Pink Eye Treatment and Medications

What is pink eye?

Pink eye is most common in young children, however, people of any age can get pink eye, according to KidsHealth.org. Pink eye is highly contagious and can quickly spread in schools and playgrounds as well as from one family member to another.

Pink eye symptoms can vary, depending on the cause. Common symptoms, according to John Hopkins Medicine, include:

• Red eyes
• Gritty feeling in one or both eyes
• Itching, irritation, or burning sensations
• Clear, thin drainage and increased tearing
• Stringy or thick, green discharge from eyes
• Eyelids matted together when first waking
• Swelling of eyelids
• Blurred vision
• Flu-like symptoms including cough, sore throat, fatigue

There are several different forms of conjunctivitis. These include:

• Viral: Conjunctivitis can result from exposure to viral infections that are associated with the common cold or other upper respiratory infections, such as measles or the flu. Viral pink eye clears up without treatment, usually after the fifth day. Over-the-counter medications, such as lubricating eye drops and decongestants, can reduce surface swelling and itching.
• Bacterial: This is the most common type of conjunctivitis during the winter months. It can be spread without direct contact with the infected person as the bacteria can live on surfaces. The most common types of bacteria that cause pink eye include staphylococcus aureus, haemophilus influenza, streptococcus pneumonia, and pseudomonas aeruginosa. Bacterial conjunctivitis usually produces a thick eye discharge or pus. Your doctor might prescribe antibiotic eye drops or ointments, and treatment can take one to two weeks.
• Gonococcal and chlamydial conjunctivitis: The same bacteria that causes these sexually transmitted infections can also cause pink eye. Newborns can be exposed as they pass through the birth canal. Women who are pregnant and might have been exposed to gonorrhea or chlamydia should get tested and treated before giving birth. This type of pink eye frequently progresses quickly and can lead to corneal dislocation. Another sexually transmitted infection, eye herpes or the herpes simplex virus, can sometimes be mistaken for pink eye according to the American Academy of Ophthalmology.
• Giant papillary conjunctivitis: This type of pink eye usually impacts both eyes and often affects people who wear soft contact lenses. Symptoms include itching, heavy discharge, tearing, red bumps on the inside of the eyelid, and it can lead to contact lens intolerance. Treatment includes not wearing contact lenses, at least until the infection has completely cleared. Some people might need to switch to a different type of contact lens.
• Non-infectious conjunctivitis: Irritants can cause this type of pink eye. These can include chemicals, facial or eye makeup, air pollution, diesel exhaust, smoke, and chlorine in swimming pools. Some ingested substances, such as turmeric and eyebright, can also cause it.
• Allergies: The most common type of allergic conjunctivitis is red, itchy eyes. Allergies to pollen, animal dander, mold, dust mites, cosmetics, and contact lens solutions might result in pink eye. Eye drops containing antihistamines could offer symptom relief. Allergic conjunctivitis may appear seasonally or perennially, depending on the allergen.

How is pink eye diagnosed?

Your physician can usually diagnose pink eye based on an examination of your eyes, a description of symptoms, and your health history. The different types of conjunctivitis have similar symptoms, however, your doctor can often determine the cause of pink eye without laboratory tests. Doctors rarely take samples of eye discharge for further testing, according to the CDC.

You should also seek care if you experience:

• Eye pain
• Reduced or blurry vision
• Sensitivity to light
• Inability to open the eyelid
• Severe headache or nausea

Most people begin the diagnostic process with their primary physician. For more severe cases, your doctor might refer you to an eye doctor, such as an ophthalmologist or optometrist, who specializes in eye diseases. During the examination, your doctor might ask questions such as:

• When did your symptoms begin?
• Do you have discharge from your eye continuously or only at certain times of the day?
• Do you have symptoms other than in your eyes, such as fever, coughing, sore throat, nasal congestion, or sneezing?
• If you wear contact lenses and if so, when was the last time you wore them?
• Are you experiencing sensitivity to light, blurry vision, or tenderness around the eye?
• Are you experiencing a headache or nausea?
• Have you had any recent trauma to the eye?

Once you have received a diagnosis, you might want to ask your doctor questions, such as:

• Is my pink eye contagious? If so, what steps should I take to avoid spreading it to other people?
• Do I need to stay home from school or work? If so, for how long?
• What can I do at home to relieve symptoms and discomfort?
• What can I do to prevent pink eye in the future?

Pink eye treatment options

• Antibiotic drops or ointments
• Steroid drops or ointments
• Allergy drops for eyes
• Oral antibiotics
• Artificial tears

Pink eye medications

Treatment for pink eye is dependent on the underlying cause. Some of the different types of drugs used include:

Ophthalmic antibiotic eyedrops

• Bleph 10 (sulfacetamide sodium)
• Moxeza (moxifloxacin)
• Polytrim (polymyxin/trimethoprim)
• Bacticin (bacitracin)
• AK-Poly-Bac, Polycin-B, Polysporin Ophthalmic (polymyxin-bacitracin)
• Besivance (besifloxacin)
• Ciloxan (ciprofloxacin)
• Quixin, Iquix (levofloxacin)
• Ocuflox (ofloxacin)

Topical antihistamines

Antihistamines work to relieve symptoms of allergic conjunctivitis symptoms such as redness and itching. Examples of these include:

• Patanol, Pataday (olopatadine)
• Lastacaft (alcaftadine)
• Bepreve (bepotastine)
• Optivar (azelastine)
• Elestat (epinastine)

Mast cell stabilizers

These work to stop cells from releasing histamines and can reduce eye itching caused by allergies. These include:

• Alocril (nedocromil)
• Alomide (lodoxamide tromethamine)
• Alamast (pemirolast)

Ocular steroids

Your doctor might suggest ocular steroids if other medications do not offer relief. These are prescription eye drops. These drops are often used as a last resort as they can increase pressure in your eyes and increase the risk of cataracts. Before prescribing ocular steroids, your doctor should check for viral eye infections.

