Pink eye, or conjunctivitis, is an extremely common childhood illness and this question is one we often face in clinic.
First, it is helpful to know that there are various types of conjunctivitis.
Bacterial conjunctivitis causes red, itchy, and often painful eyes. It can affect one or both eyes, and is often accompanied by yellowish discharge and mild swelling. This type of pink eye sometimes requires antibiotic eye drops prescribed by a pediatrician.
Viral conjunctivitis causes pink, watery, itchy eyes. It may affect one or both eyes. Note that it is sometimes difficult to determine whether a child has bacterial or viral pink eye. The vast majority of cases of either type will resolve on their own within 5-7 days without treatment.
Allergic conjunctivitis is itchy, watery, pink eyes that tend to occur in a seasonal nature. It generally affects both eyes.
Irritant conjunctivitis manifests as pink, watery eyes after contact with an eye irritant (such as sand or chlorine). It generally resolves quickly without treatment, although contact with some irritants may require eye washing.
The majority of cases of pinkeye in school-aged children are viral in nature. These infections are generally mild and resolve without antibiotic treatment. They are, however, contagious during the period that the child has symptoms. The illness is spread via contact with eye discharge, either directly or by touching surfaces that have been in contact with the discharge. You might imagine that in a busy childcare or school setting full of curious young children, it can be challenging to limit spread.
The decision whether to keep you child home from school is sometimes a difficult one, and depends on various factors.
- Is your child ill with more generalized symptoms including fever? If so, it may be prudent to keep the child home.
- What is your childcare or school’s policy regarding pink eye? On a practical level, this may be the primary factor to consider when deciding whether to keep your child home. Many schools have a policy that a child may return to school 24 hours after starting antibiotic drops for conjunctivitis. Therefore, if you believe your child’s infection is bacterial it is prudent to see your child’s pediatrician to determine whether they need drops.
For the vast majority of cases of pink eye, which are viral in nature, you might think of it as you do a common cold. The truth is that, like the common cold, a child is often contagious and has exposed friends and classmates before symptoms are even noticed. Prevention is the best cure for these common viruses. Learn about how your child’s school attempts to limit transmission of these illnesses. Teach even very young children to wash their hands frequently (especially if they are rubbing/itching their eyes), to sneeze in their sleeve, and to cover their mouth if they cough.
If you have further questions about pink eye or your child’s symptoms seem to be worsening rather than improving after a few days, seek care from your pediatrician.
This article originally appeared as part of the “Ask the Pediatrician” column at HealthyChildren.org, the parent information site of the American Academy of Pediatrics. For more information see,