Conjunctivitis (pink eye)
Also called: pink eye, red eye, eye infection, viral conjunctivitis, bacterial conjunctivitis, allergic conjunctivitis
Conjunctivitis (pink eye) is redness and swelling of the thin clear layer over the white of the eye, usually caused by a virus, bacteria or an allergy. Most cases get better on their own within one to two weeks, and good hand washing stops it spreading.
General health information for Pakistan. It does not give doses or brand advice. If you are worried, or symptoms are severe, see a doctor. When to see a doctor
Overview
Conjunctivitis means inflammation of the conjunctiva (the thin, clear layer that covers the white of the eye and the inside of the eyelids). The eye looks pink or red, feels gritty or itchy, and may water or make sticky pus. It can affect one eye or both.
There are three main types. Viral conjunctivitis is the most common and is usually caused by a group of viruses called adenoviruses. It spreads very easily and can cause large outbreaks, as seen in Pakistan in recent years. Bacterial conjunctivitis is also catching and tends to make thick, sticky discharge that glues the lashes together in the morning. Allergic conjunctivitis is caused by things like pollen, dust mites or pet hair. It is very itchy but it does not spread to other people. Chemicals, smoke, dust and wearing contact lenses for too long can also irritate the eye.
Most pink eye is mild. Viral pink eye usually clears within one to two weeks, sometimes up to three weeks, and antibiotics do not help it. Mild bacterial pink eye often clears without treatment, though antibiotic drops can shorten it. Pink eye in a newborn baby, or red eye with pain, light sensitivity or blurred vision, needs a doctor quickly, because it can be a sign of something more serious.
In Pakistan
In the 2023 pink eye outbreak, which spread from Karachi and Lahore across Punjab and Khyber Pakhtunkhwa, Punjab health authorities recorded 379,690 cases in 36 districts and schools were closed for a time. In September 2025 Pakistan's NIH warned of a new surge after floods and advised against using antibiotics for viral pink eye.
Symptoms
- Pink or red colour in the white of one or both eyes
- A gritty or burning feeling, or an urge to rub the eye
- Itching, which is often strong in allergic conjunctivitis
- Watery eyes and extra tears
- Sticky yellow or green pus that crusts the lashes, especially on waking (more typical of bacterial infection)
- Swollen eyelids or swelling of the lining of the eye
- Mild sensitivity to light
- Cold-like symptoms, a sore throat or fever along with red eyes (common with viral infection)
Causes and risk factors
Causes
- Viruses, most often adenoviruses; others include the herpes viruses and some enteroviruses
- Bacteria, such as staphylococcus, streptococcus and haemophilus germs; in newborns and sexually active adults, gonorrhoea and chlamydia
- Allergy to pollen, dust mites, mould, animal dander, cosmetics or some eye drops
- Irritants such as chemicals, smoke, dust, fumes or something stuck in the eye
- Contact lens wear, especially overuse or poor lens cleaning
What makes it more likely
- Close contact with someone who has pink eye, for example at home, school or in crowded shelters
- Touching or rubbing your eyes with unwashed hands
- Sharing towels, pillows, make-up or eye drops
- Young age: bacterial pink eye is more common in children
- Hay fever, asthma or eczema, which make allergic pink eye more likely
- Wearing contact lenses for longer than advised or not cleaning them well
- Floods and contact with dirty water
- A newborn whose mother has an infection such as chlamydia or gonorrhoea, even without symptoms
Complications
Most pink eye heals with no lasting harm. Some viral types inflame the clear front window of the eye (the cornea) and can cause loss of vision. Herpes virus infection of the eye can damage the cornea and lead to inflammation inside the eye, so it needs an eye specialist. Contact lens wearers with bacterial infection have a higher risk of a serious corneal infection (keratitis). Gonorrhoea in the eye can damage the cornea quickly. In newborns, untreated gonorrhoea can spread to the blood and brain and cause blindness, and chlamydia can spread to the lungs. Using steroid eye drops without specialist advice can slow healing and raise eye pressure.
