Pinkeye in Kids: Symptoms, Treatment & When to Call

Quick answer: Pinkeye in kids (conjunctivitis) is inflammation of the thin, clear layer that covers the white of the eye and lines the eyelids. It makes the eye look pink or red and can cause watering, itching, a gritty feeling, swollen lids and discharge. Most cases are caused by viruses, bacteria or allergies. Viral pinkeye usually comes with a cold and gets better on its own, often within 1 to 2 weeks. Bacterial pinkeye tends to cause thick yellow or green pus and eyelids stuck together after sleep, and a doctor may prescribe antibiotic drops or ointment. Allergic pinkeye mainly itches and is not contagious. Any newborn with red or sticky eyes, and any child with eye pain, vision changes, light sensitivity or a very red, swollen eyelid, needs to be seen right away.

Pinkeye is one of the most common eye problems in childhood, and it spreads easily in daycares and classrooms. This guide explains how to tell the main types apart, what you can safely do at home, whether your child needs antibiotics, when they can go back to school, and which symptoms mean you should call the doctor or go to the ER.

What is pinkeye?

The conjunctiva is a thin membrane over the white of the eye and the inside of the eyelids. When it gets inflamed, its small blood vessels become more visible, so the eye looks pink or red. The CDC lists viruses, bacteria and allergens as the most common causes. Irritants such as pool chlorine or smoke, a stray eyelash or speck of grit, and contact lens problems can also cause it.

KidsHealth (Nemours) notes that viral and bacterial pinkeye are often caused by the same germs behind colds, ear infections, sinus infections and sore throats, which is why pinkeye so often shows up alongside a cold.

Pinkeye symptoms in kids

According to the CDC, common signs include:

Pink or red color in the white of one or both eyes
Swollen eyelids
Watery or teary eyes
A feeling that something is in the eye, or an urge to rub it
Itching, irritation or burning
Discharge, which can be mucus or pus

Some children are also bothered by bright light. Babies and toddlers can’t describe how their eyes feel, so you may notice more eye rubbing, fussiness or crusting on the lashes instead.

Viral, bacterial or allergic? Clues to the type

The type matters because the treatment is different. These patterns, described by the American Academy of Pediatrics (AAP) and Seattle Children’s, can help, but they overlap and only a clinician can say for sure:

Viral pinkeye: pink, watery eyes with little or no pus, often during or right after a cold. The eye may be sensitive to light. It is contagious while symptoms last, and the AAP notes that one common virus (adenovirus) can stay contagious for weeks and cause outbreaks in schools and child care.
Bacterial pinkeye: more than a small amount of yellow or green discharge, and eyelids that are crusted or stuck shut after sleep, with pus that keeps coming back during the day. It can affect one or both eyes.
Allergic pinkeye: itchy, red, watery eyes, usually both at once, often with other allergy symptoms like sneezing. It is triggered by things like pollen, pet dander or dust mites and is not contagious.
Irritant pinkeye: red, watery eyes soon after contact with something like chlorinated pool water. It is not contagious and usually settles once the irritant is gone.

Pinkeye in newborns

Red, swollen or sticky eyes in a newborn are different. The CDC says newborns with pinkeye symptoms should see a doctor right away, because an infection in the first weeks of life can be serious. The NHS advises an urgent appointment for any baby under 30 days old with red, sticky eyes. Doctors routinely put antibiotic ointment or drops in newborns’ eyes after birth to help prevent these infections.

Not every watery eye in a baby is pinkeye. Seattle Children’s notes that a blocked tear duct, present in about 10% of newborns, causes constant tearing without redness or eyelid swelling. It can sometimes become infected and produce pus, so let your pediatrician take a look.

How pinkeye is treated

Viral pinkeye doesn’t need antibiotics. The CDC is clear that antibiotics do not help viral pinkeye. Most cases are mild and clear in 7 to 14 days, though some take 2 to 3 weeks or longer. Seattle Children’s says pinkeye that comes with a cold usually lasts about 7 days.

Bacterial pinkeye may be treated with prescription antibiotic eye drops or ointment. The CDC says mild cases can improve without antibiotics in 2 to 5 days, but that antibiotics may shorten the illness, reduce complications and lower the chance of spreading it. Antibiotics are more likely to be needed when there is pus-like discharge or the child has a weakened immune system. With treatment, Seattle Children’s says the pus should clear within about 3 days, though redness can last up to a week.

A note on differing guidance: the AAP’s child care guidance is more cautious about antibiotics, saying most children with pinkeye get better in 5 or 6 days without them and that antibiotics shorten illness only slightly. That’s why some pediatricians prescribe drops and others suggest waiting. Follow your own child’s doctor.

Allergic pinkeye improves when the trigger is removed. Your pediatrician may suggest an allergy medicine by mouth or antihistamine eye drops. Ask before using any over-the-counter eye drops in a young child.

Home care for pinkeye

Clean the eyelids gently. Wipe away discharge with warm water and a clean cotton ball or gauze. Use a fresh cotton ball for each eye and each wipe, and throw it away right after.
Use a cool compress on closed eyes for a few minutes to ease itching and puffiness. Some kids prefer a warm one.
Try artificial tears. The CDC says lubricating eye drops can relieve dryness and irritation. They are sold without a prescription; follow the package directions or ask your pediatrician.
Skip “get the red out” drops. Seattle Children’s notes that redness-relief (vasoconstrictor) drops and antibiotic drops don’t help viral pinkeye.
Give prescribed drops correctly. If your child won’t open their eye, have them lie down and place the drop in the inner corner of the closed eye. When they blink, it will flow in. If drops are a daily battle, ask the doctor whether an ointment is an option.
Take a break from contact lenses. Kids who wear contacts should switch to glasses until the eye is better. Throw away disposable lenses and clean reusable lenses and their case before wearing them again.
Finish the full course of any prescribed antibiotic drops or ointment, even if the eye looks better sooner.

