Early signs of pink eye may include red, irritated, and watery eyes. The eyes may also feel itchy or gritty. People may also have a discharge from the eye, which can cause the eyelashes to stick together after waking up.

Viral or bacterial conjunctivitis, or pink eye, may begin in one eye but later spread to both eyes. Allergic conjunctivitis usually develops in both eyes, and people may have itchy or watery eyes.

This article examines the first signs of pink eye, treatment, and when to speak with a doctor.

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Early signs of conjunctivitis may include redness or mild irritation in the eye. The eye may be itchy or watery.

Other signs that people may be getting conjunctivitis include:

See what pink eye looks like.

Viral or bacterial conjunctivitis usually begins in one eye. As symptoms develop, the infection may spread from one eye to the other within days.

Allergic conjunctivitis usually affects both eyes from the beginning. With viral conjunctivitis, people may also have other symptoms of a virus, such as cold or flu-like symptoms.

Symptoms of bacterial conjunctivitis often begin 24–72 hours after contact with the bacteria. Viral conjunctivitis symptoms develop between 12 hours and 12 days after exposure to the virus.

The first symptoms of viral conjunctivitis may occur suddenly and cause pain or a feeling of something in the eye, such as dust.

Read about the difference between viral and bacterial conjunctivitis.

In most cases, pink eye will resolve by itself or with treatment at home. People will need to speak with a doctor if they experience any of the following:

  • eyes that are very painful or very red
  • a large amount of mucus discharge from the eye
  • blurry vision or sensitivity to light that does not improve after cleaning discharge from the eyes
  • symptoms that do not improve within a few days or worsen over time

If a person wears contact lenses or has recently scratched or injured their eye, they should consider consulting a doctor. Additionally, people with a medical condition that weakens the immune system, such as cancer or HIV, may wish to contact a doctor regarding their pink eye.

To diagnose pink eye, a doctor will assess symptoms and ask people questions to determine the likely cause. This can help the doctor recommend the best treatment.

A doctor may conduct an eye examination to assess the eye’s health and rule out other conditions. These tests may include:

  • visual acuity test to check vision
  • the use of bright light and magnification to check the health of the conjunctiva and outer eye tissue
  • examination of the inner structures of the eye

If conjunctivitis does not improve or respond to treatment, a doctor may take an eye culture or smear of the conjunctiva for laboratory testing.

Learn more about how the eyes work.

People may be able to treat conjunctivitis at home with the following remedies:

  • using over-the-counter (OTC) artificial tears, which are eye drops to lubricate the eyes
  • taking OTC pain relief medication, such as ibuprofen, to help ease painful symptoms
  • dampening a clean washcloth with warm water and gently holding it over the eye (using a clean cloth for each eye to prevent spreading the infection and repeating as many times throughout the day as feels comfortable)
  • if the eyes are stuck together in the morning, dampening a clean washcloth with warm water and gently wipe the eye to loosen any dried discharge
  • applying a cool compress to the eyes to soothe discomfort
  • for allergic conjunctivitis, using OTC allergy eye drops or allergy medication
  • avoiding any allergens that may trigger allergic conjunctivitis, such as pollen or pet dander

Conjunctivitis usually resolves by itself within 1–2 weeks.

If symptoms do not improve with home remedies, a doctor may prescribe topical or oral medication to treat conjunctivitis. This may include:

People who usually wear contact lenses should avoid wearing them until the conjunctivitis clears. They should also wear a new pair of contact lenses to avoid getting a repeat infection and throw out their old contact lens case to avoid repeat infection.

People will also need to avoid wearing eye makeup while the eye heals and throw away any old makeup that may cause an infection.

Learn more about home remedies for pink eye.

Other conditions may cause similar symptoms to pink eye, including:

Find more eye health information and resources in our dedicated hub.

Early signs of pink eye include redness, irritation, itching, and watery eyes. People may have a gritty feeling in the eye and discharge.

In many cases, conjunctivitis will resolve by itself within a few weeks. Home remedies, such as artificial tears and warm or cool eye compresses, may help ease symptoms.

Treatment for conjunctivitis may include antibiotic, antiviral, or anti-allergy medications, depending on the type of conjunctivitis.