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Not every case of pink eye needs antibiotic drops, and not every case is contagious — which is exactly why "pink eye" (conjunctivitis) is more useful to think of as three different conditions that happen to look similar, rather than one single illness.
Viral pink eye
What it looks like: watery discharge, often starting in one eye and spreading to the other within a few days, frequently alongside a cold.
Treatment: none needed beyond comfort care — it runs its course like any other virus, typically clearing in 7-14 days. It's the most contagious type, spreading easily through touch.
Bacterial pink eye
What it looks like: thick, yellow-green discharge that can crust the eyelids shut after sleep, usually in one eye.
Treatment: antibiotic eye drops or ointment from a pediatrician, which typically clear it within a few days. It's also contagious until treatment has been used for 24 hours.
Allergic pink eye
What it looks like: itchy, watery eyes in both eyes at once, often alongside other allergy symptoms like sneezing or a runny nose, and frequently tied to a seasonal pattern.
Treatment: antihistamine eye drops or oral allergy medication. Importantly, it is not contagious at all — no isolation from other kids needed.
When to see a doctor
- Significant eye pain, light sensitivity, or blurred vision — beyond typical irritation.
- Thick discharge that keeps returning after cleaning, especially in a newborn.
- Swelling and redness spreading beyond the eye itself, onto the eyelid or surrounding skin.
- Symptoms in a baby under 2 months old — always worth a same-day call at this age.
Going back to school or daycare
Most schools require 24 hours of antibiotic treatment for bacterial pink eye before return. Viral pink eye policies vary more by school, and allergic pink eye typically doesn't require any exclusion at all since it isn't contagious — check your specific school's policy since practices differ.
Frequently asked questions
Is pink eye always contagious?
No — viral and bacterial pink eye are contagious, but allergic pink eye is not. This is one of the most useful distinctions for deciding whether a child needs to stay home.
Can I use leftover antibiotic eye drops from a previous infection?
No — always get a fresh evaluation. Using old drops risks the wrong treatment for a different type of pink eye, and expired or contaminated drops can make things worse.
How do I clean discharge from my child’s eyes at home?
Use a clean, soft cloth or cotton ball with warm water, wiping gently from the inner corner outward, and use a fresh cloth for each eye to avoid spreading infection from one eye to the other.
