Pink eye (Conjunctivitis) | Colorado Department of Public Health and Environment

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What is pink eye (Conjunctivitis)?

Pink eye (Conjunctivitis) is inflammation (i.e., redness, swelling) of the thin tissues covering the white part of the eye and inside of the eyelids. Pink eye is most often caused by a virus, but it can be caused by a variety of bacterial, viral, and fungal pathogens, as well as allergies (such as pollen, mold, or cosmetics), contact lens use, indoor or outdoor air pollution (such as smoke or dust), and chemical irritation (such as after swimming, or exposure to chemical fumes). Pink eye is common in children and adults, and it can be difficult to determine the exact cause.

Signs and symptoms

Excess amount of blood in the whites of the eye and eyelid, giving the eye a pink or red appearance
Eye itchiness, irritation, swelling, watery, light sensitivity, and/or burning
Bacterial or viral: One or both eyes can be affected. There is usually a discharge (thicker, whitish-yellowish in bacterial infections) from the eye. Respiratory infection symptoms or swollen lymph nodes near the front of the ear may be present. Bacterial pink eye symptoms can last a couple of days to three weeks, but generally symptoms improve in 2-5 days without treatment. Viral pink eye symptoms can last from 1-3 weeks or more.
Allergies: Usually both eyes are affected. Symptoms like itchy nose, sneezing, or scratchy throat may be present, and symptoms may be seasonal. Typically symptoms clear once the allergen is removed.
Chemical irritation: One or both eyes can be affected.

Incubation period

Bacterial: Unknown because the bacteria that cause it are commonly present in most individuals and do not cause infection
Viral: Variable
Allergies or chemical irritation: Variable

Contagious period and spread

Bacterial and viral: Can be easily spread by direct contact with discharge from the eye of a person with infection or by direct contact with objects contaminated with eye discharge. Contaminated fingers, clothing, towels, shared eye makeup applicators, etc., may spread the infection.
Bacterial: People with infection are contagious as long as they have symptoms or until antibiotic eye drops or ointment are started.
Viral: Some types are contagious as long as a person has symptoms (which can be variable).
Allergies or chemical irritation: Not contagious.

Public health reporting requirements

Individual cases are not reportable.
Suspected outbreaks of pink eye are reportable to state or local public health.
If two or more children from separate families in one classroom have red eyes with watery discharge, consult with public health to prevent further spread.

Control of spread

Encourage frequent handwashing.
Avoid touching or rubbing eyes and avoid sharing personal items.
Ensure good cleaning and sanitizing practices are being followed. See Disease Prevention: The Facility Environment.

Treatment

Most children with pink eye get better after 5-6 days without antibiotics.

Bacterial: A health care provider may prescribe antibiotic eye drops or topical ointment. Antibiotic treatment will generally speed recovery and reduce spread to others.
Viral: There is usually no treatment.
Chemical irritation: Symptoms generally resolve once the irritant is removed.
Allergies: May be treated with allergy medications.

Exclusion

Children do not need to be excluded for pink eye unless the child meets other exclusion criteria, such as fever or behavioral change.

Role of teachers, caregivers, and family

Report the infection to the staff member designated for decision-making and action related to care of ill children. That person, in turn, alerts possibly exposed family and staff members to watch for symptoms.
Parents/guardians should consult with the child’s health care provider about diagnosis and treatment.
Complete all medications as prescribed.