When to see a doctor
- Any redness, swelling or sticky discharge in a newborn baby (especially under 30 days old): see a doctor the same day
- Eye pain, rather than just grittiness or itching
- Sensitivity to light that makes it hard to keep the eye open
- Blurred vision that does not clear when you blink or wipe away the discharge, or other changes in vision
- A very red eye, or a lot of thick pus coming back quickly after wiping
- Red eye in a contact lens wearer, or bacterial pink eye that does not start to improve within a day of antibiotic drops
- Pink eye in someone with a weak immune system, or with blisters on the eyelid, forehead or tip of the nose
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Diagnosis
A doctor or pharmacist can usually tell it is conjunctivitis by asking about the symptoms and looking at the eyes. They ask whether one or both eyes are affected, what the discharge is like, whether it itches, whether you wear contact lenses, and whether you have had a cold, hay fever or contact with someone who has pink eye. Watery discharge with a cold points to a virus, thick pus points to bacteria, and strong itching with other allergies points to an allergy.
An eye doctor may check your vision and look at the eye with a special microscope, sometimes with a yellow dye to show damage on the cornea, for example from herpes. Tests are not needed for most people. A swab of the eye may be sent to the laboratory if the infection is severe, keeps coming back, does not respond to treatment, affects a newborn, or may be caused by gonorrhoea, chlamydia or herpes.
Treatment
- Clean the eyelids gently with cotton wool dipped in boiled water that has cooled, using a fresh piece for each eye
- Use a cool, clean cloth on the eyes and lubricating eye drops (artificial tears) for comfort; stop wearing contact lenses until the eye has fully recovered
- For viral pink eye, do not use antibiotics: they do not work against viruses. It usually settles by itself. Antiviral medicine is used only for serious virus types such as herpes, under an eye doctor
- For bacterial pink eye, mild cases often clear without treatment. Your doctor may prescribe antibiotic eye drops or ointment to shorten it, especially when there is pus. Children under 2 need a doctor's prescription
- For allergic pink eye, keep away from the trigger if you can, and ask about antihistamine or anti-allergy eye drops or allergy tablets
- Do not use steroid eye drops, or drops that combine a steroid with an antibiotic, unless an eye specialist prescribes them
- See an eye specialist if the eye is painful, vision is affected, you wear contact lenses, or it is not getting better
Medicines in Pakistan
Medicines a doctor may use, by group. Read the role: some are only for special cases. Each link opens our page for that medicine, with every brand and its official DRAP price. Your doctor decides which medicine and dose are right for you.
| Group | Role | Medicines |
|---|---|---|
| Antibiotic eye drops and ointments | For bacterial pink eye when your doctor thinks treatment is needed. Chloramphenicol drops are a common first choice in UK guidance. Fluoroquinolone drops are kept for more severe infection and for contact lens wearers. Ointment is sometimes used at night. They do not help viral or allergic pink eye | Chloramphenicol (8 brands), Ofloxacin (59 brands), Ciprofloxacin (761 brands), Levofloxacin (456 brands), Moxifloxacin (197 brands), Erythromycin (11 brands), Azithromycin (662 brands) |
| Antibiotics by mouth or injection | Only for pink eye caused by gonorrhoea or chlamydia, in adults or newborns, chosen and given by a doctor | Ceftriaxone (747 brands), Azithromycin (662 brands) |
| Antiviral medicines | For eye infection with herpes simplex or shingles virus, started and checked by an eye doctor. Not needed for ordinary viral pink eye | Aciclovir (102 brands) |
| Antihistamine tablets | Can help itching in moderate to severe allergic pink eye, often alongside anti-allergy eye drops; your doctor or pharmacist advises which one | Cetirizine (42 brands), Loratadine (175 brands), Fexofenadine (46 brands) |
