Pink eye treatment depends entirely on what’s causing it. Most cases are viral and clear up on their own within 7 to 14 days with nothing more than cold compresses and artificial tears. Bacterial pink eye can be treated with antibiotic eye drops, though mild cases also resolve without them. Allergic pink eye responds to antihistamine drops, many of which are available over the counter.
Viral Pink Eye: Supportive Care Only
Viruses cause the majority of pink eye cases, and there’s no medication that speeds recovery. Like a common cold, the infection simply has to run its course. Most mild cases clear up in 7 to 14 days, though some take two to three weeks or longer.
While you wait it out, two things help with comfort. Artificial tears (lubricating eye drops sold without a prescription) ease the dryness and irritation. Cold compresses applied to closed eyelids several times a day reduce inflammation and soothe that gritty feeling. Warm compresses work too if they feel better to you. Soak a clean, lint-free cloth in water, wring it out, and place it gently over the affected eye. If only one eye is infected, use a separate cloth for each eye to avoid spreading the virus.
Bacterial Pink Eye: Antibiotics Help but Aren’t Always Necessary
Bacterial pink eye produces thicker, yellow-green discharge and often causes the eyelids to stick together in the morning. Antibiotic eye drops or ointments are the standard prescription treatment, and they can shorten the illness, particularly in the first two to five days. The most commonly prescribed options are drops containing fluoroquinolones (like moxifloxacin) or aminoglycosides (like tobramycin), along with erythromycin ointment, which is applied as a small ribbon inside the lower eyelid.
Here’s what many people don’t realize: most bacterial pink eye resolves on its own within one to two weeks, even without antibiotics. The American Academy of Ophthalmology notes that most people diagnosed with pink eye get a prescription for antibiotic drops even though antibiotics usually don’t help it clear up faster. Return visits for ongoing problems are rare, under 4%, regardless of whether antibiotics were prescribed. Doctors typically reserve antibiotics for cases that haven’t improved after two to three weeks, or for infants under one month old.
If you do get a prescription, use it for the full course even after symptoms improve. This prevents resistant bacteria from sticking around.
Allergic Pink Eye: Antihistamine Drops
If your pink eye comes with intense itching in both eyes, a runny nose, or seasonal allergy symptoms, the cause is likely allergic rather than infectious. This type isn’t contagious and won’t respond to antibiotics.
Several effective eye drops are available without a prescription:
- Ketotifen (sold as Zaditor), which both blocks histamine and stabilizes the cells that release it
- Olopatadine (sold as Patanol), which works similarly
- Azelastine, another dual-action option
These combination drops are the most practical choice because they address both the immediate itch and the underlying allergic reaction. Avoiding the allergen (pollen, pet dander, dust) is equally important. Cool compresses and artificial tears provide additional relief on top of the drops. Oral antihistamines can also help if your eye symptoms are part of a broader allergy flare.
What You Can Buy Without a Prescription
For any type of pink eye, two over-the-counter products are worth picking up right away: artificial tears and a cold compress (or just a clean cloth and cold water). These won’t cure an infection, but they address the discomfort that makes pink eye miserable. Avoid drops marketed as redness relievers, which work by constricting blood vessels and can cause rebound redness with repeated use. Plain lubricating drops labeled “artificial tears” are what you want.
Antihistamine eye drops like ketotifen are also sold over the counter and are the right pick if allergies are the trigger. Antibiotic drops, however, require a prescription.
Pink Eye in Newborns
Pink eye in babies under one month old is treated much more aggressively than in older children or adults. Hospitals routinely apply erythromycin ointment to newborns’ eyes at birth to prevent infections from bacteria like gonorrhea and chlamydia that can be passed during delivery.
If a newborn does develop pink eye, the treatment depends on the cause. Chlamydial infections require oral antibiotics because the infection often extends beyond the eye into the throat and lungs. Gonococcal infections typically call for hospitalization and injectable antibiotics. These are not situations for home care or waiting it out. Any eye redness or discharge in a baby younger than one month warrants prompt medical evaluation.
Signs That Need Urgent Attention
Most pink eye is uncomfortable but harmless. A few symptoms, however, signal something more serious than standard conjunctivitis: eye pain (not just irritation), blurred vision, sensitivity to light, or a feeling that something is stuck in your eye. These can indicate conditions that affect deeper structures of the eye and need a same-day evaluation. Thick discharge that returns immediately after wiping, or symptoms that worsen after several days instead of gradually improving, also warrant a closer look from a professional.