Infections can affect different parts of the eye causing a so-called red-eye. The conjunctiva – the pink rim if you pull down your lower lid – is the most common site of infection, called conjunctivitis. This usually affects both eyes and goes alongside viral respiratory infections giving cold symptoms. Children may be more prone to bacterial conjunctivitis. You might get a clear, yellow, or green discharge which might cause blurring of the vision until they’re cleaned, and eyes may be crusty and stuck together on waking. The usual whites of the eyes look pink, the pink rim looks red, and it looks a bit red and swollen around the eyes. It’s not usually very painful.
A stye is a mild bacterial infection of glands on your lashline, causing a painful red pimple on your upper or lower eyelid. This does not usually need treatment and improves after a few days.
Other infections are more likely to affect one eye and may be more serious. Keratitis affects the cornea, the glass-like coating of your eye, which may come from bacteria, viruses, or parasites in tap water, and contact lens wearers are at particular risk.
You may get the appearance of red-eye, pain, and watering for reasons other than infection, such as uveitis or glaucoma, and these require urgent medical assessment. Allergy can cause a similar red eye, but it’s more likely to feel itchy and both eyes are affected, usually with lots of watering and gritty or burning feeling.
Conjunctivitis is very easily spread, so it’s important to keep good hand hygiene, avoid rubbing your eyes then touching anything or anyone, and keep your distance from people if you are coughing or sneezing.
Similarly, a stye can spread from one of your eyes to the other, so, again, avoid rubbing your eyes and keep separate towels and bed linen from others in your household.
For most cases, gentle thorough cleansing is enough to clear an eye infection. For children under the age of two years old or for mild cases in adults, you may want to first try using freshly boiled and cooled water and a clean flannel.
Gently wipe over the eyelids starting from the outer edge of the lashline with eyelid closed and sweep inwards and downwards towards the inner corner near the nose. This can help clear crusting and debris in the eyes and eyelashes safely. Repeat every two to four hours, for up to 48 hours, and a cool flannel may also be useful to soothe itchy or irritated eyes.
Antibiotic eye drops or ointments are available for adults and children over 2 years old to treat bacterial conjunctivitis but should be reserved for more severe or prolonged cases. Those under 2 years old need a prescription from their doctor.
Conjunctivitis usually clears up without any medication. See your doctor if symptoms haven’t improved after a couple of weeks. Antibiotics are not usually required for conjunctivitis, but your doctor may consider them under certain circumstances, including if a sexually transmitted infection could be the cause.
If you suspect an allergy is to blame, keep a symptom diary to identify the trigger and try antihistamine drops from the pharmacy.
If your vision is affected – it's consistently reduced in one eye, you feel very sensitive to light, lights look hazy, or there’s wavy lines or flashing – you should seek urgent attention from your doctor, 111 or an Emergency Department. Similarly, if the pain is deep and intense, especially if you wear contact lenses, this is a reason to seek urgent attention.
If your baby is less than 28 days old and experiencing a red-eye or discharge, see your doctor urgently for assessment.
If you feel well and your work does not require close contact with others, you can go to work with conjunctivitis. Your child can go to school or nursery if they are well. If you have reason to believe something more serious is going on with your eyes, you should prioritise seeking urgent medical attention.
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