Red Eye: Is It Pink Eye, Allergies, or Something Worse?

Most red eyes are caused by something common and manageable, like pink eye (conjunctivitis), allergies, dry eye or a small broken blood vessel. But a red eye with pain, light sensitivity or blurry vision can mean something more serious, like a corneal infection or inflammation inside the eye. Get it checked the same day.

We see a lot of red eyes. Most need a cool compress and reassurance. A few need treatment within hours. Here's how to tell the difference.

Why does an eye turn red?

The white of your eye is covered by a thin, clear layer called the conjunctiva. It is full of tiny blood vessels. When the eye is irritated, infected or inflamed, those vessels widen and the eye looks red. Whether it hurts, and what comes with it, are big clues to the cause.

Is it pink eye?

"Pink eye" is the everyday name for conjunctivitis, which means inflammation of the conjunctiva. There are three main kinds.

Viral conjunctivitis

This is the most common kind and often comes with a cold. The eye is red, watery and gritty, and it often spreads from one eye to the other. It's very contagious. Antibiotics don't help viruses, so it usually runs its course over one to a few weeks. Cool compresses and artificial tears help.

Bacterial conjunctivitis

Bacterial pink eye tends to cause thick yellow or green discharge, and your lashes may be stuck together in the morning. It's contagious. Your eye doctor may prescribe antibiotic drops.

Allergic conjunctivitis

Allergy eyes itch. That's the hallmark. Both eyes are usually affected, often with puffy lids and sneezing. It's not contagious. In Georgia and East Tennessee, spring and fall pollen send plenty of itchy eyes our way.

Stop the spread: wash your hands often. Don't share towels, pillowcases or makeup. Throw away eye makeup you used while infected.

What about a bright red spot that showed up overnight?

That's often a subconjunctival hemorrhage, a small broken blood vessel under the clear surface of the eye. It looks alarming but usually doesn't hurt or affect vision. It can follow a cough, sneeze, straining or rubbing, and it usually fades over a week or two, like a bruise. Get it checked if it followed an injury, if it keeps happening, or if you take blood thinners.

Could it be dry eye?

Yes. Dry eye often causes mild redness with burning, grittiness or tired eyes, especially with screens and fans. If your eyes are red most days, read our post on why your eye drops stopped working or learn about our dry eye care.

Why is a red eye riskier for contact lens wearers?

A contact lens can trap germs against the cornea and lead to a corneal ulcer, an open sore on the clear front of the eye. Ulcers can worsen quickly and scar the cornea.

If your eye is red and painful:

• Take your lenses out and leave them out
• Don't switch to a fresh pair "to see if it helps"
• Bring your lenses and case to your visit
• Call us the same day

Prevention is simple: don't sleep in lenses unless your doctor says you can, keep water away from them, and replace them on schedule.

When is a red eye something worse?

A few conditions look like "just a red eye" at first but need care quickly.

• Iritis or uveitis. This is inflammation inside the eye. It often causes an aching eye, redness around the colored part of the eye, light sensitivity and blurry vision. It needs treatment from an eye doctor and can be linked to other health conditions.
• Acute angle-closure glaucoma. The eye's drainage area suddenly gets blocked, and pressure inside the eye rises fast. Signs include severe eye pain, a red eye, blurred vision, halos around lights, headache and nausea or vomiting. This is an emergency.
• Injury or a foreign body. A scratch on the cornea, or something stuck in the eye, causes pain, tearing and redness.
• Chemical exposure. Cleaners, pool chemicals, lawn products and other chemicals can badly damage the eye in minutes.

For a chemical splash, rinse first. Flush the eye with clean, lukewarm water right away for at least 15 minutes, holding the lids open. Then call us or go to the emergency room. Don't stop to call before you rinse.

Should I use leftover eye drops?

Please don't. Old antibiotic drops may be expired, contaminated or the wrong medicine, and they can hide the signs we need to see. Some prescription drops, like steroids, can make certain infections much worse. Never share drops with family, even if their eyes look the same. And go easy on "get the red out" drops, which can mask problems and cause rebound redness.

When to call us the same day

Call us the same day if you have a red eye along with:

• Eye pain, more than mild irritation
• Sensitivity to light
• Blurry vision that doesn't clear when you blink
• Contact lens wear and a red, painful eye
• A white or gray spot on the clear front of the eye
• Redness after an injury, or a feeling that something is stuck in your eye
• Symptoms that aren't improving after a few days

Call us right away or go to the emergency room if you have:

• A chemical splash in the eye (rinse first, then call)
• Severe eye pain with nausea, vomiting or halos around lights
• Sudden vision loss
• A serious injury or something that has cut or punctured the eye

How we do it at Bolt Eye Group

At Bolt Eye Group, we offer same-day visits for red, painful or injured eyes on the days each office is open. We examine the eye under the microscope, check your vision and eye pressure, and use a special dye when needed to spot scratches or ulcers. Our goal is for you to leave knowing what's causing the redness and what to do about it.

We accept VSP, EyeMed, Davis Vision, Spectera, Medicare and major medical plans, including Blue Cross Blue Shield, Aetna, UnitedHealthcare, Cigna and Humana. HSA/FSA and CareCredit are welcome.

Frequently asked questions

How can I tell if pink eye is viral or bacterial?

Viral pink eye usually causes watery discharge and often comes with a cold. Bacterial pink eye tends to cause thick yellow or green discharge. They can overlap, so an eye exam is the best way to tell.

How long is pink eye contagious?

Viral pink eye can be contagious for as long as the eye is red and watery. With bacterial pink eye, your doctor can tell you when it's safe to return to work or school after treatment starts. Good handwashing helps protect your family either way.

Is a broken blood vessel in my eye dangerous?

Usually not. A subconjunctival hemorrhage looks dramatic but often clears on its own in a week or two. Have it checked if it followed an injury, keeps happening, or comes with pain or vision changes.

Should I keep wearing contacts with a red eye?

No. Take them out and leave them out until your eye doctor says it's safe. If the eye is painful too, call us the same day.

Book an exam at your nearest Bolt Eye Group office

Red, irritated or painful eyes? Don't guess. Book an exam or call for a same-day visit at your nearest Bolt Eye Group office in Canton, East Cobb/Marietta, Lawrenceville, Riverdale or Johnson City, TN. See all locations and directions.