Viral Conjunctivitis (Pink Eye)

What is viral conjunctivitis?

Viral conjunctivitis (kuhn·juhngk·tuh·vai·tuhs) is an infection of the eye caused by a virus and is the most common cause of infectious conjunctivitis. Conjunctivitis, or pink eye, is inflammation of the conjunctiva. The conjunctiva is a thin, clear membrane that covers the white part of the eyeball (the sclera) and the inside of the eyelid. Bacteria, allergies, and chemical irritants can also cause conjunctivitis.

anatomy of the human eye relevant to viral conjunctivitis (pink eye), emphasizing areas such as eyelid, sclera, cornea and conjunctiva.

Anatomy of the human eye, showing the conjunctiva

What causes viral conjunctivitis?

Viral conjunctivitis is usually caused by the virus that gives you the common cold, called Adenovirus.

You may also have:

  • a runny nose
  • a sore throat
  • congestion
  • fever
  • swollen lymph nodes

Viral conjunctivitis can spread when you come in close contact with someone who has a viral eye infection, and then you touch your face or eyes. You can also get it from someone who is coughing or sneezing with cold. It can spread easily through schools and crowded places.

Other viruses that cause pink eye include:

  • Coronavirus: Causes COVID-19
  • Herpes Simplex: Causes cold sores on your lips
  • Varicella-Zoster: Causes chickenpox and shingles
  • Rubeola: Causes measles

Herpes virus and Varicella-zoster conjunctivitis can be serious and cause loss of vision. Both can be treated with antiviral medication which can be oral (by mouth) and/or topical (eye drops).

What are the symptoms of viral conjunctivitis?

Viral conjunctivitis usually starts in one eye and if you’re not careful it can quickly spread to your other eye or to other people.

Symptoms include:

  • Red eyes
  • Watery eyes
  • Sensitivity to light
  • A feeling that there is something in your eye
  • Itching or burning eyes

Most people with viral conjunctivitis have watery eyes and rarely experience pain or blurry vision. This is different from the thick, pus-like discharge seen with bacterial conjunctivitis.

Close-up view of an eye affected by viral conjunctivitis, showing redness and watery eyes.

Close-up view of an eye affected by viral conjunctivitis,
showing redness and watery eyes

How is viral conjunctivitis diagnosed?

It is not necessary to visit your eye doctor at the first symptoms of eye irritation.

You should make an appointment with your eye doctor or primary care provider if you have any of the following:

  • Pain, blurry vision, or increased thick discharge
  • Symptoms worsen
  • Wear contact lens and have a red eye for more than one day
  • Experience any eye pain

Your doctor can diagnose viral conjunctivitis based on your symptoms and through an eye exam.

During the exam, the doctor will:

  • Take your health history
  • Check your visual acuity (test how well you can see through your central vision in each eye with an eye chart)
  • Examine the front of your eye (including your cornea)

The doctor will determine the best treatment for you.

How is viral conjunctivitis treated?

Viral conjunctivitis usually goes away in one to two weeks without treatment. Like the common cold, the infection needs to run its course. Symptoms may get worse for three to five days before they start to get better. It may take up to three weeks for symptoms to resolve.  If you have symptoms of conjunctivitis that do not improve in one week, see an eye doctor.

To help the symptoms, you can:

  • Use warm or cool compresses to relieve discomfort
  • Use artificial tear eyedrops (talk with an eye care provider to learn which type of artificial tears might be right for you)
  • Avoid the use of eye drops that reduce redness (it can make redness worse)
  • Not wear contact lenses until the infection is gone

How can you prevent viral conjunctivitis?

Viral conjunctivitis can spread easily. You can prevent spreading it to your other eye and other people.

The best way to prevent viral conjunctivitis is to practice good hygiene:

  • Avoid touching or rubbing the infected eye
  • Wash your hands often with soap and water
  • Use paper towels or tissues instead of cloth towels
  • Do not share towels or pillows
  • Wipe any discharge from eyes
  • Wash any cloth towels, washcloths, and linens in a hot water laundry cycle
  • Do not use contact lenses or eye makeup until your eye is healed
  • Throw away old cosmetics, especially mascara
  • If you wear contacts, replace your lens case with a new one
  • If you wear disposable contacts, throw them away and use a new pair
  • If your contacts are not disposable, make sure you clean them well

Questions to ask your doctor

  • What is causing my conjunctivitis?
  • What can I do to treat it?
  • How will I know my condition is getting worse?
  • How long will it take for my eye to get better?
  • How can I prevent spreading it to others?
  • Do I need to stay home from work or school?
  • Will this condition cause any permanent damage to my eye?
  • Do I need to come back for a follow-up visit?
  • When is it safe to wear contact lenses again? (if you use them)

Resources

Tips and a how to video for taking eye drop medications

a woman taking eye drop medicine