Your child wakes up with a red eye, crusted eyelashes, and lots of itching and rubbing. Is it pink eye? Is it allergies? And, most pressing, is it contagious?
In this article, we’ll cover what pink eye is and symptoms to watch for; what viral, bacterial, and allergic pink eye look like; whether pink eye is contagious; what treatment options are available and when to see a doctor; and when your child can return to school after a case of pink eye.
What Is Pink Eye?
Pink eye (conjunctivitis) occurs when the conjunctiva—the thin membrane that lines the inside of your eyelids and covers the sclera—becomes inflamed. This inflammation causes the eye to appear pink or red because it makes the small blood vessels more visible.
While the redness and puffiness can look alarming, most cases of pink eye are mild and resolve without complication. Pink eye is one of the most commonly seen eye conditions in children (1, 2).
A Note on Pink Eye in Newborns:
Newborns who develop pink eye should be seen by a medical provider right away (3). Common signs to look for are drainage from the eye and puffy red eyelids occurring anywhere between a few days to a few weeks after birth (3). Conjunctivitis in newborns is most commonly caused by bacterial infection, irritation, or blocked tear duct (3).
For more information on neonatal conjunctivitis: Understanding Newborn Antibiotic Eye Ointment
Common Symptoms of Pink Eye in Kids
Although symptoms of pink eye vary depending on the cause, the majority of cases share a few common signs (2, 4):
- Redness or pinkness in one or both eyes
- Excessive eye watering
- Itchiness
- Burning sensation
- Discharge
- Crusting along the eyelashes
- Light sensitivity
- Sandy or gritty feeling in the eye
The most common forms of pink eye in children are viral conjunctivitis, bacterial conjunctivitis, and allergic conjunctivitis. Because so many of the symptoms tend to overlap, it’s not always easy to identify which of these your child may be experiencing (2). However, there are a few clues that can help.
Viral Pink Eye
Viral conjunctivitis is the most common form of infectious pink eye (2, 5).
How to Know if My Child’s Pink Eye Is Viral?
It can be hard to know if pink eye is viral or bacterial. One major clue that your child’s pink eye is viral in nature is that it develops alongside a cold or other viral upper respiratory infection (2). Viral pink eye typically causes more watery discharge (compared to bacterial pink eye which may cause thicker discharge), burning, and a gritty sensation in the eye (2, 5).
While it is uncomfortable, viral pink eye tends to resolve on its own and treatment is generally focused on promoting comfort as the symptoms run their course (2, 5) and supporting a healthy immune response.
Bacterial Pink Eye
Bacterial conjunctivitis is especially common in children (2), and it occurs when bacteria spread from unwashed hands, respiratory droplets (from a cough or sneeze), or direct contact with contaminated objects.
How to Know if My Child’s Pink Eye Is Bacterial?
In children, bacterial pink eye is most frequently caused by (2, 6):
- Haemophilus influenzae: The most common cause in children.
- Streptococcus pneumoniae: Often linked with ear or sinus infections.
- Moraxella catarrhalis: Commonly associated with respiratory infections.
- Staphylococcus aureus: Staph bacteria that naturally live on the skin.
Unlike viral pink eye, bacterial infections cause a thicker, purulent discharge (2). Parents often notice that their child’s eyes are crusted shut when they wake up in the morning, and it may be less likely to cause itching (2).
Allergic Pink Eye
Allergic conjunctivitis occurs in reaction to an allergen—such as pollen, pet dander, mold, or dust (1, 2). Although this form of pink eye affects a large percentage of the population, and it can be very bothersome, many people never seek treatment for it (1).
How to Know if My Child Has Allergic Pink Eye?
The most consistent symptom of allergic pink eye is itching that affects both eyes simultaneously (1, 2). Children with allergic pink eye may also experience other allergy symptoms, such as sneezing or running nose (1, 2).
Is Pink Eye Contagious?
It depends on what’s causing the pink eye.
Both viral and bacterial pink eye spread through direct contact with eye secretions and contaminated surfaces (4, 7). This is one of the big reasons why pink eye always seems to make its way through daycare centers, classrooms, and households. Encouraging good hand washing habits, avoiding rubbing the eyes, and not sharing towels, pillows, washcloths, or eye makeup can greatly reduce the spread of infection (4, 7).
If your child has pink eye, it can also be helpful to throw away used tissues immediately after use and wash hands afterward. Changing pillowcases, sheets, towels, and washcloths frequently and making sure to wash them in hot water can help to lessen the spread of germs in the household. It is also helpful to pay extra attention to keeping high-touch volume surfaces (i.e. light switches, doorknobs, remote controls, tablets, toys, etc.) clean (4).
It’s easy to overlook the items that travel with your child throughout the day. Car seats, strollers, baby carriers, and other frequently handled items also have a tendency to collect germs and contribute to the spread of infection between siblings. Regular cleaning of these surfaces is especially helpful when one child in the household is experiencing symptoms (4).
Conversely, allergic pink eye is not contagious (4). Because it is caused by the body’s internal immune response to allergens, it cannot be passed from person to person. However, some of the same habits apply. Washing hands and faces after playing outside, spending time with pets, or coming back inside on days the pollen count is high may help to remove allergens before they can irritate the eyes. Additionally, cleaning things like strollers, car seats, and outdoor gear can help reduce allergen exposure.