Also used (not yet in our price list): Lubricating eye drops (artificial tears), Antihistamine eye drops, alone or with a vasoconstrictor (redness-reducing) drop, for allergic pink eye, Mast cell stabiliser eye drops (anti-allergy drops that prevent itching), Fusidic acid eye drops (used when chloramphenicol is not suitable and the germ is sensitive), Polymyxin B with trimethoprim eye drops, Ganciclovir eye gel (for herpes eye infection, from an eye doctor)
Self-care and prevention
Self-care
- Wash your hands with soap and water often, especially after touching your eyes; use an alcohol hand gel if soap is not available
- Gently wipe away crusts with cotton wool and cooled boiled water, using a fresh piece for each eye
- Hold a cool, clean cloth on the eyes for a few minutes to ease soreness
- Try not to touch or rub your eyes
- Use your own towel, pillowcase and face cloth, and wash them in hot water with detergent
- Do not share make-up or eye drops
- Leave out contact lenses until the eye is better and a doctor says it is safe
Prevention
- Wash hands regularly and keep hands away from the eyes
- Do not share towels, pillows, handkerchiefs, make-up or eye drops
- Keep children with infectious pink eye at home while they have symptoms, as advised by their doctor or school
- In floods, avoid dirty water touching your face and eyes, and wash only with clean, boiled or disinfected water
- Wear, clean and replace contact lenses only as advised
- Newborns are often given antibiotic eye drops or ointment soon after birth to prevent infection; a mother with genital herpes should talk to her doctor before delivery
Common questions
Do I need antibiotic eye drops for pink eye?
Often not. Most pink eye is caused by a virus, and antibiotics do not work against viruses. Mild bacterial pink eye often clears by itself too. A doctor may prescribe antibiotic drops if there is a lot of pus, if you have a weak immune system, or if it is not getting better.
How long is pink eye contagious and when can I go back to school or work?
Viral and bacterial pink eye spread easily while symptoms last. Advice differs: the UK NHS says you need not stay off work or school unless you feel very unwell, while Pakistan's NIH advises staying home for 5 to 7 days after symptoms start during outbreaks, and keeping children home until symptoms settle. Ask your doctor, and stay home if you have a fever.
How can I tell if pink eye is viral, bacterial or allergic?
Watery eyes with a cold or sore throat suggest a virus. Thick yellow or green pus that sticks the lashes together suggests bacteria. Strong itching in both eyes, with hay fever or other allergies, suggests allergy. The signs overlap, so ask a doctor or pharmacist if you are unsure.
Is it safe to use steroid eye drops for a red eye?
Not without an eye specialist. Steroid drops can slow healing, raise the pressure inside the eye and, rarely, damage the cornea. Some drops combine a steroid with an antibiotic, so check with a doctor or pharmacist before using any eye drops for a red eye.
Why is pink eye in a newborn baby serious?
In newborns it can be caused by germs passed from the mother at birth, such as gonorrhoea or chlamydia. Without quick treatment these can damage the eye, cause blindness or spread to the blood, brain or lungs. A baby with red, sticky eyes should see a doctor the same day.
Sources
- CDC. Clinical Overview of Pink Eye (Conjunctivitis) (n.d.).
- CDC. How to Treat Pink Eye (n.d.).
- CDC. Pink Eye in Newborns (n.d.).
- National Institute of Health (NIH) Pakistan, Center for Disease Control. Advisory for the Prevention and Control of Conjunctivitis (2025).
- NHS Lothian Antimicrobial prescribing toolkit (Right Decision Service, NHS Scotland). Conjunctivitis (n.d.).
- NHS. Conjunctivitis - NHS (n.d.).
- StatPearls (NCBI Bookshelf). Conjunctivitis - StatPearls - NCBI Bookshelf (n.d.).
- Archives of Iranian Medicine (Mahmood, Shama, Zhang; editorial). The Rising Challenge: Addressing the Pink Eye (Acute Conjunctivitis) Outbreak in Pakistan (2024).
Prepared from the sources listed below by the MedInfoBase team. Last reviewed 16 October 2026. This page is general health information, not medical advice. It gives no doses and does not replace a doctor: talk to your doctor or pharmacist before starting, stopping or changing any medicine. How we write and check our pages.
Related conditions
Allergic rhinitis (hay fever)Dry eyeCommon coldEczema (atopic dermatitis)