Is pinkeye contagious? When can my child go back to school?

Viral and bacterial pinkeye are both contagious. Allergic and irritant pinkeye are not. Germs spread when hands touch eye discharge or contaminated surfaces and then touch the eyes.

School rules vary, and expert sources don’t fully agree:

The AAP says there is no single rule. Keeping your child home makes sense if they have a fever or seem generally sick, and many schools allow a return 24 hours after starting antibiotic drops.
Seattle Children’s says children with pinkeye from a cold don’t need to miss school, and children with bacterial pinkeye can return once only a small amount of pus remains and they’ve had antibiotic drops for 24 hours.
The CDC says people without a fever or other symptoms may return with their doctor’s approval, but should stay home if they still have symptoms and their activities involve close contact with others.
The NHS (UK) says children don’t need to stay away from school unless they feel very unwell.

Check your school or daycare’s policy, and ask your pediatrician if you’re unsure.

How to prevent pinkeye from spreading

Wash hands often with soap and water, especially after touching your child’s eyes or putting in drops.
Teach kids not to rub or touch their eyes.
Don’t share towels, washcloths, pillowcases, tissues or eye drops.
Wash your child’s pillowcases, towels and washcloths in hot water.
Clean frequently touched items like doorknobs, tablets and shared toys.
Keep your child’s vaccines up to date. The CDC notes that vaccines can prevent some infections linked to pinkeye.
For allergic pinkeye, keep windows closed on high-pollen days and dust and vacuum often.

When to call the doctor

Call your pediatrician if your child:

Has yellow or green pus, or eyelids stuck together after sleep
Has only one red eye that lasts more than 24 hours
Has a fever that lasts more than 3 days, or comes back after being gone for a day
Has symptoms that get worse instead of better
Has been on antibiotic drops and isn’t improving. The CDC says to see a provider if bacterial pinkeye isn’t better after 24 hours of antibiotics; Seattle Children’s says to call if pus is still there after 3 days of drops.
Still has redness after about a week, or symptoms that haven’t cleared in 2 to 3 weeks
Has a weakened immune system
Wears contact lenses and has eye symptoms

When to go to the ER / call 911

Call 911 if your child’s illness or injury seems life-threatening.

Get medical care right away (ER, urgent care or a same-day visit) if:

Your baby is a newborn with red, swollen or sticky eyes
Your baby is under 12 weeks old and has any fever. Don’t give fever medicine before they’re seen.
Your child has eye pain that is more than mild
Your child has blurred vision that doesn’t clear after wiping away discharge, or any change in vision
Your child is very sensitive to light or keeps turning away from it
The eyelid or skin around the eye is very red, swollen or tender. Seattle Children’s notes this can be a sign of eyelid cellulitis, a deeper skin infection that needs prompt treatment.
Your child can’t stop tearing or blinking
Your child has a fever above 104°F (40°C)
Your child looks or acts very sick

The AAP also notes that red eyes can occasionally be part of a whole-body illness such as Kawasaki disease, so red eyes together with a fever that lasts several days should always be checked.

For other common childhood infections, see our guides to ear infections in kids, strep throat vs. sore throat and cold vs. flu vs. RSV vs. COVID in kids. If your child hurt their eye, read what to do if your child injures their eye.

Frequently Asked Questions

How can I tell if my child’s pinkeye is viral or bacterial?

Viral pinkeye usually causes pink, watery eyes with little or no pus and often comes with a cold. Bacterial pinkeye tends to cause thick yellow or green discharge and eyelids that are stuck together after sleep. The signs overlap, so call your pediatrician if your child has pus or you aren’t sure.

Does pinkeye go away on its own?

Often, yes. According to the CDC, viral pinkeye usually clears in 7 to 14 days without treatment, and mild bacterial pinkeye can clear in 2 to 5 days. A doctor may still prescribe antibiotic drops for bacterial pinkeye to shorten it and limit spread, and newborns with pinkeye always need to be seen right away.

Do kids need antibiotic eye drops for pinkeye?

Not always. Antibiotics do not help viral or allergic pinkeye. For bacterial pinkeye, a doctor may prescribe antibiotic drops or ointment, especially when there is pus. Expert groups differ on how much antibiotics help, so follow your child’s pediatrician.

How long is pinkeye contagious?

Viral pinkeye is contagious while symptoms last, and some viruses can spread for longer. Bacterial pinkeye is contagious until symptoms go away or until about 24 to 48 hours after starting antibiotics. Allergic pinkeye is not contagious.

Can my child go to school or daycare with pinkeye?

It depends on the type and the school’s policy. Many schools allow a child with bacterial pinkeye to return after 24 hours of antibiotic drops, and children with mild viral pinkeye from a cold often don’t need to stay home. Keep your child home if they have a fever or seem sick, and check your school’s rules.

Is pinkeye in a newborn an emergency?

Red, swollen or sticky eyes in a newborn should be checked by a doctor right away, according to the CDC. Infections passed during birth can be serious in young babies. A blocked tear duct, which causes watery eyes without redness, is more common and less worrying, but your pediatrician should still take a look.

When is pinkeye an emergency?

Get care right away if a child with pinkeye has eye pain, blurred or changed vision, strong sensitivity to light, a very red or swollen eyelid, a fever in a baby under 12 weeks, or seems very sick. Any newborn with pinkeye symptoms also needs to be seen promptly.

Related guides

Sources

This article is for general information and is not a substitute for advice from your child’s doctor. In an emergency, call 911.

Pinkeye in Kids: Symptoms, Treatment and When to Call the Doctor

What is pinkeye?

Pinkeye symptoms in kids