Pink Eye Treatment Options
The best treatments for pink eye depend on the underlying cause. In many cases, treatment focuses on supporting comfort as symptoms improve.
Viral pink eye typically resolves on its own without treatment (2). Because viral and bacterial pink eye can appear similar, healthcare providers may occasionally prescribe antibiotic treatment when the cause is uncertain (1, 2). Topical antibiotic ointment is also often prescribed to help decrease the duration of symptoms (2, 6). However, you know your child best, and you can always work with a healthcare provider to determine the most appropriate course of action.
In some cases, a provider may recommend monitoring symptoms to see if they improve (2, 6). In other cases—such as in very young infants or when symptoms are more severe—prompt treatment may be recommended instead. If you’re unsure of the best approach, don’t hesitate to ask your healthcare provider about the benefits and risks of other viable treatment options.
Treatment for allergic pink eye typically consists of reducing exposure to allergens, eye drops, or mast cell inhibitors, which suppress inflammatory chemicals like histamine (1, 2).
To learn more about antibiotic treatment, read these articles:
- Restoring Gut Health After Antibiotics: A Guide for Families
- When Antibiotics Are Needed & How to Care for Your Microbiome
Home Remedies to Support Comfort for Pink Eye
Although pink eye is uncomfortable, there are several simple ways you can help to alleviate your child’s discomfort at home.
- Applying a cool, clean compress over closed eyelids can help to soothe irritation and reduce redness (5, 7).
- Gently cleansing the affected eye of discharge can also help keep the area more comfortable (7).
- Artificial tears may provide temporary relief from dryness or irritation as well (5, 7), though many kids may not enjoy the application.
- Encouraging your child to get plenty of rest, hydration, and good nutrition may help support healthy immune function as their body recovers.
For more information on supporting immune health, read these articles:
- All About Echinacea: A Gentle Herb For Immune Support
- Medicinal Mushrooms For Immunity, Gut Health, & More (Plus Three Family Friendly Recipes)
When Can My Child with Pink Eye Go Back to School?
If your child has pink eye, deciding whether they should stay home from daycare or school can feel confusing. While policies vary between schools and daycare centers, experts recommend considering factors such as symptom severity, overall illness, hygiene habits, and a child’s ability to participate in activities (8). It’s always a good idea to follow your facility’s specific policies or consult a healthcare provider if you’re unsure (8).
When to See a Doctor
It’s important to contact your child’s healthcare provider if you are unsure of what’s causing their symptoms or if their condition isn’t improving.
You should seek medical care if your child has:
- Severe eye pain
- Sensitivity to light
- Blurred vision/changes in vision
- Intense eye redness or swelling
- Symptoms that get worse/do not improve
- A weakened immune system
Infants with pink eye should be seen by a healthcare provider promptly, as eye infections in newborns can sometimes be serious (8, 9).
Summary
Pink eye is a common condition in children that can be caused by viruses, bacteria, or allergies. While symptoms such as redness, discharge, and itching look similar, certain clues may help to identify the underlying cause. Viral pink eye and bacterial pink eye are contagious, while allergic pink eye is not. Understanding these differences can help parents make better informed decisions about treatment, school attendance, and when to seek medical care.
References
- Cronau H, Kankanala RR, Mauger T. Diagnosis and management of red eye in primary care. Am Fam Physician. 2010 Jan 15;81(2):137-44. PMID: 20082509.
- Mahoney MJ, Bekibele R, Notermann SL, Reuter TG, Borman-Shoap EC. Pediatric Conjunctivitis: A Review of Clinical Manifestations, Diagnosis, and Management. Children (Basel). 2023 Apr 29;10(5):808. doi: 10.3390/children10050808. PMID: 37238356; PMCID: PMC10217501.
- CDC. Pink Eye in Newborns. Conjunctivitis (Pink Eye). Published April 15, 2024. https://www.cdc.gov/conjunctivitis/newborns/index.html
- CDC. Conjunctivitis | Pink Eye | about | CDC. www.cdc.gov. Published April 15, 2024. https://www.cdc.gov/conjunctivitis/about/index.html
- Shunmugam M, Giovannetti F, Yeung SN, Iovieno A. An Update on Viral Conjunctivitis Treatment Strategies: A Narrative Literature Review. Microorganisms. 2025 Jul 22;13(8):1712. doi: 10.3390/microorganisms13081712. PMID: 40871219; PMCID: PMC12388293.
- Epling J. Bacterial conjunctivitis. BMJ Clinical Evidence. 2012;2012:0704. https://pmc.ncbi.nlm.nih.gov/articles/PMC3635545/
- CDC. Clinical Overview of Pink Eye (Conjunctivitis). Conjunctivitis (Pink Eye). Published May 10, 2024. https://www.cdc.gov/conjunctivitis/hcp/clinical-overview/index.html
- Frost HM, Stein AB, Keith A, Jenkins TC. Cost-Effectiveness of Pediatric Conjunctivitis Management and Return to Childcare and School Strategies: A Comparative Study. J Pediatric Infect Dis Soc. 2024 Jul 20;13(7):341-348. doi: 10.1093/jpids/piae046. PMID: 38761052; PMCID: PMC11519041.
- CDC. How to Treat Pink Eye. Conjunctivitis (Pink Eye). Published May 10, 2024. https://www.cdc.gov/conjunctivitis/treatment/index.html
