Conjunctivitis treatment depends entirely on which type you have. Bacterial conjunctivitis responds to antibiotic eye drops, viral conjunctivitis clears on its own in one to three weeks, and allergic conjunctivitis improves with antihistamine drops. Getting the type right matters because the wrong approach wastes time and money, and in some cases lets the real problem get worse.
Figuring Out Which Type You Have
The three main types of conjunctivitis look and feel different enough that you can often narrow it down before seeing a doctor. Bacterial conjunctivitis produces thick, yellow-green discharge that crusts your eyelids shut overnight. It can affect one or both eyes and sometimes causes eyelid swelling and blurry vision.
Viral conjunctivitis tends to start in one eye and spread to the other within a day or two. The discharge is watery rather than thick, and you may notice swollen lymph nodes near your ear. It often shows up alongside a cold or upper respiratory infection. This is the most common form, and it’s highly contagious.
Allergic conjunctivitis hits both eyes at once and itching is the dominant symptom. You’ll likely have watery eyes, sneezing, and a runny nose at the same time. It flares with seasonal allergens like pollen or year-round triggers like dust and pet dander. There’s no discharge crust, and it’s not contagious.
Treating Bacterial Conjunctivitis
Bacterial conjunctivitis is treated with prescription antibiotic eye drops or ointment, typically applied four times daily for five to seven days. Common options include tobramycin, fluoroquinolones, and trimethoprim/polymyxin B combinations. The specific antibiotic your doctor picks doesn’t meaningfully change the outcome, so there’s no need to push for a particular brand.
Most bacterial cases actually resolve on their own within one to two weeks even without antibiotics. The drops speed things up and reduce the window during which you can spread the infection to others. For mild cases, some doctors take a wait-and-see approach and only prescribe antibiotics if symptoms haven’t improved after a few days. Severe cases with significant eyelid swelling, pain, or vision changes warrant antibiotics from the start.
Managing Viral Conjunctivitis at Home
There’s no antiviral drop for common viral conjunctivitis. The infection has to run its course, which takes 7 to 14 days in mild cases and up to three weeks in more stubborn ones. Some cases linger for a full month. Your job is symptom management and not spreading it to others.
Artificial tears are your best tool. Use them four times a day, or up to ten times daily if you switch to preservative-free drops. They won’t shorten the illness, but they relieve the gritty, dry feeling that makes viral pink eye so uncomfortable. Cool compresses also help: soak a clean, lint-free cloth in cool water, wring it out, and hold it gently over your closed eyelid for a few minutes at a time. Some people prefer warm compresses, and either temperature is fine.
If pink eye affects only one eye, use a separate cloth for each eye. This sounds like a small detail, but viral conjunctivitis spreads easily through contaminated surfaces, including your own washcloth. Wash your hands frequently, avoid touching your eyes, and don’t share towels or pillowcases with anyone in your household.
Treating Allergic Conjunctivitis
Allergic conjunctivitis responds to over-the-counter antihistamine eye drops. The most effective options contain ingredients that do double duty: they block the histamine that causes itching and also stabilize the cells that release it in the first place. Ketotifen and olopatadine are the two most widely available dual-action drops. You’ll find ketotifen sold under brand names like Zaditor and Alaway at most pharmacies without a prescription.
For seasonal allergies that flare predictably every spring or fall, starting these drops a week or two before your usual symptom window gives them time to build up their protective effect. Cool compresses and artificial tears also help with the puffiness and watering. Oral antihistamines can reduce eye symptoms too, though not as quickly or directly as the drops. The most important long-term strategy is limiting exposure to whatever triggers your symptoms, whether that means keeping windows closed during high-pollen days, washing bedding frequently, or keeping pets out of the bedroom.
Contact Lens Rules During Pink Eye
Stop wearing contact lenses as soon as you notice symptoms, regardless of which type of conjunctivitis you have. Contacts trap bacteria and viruses against the surface of your eye, slow healing, and increase the risk of a more serious corneal infection. Don’t put them back in until your symptoms are completely gone.
If you wear disposable lenses, throw out the pair you were wearing when symptoms started, along with the cleaning solution and lens case. If your lenses aren’t disposable, clean them thoroughly before using them again. Your eye doctor can tell you when it’s safe to resume wear.
Warning Signs That Need Urgent Care
Most conjunctivitis is mild and resolves without complications. But a few symptoms suggest something more serious is happening, potentially a corneal infection, inflammation inside the eye, or elevated eye pressure. Seek prompt medical attention if you experience moderate or severe eye pain (not just mild irritation), sensitivity to light, noticeable vision changes, or if your symptoms worsen despite treatment.
These symptoms overlap with conditions like keratitis and uveitis, which can cause permanent vision damage if left untreated. Pain and light sensitivity in particular are not typical of simple conjunctivitis, and their presence should prompt an eye exam rather than another round of home remedies.
Pink Eye in Newborns
Conjunctivitis in newborns is a different situation entirely. Babies can pick up bacterial infections during delivery, and some of these organisms cause rapid, severe eye damage. Gonococcal conjunctivitis can progress to corneal ulcers, bloodstream infections, and even meningitis if untreated. Chlamydial conjunctivitis can spread to the lungs.
Newborn conjunctivitis always requires medical evaluation. Treatment depends on the cause and may involve antibiotic drops, oral antibiotics, or intravenous antibiotics for more serious infections. One reassuring exception: if a newborn’s eyes become irritated from the antibiotic ointment routinely applied at birth, this chemical conjunctivitis clears on its own within 24 to 36 hours without treatment.
Returning to Work or School
There’s no fixed number of days you need to stay home. The CDC’s guidance is practical: if you don’t have a fever and your symptoms are improving, you can return with your doctor’s approval. If your job or school involves close contact with others and you still have active symptoms like discharge and redness, stay home. Viral conjunctivitis remains contagious as long as the eye is watering and red, which can last two weeks or longer. Bacterial conjunctivitis is generally considered safe 24 hours after starting antibiotic drops, though policies vary by workplace and school district.
What OTC Drops Can and Cannot Do
It’s worth being clear about what you can buy without a prescription. Artificial tears and antihistamine eye drops are available over the counter. Antibiotic eye drops are not. The “redness relief” drops you’ll find at the pharmacy (containing ingredients like naphazoline or tetrahydrozoline) temporarily constrict blood vessels to make your eyes look whiter, but they don’t treat the underlying infection. Using them repeatedly can cause rebound redness that makes things worse.
If you suspect bacterial conjunctivitis, you need a prescription. For viral conjunctivitis, no prescription will help, and OTC artificial tears are the right move. For allergic conjunctivitis, OTC antihistamine drops like ketotifen are genuinely effective and often all you need.