Over-the-counter topical antihistamines and decongestants

• Naphcon-A, Ocuhist (pheniramine maleate/naphazoline): Side-effects include hyperemia and chemosis.
• Zaditor, Alaway, Zyrtec Itchy Eye, Claritin Eye (ketotifen fumarate): These drops relieve itching and redness, are generally well-tolerated and can be used for children as young as three years old.

What is the best pink eye medication?

There are several treatments for conjunctivitis, but there is no "best" medication. What works for one person might not work for another. Everyone reacts differently to medicines. Your doctor will take your medical condition, medical history, and other medication you are taking into consideration when suggesting a treatment for you. When looking at standard dosing, it is important to keep in mind that interval frequency and duration of treatment may vary based on the severity of each patient’s case.

Common side effects of pink eye medications

Ophthalmic antibiotic eye drops and ointments

• Stinging or burning in eyes when first applied
• Temporary blurriness
• Rash
• Pain, redness, or swelling around the eyes
• Vision problems

Antihistamines/Allergy medications

These are common side effects of oral antihistamines but not commonly found in topical creams. Consider topical forms of these medications if you experience any of these side effects:

• Dry mouth
• Dizziness
• Drowsiness
• Nausea
• Vomiting
• Restlessness
• Moodiness
• Trouble urinating
• Blurred vision
• Confusion

Mast cell stabilizers

• Burning, stinging or blurred vision when first applied
• Throat irritation
• Coughing
• Skin rash

Ocular steroids

• Increased pressure in your eyes
• Increased risk of glaucoma
• Increased risk of cataracts
• Increased susceptibility to infection

What are the best home remedies for pink eye?

Most cases of pink eye will resolve on their own within one to two weeks. Bacterial conjunctivitis might start to improve within two to five days, but antibiotic drops can speed up the healing. If you are experiencing discomfort or pain, you should consult with your doctor. However, there are some home remedies you can use to relieve some of the discomforts of pink eye.

• Cold compress: Soak a washcloth in cool or warm water. After wringing out excess water, place the compress over your eyes for several minutes. When removing the washcloth, place directly in the washing machine. Never use the same washcloth as you can reinfect your eyes or spread the infection from one eye to the other.
• Warm cloth to clean around the eye: Pink eye can cause a discharge or pus coming from the eye. Use a warm cloth to clean the pus from around the eye and eyelashes. You might notice that the discharge forms a crust, especially when first waking. Use the warm cloth to remove the crust. As with compresses, never use the same cloth twice.
• Lubricating eye drops: Eye drops can help flush out allergens or irritants that cause pink eye. They may also relieve symptoms of itchiness.
• Pain relievers: If the pink eye causes pain, you can take over-the-counter pain relievers, such as ibuprofen or naproxen. Take the medication as directed.
• Antihistamines: Over-the-counter antihistamines can relieve symptoms of pink eye that are caused by allergens.

Preventing pink eye

There are steps to improve eye health and reduce your risk of developing pink eye according to John Hopkins Medicine:

• Wash hands or use hand sanitizer frequently
• Avoid touching eyes with your hands
• Change pillowcases often
• Do not share eye makeup or personal eye care products
• Do not reuse tissues or hand towels on your face
• Follow instructions on proper contact lens care

Alternative remedies for pink eye

There are some homeopathic eye drops, such as Similasan Allergy Eye Relief, available online and in some pharmacies. Some small studies have shown these to be effective. However, these were not controlled, scientific studies validating the results according to Healio.com. It is essential to speak with your doctor before trying any homeopathic treatments.

Frequently asked questions about pink eye

How long does pink eye last? How long is it contagious?

Each type of pink eye can last for different time frames.

• Viral conjunctivitis can take anywhere from a few days to a few weeks to resolve.
• Bacterial pink eye can take a few days to a week to heal; the use of antibiotic drops shortens that time.
• Allergic pink eye usually clears up as other allergy symptoms lessen or after the allergen or irritant is removed.
• Conjunctivitis caused by a virus or bacteria is highly contagious. It remains so until the symptoms have disappeared or, in the case of bacterial pink eye, for 24-48 hours after antibiotic treatment.

Can pink eye clear up on its own?

Most cases of pink eye, including bacterial conjunctivitis, will resolve on their own, without treatment, within seven to 14 days, according to the American Academy of Ophthalmology.

How do you get rid of pink eye overnight?

If allergies or an irritant cause your pink eye it could clear up overnight if you remove the allergens or irritants. Viral and bacterial pink eye usually takes a few days to a week to resolve on its own. But there are things you can do to relieve the discomfort, such as:

• Placing a warm, damp washcloth over the affected eye. Wash hands and use a new, damp washcloth for the other eye.
• Apply lubricating eye drops. Be careful not to let the tip of the eye dropper touch your eye. You should not use it again if it does, as it can spread the pink eye, or you can become reinfected if you use it later.
• Wash hands often.
• Stop wearing contact lens until your infection has cleared. Use a fresh pair when you start using contacts again.
• Avoid using eye makeup. Throw out any makeup you have used since you had the infection.

Do they sell over-the-counter medicine for pink eye?

Antibiotic eye drops, steroid eye drops, and some antihistamine eye drops are only available by prescription. You can purchase lubricating eye drops (artificial tears), and some antihistamine eye drops over-the-counter.

Related resources for pink eye

• Allergy medicine and treatments
• Most people with pink eye get unnecessary treatment
• KidsHealth: Conjunctivitis