness, itching, tearing, and eye discharge. 

There are several types of conjunctivitis, such as viral, allergic, bacterial, and chemical. Each type has different causes and treatment options. This is why it’s important to speak with a healthcare professional to ensure you get a correct diagnosis and effective treatment plan.

Viral conjunctivitis

Adult putting eye drops into their eye.
Jelena Stanojkovic/Getty Images

Viral conjunctivitis, also known as pink eye, is an inflammation of the conjunctiva caused by a viral infection, most commonly by the adenovirus. It’s highly contagious and can spread through direct contact or touching contaminated surfaces.

Symptoms

Symptoms of viral conjunctivitis can include:

  • redness in the white of the eye and inner eyelid
  • watery discharge
  • itchiness or irritation
  • grittiness or foreign body sensation
  • swollen eyelids
  • light sensitivity
  • mild pain or discomfort
  • crustiness around the eyelids, particularly in the morning

Viral conjunctivitis symptoms may also accompany other symptoms of a viral infection, such as a sore throat or runny nose.

Treatment options

Treatment options for viral conjunctivitis aim to ease symptoms and promote comfort. According to the Centers for Disease Control and Prevention (CDC), the infection typically resolves on its own within 1–2 weeks. Treatment options may include:

  • Artificial tears or lubricating eye drops: These over-the-counter (OTC) eye drops help reduce dryness and soothe discomfort or irritation. Brand names of commonly used lubricating eye drops include Refresh and Systane.
  • Cold compresses: You can apply a cold compress or clean washcloth soaked in cold water to the affected eye(s). This will help lower inflammation and ease symptoms.
  • Hygiene and prevention: A good hygiene practice is important to help prevent the spread of viral conjunctivitis. This includes:
    • avoiding touching or rubbing the eyes
    • washing hands frequently with soap and warm water
    • avoiding sharing towels or pillows
    • disinfecting frequently touched surfaces

Viral conjunctivitis does not typically require prescription medications. According to the CDC, antibiotics are not effective against viral infections, and doctors do not routinely prescribe them for viral conjunctivitis. But a healthcare professional may prescribe antiviral medications in severe cases.

Bacterial conjunctivitis

Bacterial conjunctivitis is an inflammation of the conjunctiva caused by a bacterial infection. The most common bacteria responsible for this condition include Staphylococcus aureus in adults and Haemophilus influenzae in children.

Bacterial conjunctivitis is highly contagious and can spread through direct contact or by touching contaminated objects.

Symptoms

Eye symptoms of bacterial conjunctivitis may include the following:

  • redness
  • a thick yellow or greenish discharge 
  • itchiness of the affected eye(s) 
  • eyelid swelling
  • grittiness or foreign body sensation
  • too much tearing 

Treatment options

A healthcare professional may prescribe antibiotic eye drops or ointments to manage bacterial conjunctivitis effectively. Antibiotics can help treat the bacterial infection, lower the spread of infection, and prevent complications such as a corneal ulcer (an open sore in the eye).

Mild bacterial conjunctivitis may get better without antibiotic treatment. It often improves in 2–5 days but can take 2 weeks to heal completely.

Commonly prescribed antibiotics for bacterial conjunctivitis include polymyxin b-trimethoprim (Polytrim) and moxifloxacin (Vigamox).

It’s important to follow the prescribed dosage and length of treatment. This helps treat the infection and prevent it from occurring again (recurrence).

In addition to antibiotic eye drops or ointments, practicing good hygiene is important. This is to help prevent the spread and recurrence of bacterial conjunctivitis. A healthcare professional may recommend:

  • washing hands frequently
  • avoiding touching or rubbing the eyes
  • avoiding sharing towels, pillows, or other personal items

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Allergic conjunctivitis

Allergic conjunctivitis is an inflammation of the conjunctiva caused by a reaction to substances like pollen, pet dander, dust mites, or certain medications. It occurs when the immune system overreacts to these allergens, leading to various symptoms.

Symptoms

Eye symptoms of allergic conjunctivitis include:

  • intense itching
  • redness 
  • watery discharge
  • burning or stinging sensation
  • swelling of the eyelids and surrounding tissues 

Treatment options

Various treatment options are available to effectively manage allergic conjunctivitis, depending on the severity of symptoms. OTC artificial tears can temporarily help relieve dryness and soothe the eyes in mild cases.

A healthcare professional may suggest using cold compresses to help relieve itching and lower inflammation in the affected eye(s).

To help ease symptoms, you can also try to identify and avoid allergens that trigger the condition. This may involve staying indoors during peak pollen seasons, using allergen-proof bedding, and avoiding exposure to pet dander or other known allergens.

Treatment options for allergic conjunctivitis may also include:

  • Antihistamine eye drops: These eye drops can help relieve itching and redness in mild cases. An example of antihistamine eye drops is ketotifen (Zaditor).
  • Mast cell stabilizers: These medications work by preventing the release of inflammatory substances and lowering symptoms like redness and itchiness. A common example is nedocromil sodium (Alocril).
  • Oral antihistamines: When symptoms are severe and not responding effectively to eye drops alone, a healthcare professional may recommend oral antihistamines like loratadine (Claritin). These medications help reduce symptoms like itching.
  • Corticosteroids: A healthcare professional may recommend corticosteroids such as prednisolone (Millipred), but typically only for a short period to help treat a short-term (acute) allergic disease.

Chemical conjunctivitis

Chemical conjunctivitis, also known as irritative or toxic conjunctivitis, occurs when the eyes come into contact with certain chemicals or irritants. These can include household cleaning products, chemicals in cosmetics, or even environmental factors like smoke or fumes. 

Symptoms

The symptoms of chemical conjunctivitis can vary but often include:

  • redness
  • itching
  • burning
  • tearing
  • swelling of the eyes

Treatment options

Treatment options for chemical conjunctivitis mainly focus on removing or neutralizing the irritant that caused the inflammation. In mild cases, rinsing the eyes with water or saline solution may relieve and help flush out the irritant. Applying cool compresses can also help soothe the eyes.

If the symptoms persist or worsen, it’s important to seek immediate medical attention. A healthcare professional may prescribe medications such as topical antihistamines or topical corticosteroids to manage the symptoms and help promote healing. 

When to speak with a doctor

You can manage conjunctivitis at home. But you may consider speaking with a healthcare professional if:

  • symptoms worsen or do not improve after a few days of home care
  • you experience severe eye pain, sensitivity to light, or blurred vision
  • you have a significant amount of green or yellow discharge

A healthcare professional can evaluate the severity of your symptoms and provide an accurate diagnosis. Based on that, they can recommend appropriate treatment options to help manage your condition and prevent complications.

Summary

The three main types of conjunctivitis are viral, bacterial, and allergic. Chemical irritants can also cause an allergic reaction and inflammation of the conjunctiva. Each type has unique causes, symptoms, and treatment options.

It’s advisable to speak with a healthcare professional to make sure you get a correct diagnosis and effective treatment plan.

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