ConditionEyes & vision
Viral Conjunctivitis (Viral Pink Eye)
Viral conjunctivitis is an infection of the conjunctiva, the thin clear layer covering the white of the eye and inner eyelids, caused by a virus, usually adenovirus. It is the most common type of conjunctivitis, or pink eye. It causes a red, gritty, watery eye that often spreads to the other eye within days, sometimes with a cold or sore throat. It is very contagious but usually harmless, clearing on its own in 1 to 3 weeks. Antibiotic drops do not help. Cool compresses, artificial tears and careful hygiene are the main treatment.
Also called: Viral pink eye, adenoviral conjunctivitis, epidemic keratoconjunctivitis, pink eye
At a glance
- What it is
- A viral infection of the eye's surface lining, usually adenovirus.
- Symptoms
- Red, watery, gritty eye, often starting in one eye and spreading to the other.
- Contagious
- Yes, highly, for as long as the eye is red and weeping, often 10 to 14 days.
- Duration
- 1 to 2 weeks, sometimes up to 3 weeks.
- Treatment
- Cool compresses, artificial tears, hygiene. Antibiotics do not help.
When to get help
Call 911 or go to the ER
- Sudden vision loss, or severe eye pain with nausea and headache
- Eye redness after a chemical splash (rinse with water for 15 minutes and seek care)
See a doctor within a day or two
- Moderate to severe eye pain, marked light sensitivity, or blurred vision that does not clear with blinking
- Red eye in a contact lens wearer (remove lenses, risk of corneal infection)
- Red eye with blisters on the eyelid or nose, or a history of cold sores in the eye (possible herpes)
- A newborn with red eyes or eye discharge in the first 4 weeks
- Swelling and redness of the eyelid and skin around the eye with fever
Book a routine appointment
- Symptoms that are not improving after 7 to 10 days, or last longer than 3 weeks
- Thick, yellow-green discharge that glues the eyelids shut (possible bacterial conjunctivitis)
Usually safe to manage at home
- A red, watery, gritty eye with normal vision and only mild discomfort, especially with a cold
What causes viral conjunctivitis
- Adenovirus causes most cases. Some strains cause epidemic keratoconjunctivitis, a more severe form that can affect the cornea.
- Herpes simplex virus (herpes keratitis) and varicella-zoster virus (shingles) cause less common but more serious eye infections that need specific treatment.
- Other viruses, such as enteroviruses, measles, influenza and SARS-CoV-2, occasionally cause conjunctivitis.
It spreads through direct contact with eye secretions, contaminated hands, towels, pillows and surfaces, and sometimes respiratory droplets. Outbreaks occur in schools, offices, swimming pools and eye clinics.
Symptoms
- redness of the white of the eye
- watery, clear discharge
- gritty, burning or "sand in the eye" feeling
- mild itching
- swollen eyelids, crusting in the morning
- starts in one eye and often spreads to the other within a few days
- mild light sensitivity
- a tender, swollen lymph node in front of the ear
- common cold symptoms or sore throat
In epidemic keratoconjunctivitis, small spots can form on the cornea after 1 to 2 weeks, causing blurred vision and glare that may last weeks to months.
Viral vs bacterial vs allergic conjunctivitis
| Viral | Bacterial | Allergic | |
|---|---|---|---|
| Discharge | Watery | Thick, yellow or green, eyelids stuck together | Watery or stringy |
| Itching | Mild | Mild | Intense |
| Eyes affected | Often one, then both | One or both | Usually both at once |
| Other symptoms | Cold, sore throat, swollen node by ear | Sometimes ear infection in children | Sneezing, runny nose, seasonal |
| Contagious | Very | Yes | No |
| Treatment | Supportive | Antibiotic drops may shorten it | Antihistamine drops, avoid allergen |
Diagnosis
Viral conjunctivitis is usually diagnosed by its typical appearance. An eye doctor may:
- examine the eye with a slit lamp and check vision
- stain the eye with fluorescein to look for corneal involvement or herpes
- use a rapid adenovirus test in the clinic
- take swabs if the case is severe, prolonged or unusual
Treatment
There is no specific medicine for adenovirus conjunctivitis. It clears on its own.
Home care
- cool compresses over closed eyes several times a day
- preservative-free artificial tears, kept in the fridge for extra comfort
- gently clean discharge with a clean, damp cloth from inner to outer corner, using a fresh area for each eye
- stop wearing contact lenses until the eye has fully recovered, and replace lenses, case and solutions
- avoid eye makeup, and throw away makeup used during the infection
- oral pain relievers such as acetaminophen (paracetamol) or ibuprofen if needed, following the label dose
Medical treatment
- antibiotic drops are not effective and are not recommended unless bacterial infection is suspected
- steroid drops are sometimes used by eye specialists for corneal spots or membranes, under close monitoring
- antiviral treatment is needed for herpes or shingles affecting the eye
How long is viral pink eye contagious?
You are usually contagious for as long as the eye is red and watering, often 10 to 14 days from the start of symptoms. To limit spread:
- wash hands often with soap and water, especially after touching your eyes
- avoid touching or rubbing your eyes
- do not share towels, pillows, washcloths, eye drops or makeup
- wash pillowcases and towels in hot water
- disinfect surfaces such as doorknobs, phones and keyboards
- stay home from work or school while discharge is heavy, or follow your school or workplace policy
- avoid swimming pools until the eye is clear
Outlook
Most people recover completely within 1 to 3 weeks. Symptoms often get worse for the first 3 to 5 days before improving. Corneal spots in epidemic keratoconjunctivitis can cause blurred vision for weeks or months but usually clear without permanent damage.
Frequently asked questions
How long does viral conjunctivitis last?
Viral pink eye usually lasts 1 to 2 weeks and can take up to 3 weeks to clear completely. It often gets worse for the first few days before improving. See a doctor if it lasts longer or vision is affected.
How long is viral pink eye contagious?
It is contagious while the eye is red and watering, typically for 10 to 14 days after symptoms start. Washing hands often and not sharing towels or pillows helps prevent spread.
How can I tell if pink eye is viral or bacterial?
Viral pink eye usually causes watery discharge, often with a cold, and spreads from one eye to the other. Bacterial pink eye causes thick yellow or green discharge that sticks the eyelids together. A doctor can confirm the type.
Do antibiotic eye drops help viral pink eye?
No. Antibiotics only work against bacteria and do not shorten viral pink eye. Cool compresses, artificial tears and good hygiene ease symptoms while the infection clears on its own.
When should I see a doctor for pink eye?
See a doctor for eye pain, light sensitivity, blurred vision, symptoms lasting more than 1 to 2 weeks, if you wear contact lenses, if you have a weakened immune system, or if a newborn has red eyes or discharge.
Sources
This guide was written from current patient and clinical guidance, including:
- American Academy of Ophthalmology: Conjunctivitis preferred practice pattern; Pink eye
- CDC: Conjunctivitis (pink eye)
- MedlinePlus (US National Library of Medicine): Pink eye
- NHS: Conjunctivitis
- American Academy of Pediatrics (HealthyChildren.org): Pink eye