Most cases of pink eye are bilateral, meaning they occur in both eyes. If the cause is an infection, symptoms may begin in one eye and spread to the other. If the cause is an allergy or irritant, symptoms may appear in both eyes at the same time.

Pink eye, or conjunctivitis, is one of the most common eye conditions. It occurs when the conjunctiva, the clear tissue that covers the white part of the eye, becomes inflamed. The condition is highly contagious, but very often, the symptoms are mild and get better on their own.

Keep reading to learn more about pink eye in both eyes, including how common it is, the symptoms, treatments, and when to contact a doctor.

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Pink eye in both eyes is common, as most cases involve both eyes. In general, conjunctivitis is among the most common eye issues for adults and children.

Pink eye can occur due to viruses, bacteria, or allergens. Newborns may develop pink eye, or neonatal conjunctivitis, due to irritation, infection, or a blocked tear duct.

Viral and bacterial conjunctivitis can look similar, but there are some differences.

Viral conjunctivitis occurs when a person contracts a virus, such as the adenovirus that causes the common cold. It typically causes a watery discharge. A person may also have cold or flu-like symptoms.

In contrast, bacterial conjunctivitis occurs due to bacteria getting in the eye. These infections can stem from several types of bacteria, such as Streptococcus pneumoniae, which commonly affects the sinuses and throat.

Bacterial pink eye is more common in children and causes a thick yellow or green sticky discharge. It may begin during or after another infection, such as an ear infection or a respiratory infection.

Both types of conjunctivitis are highly contagious and can easily spread from one eye to the other.

Pink eye can also be the result of a reaction to allergens such as grass, mold, or pollen, or chemicals such as chlorine. Around 40% of people may experience allergic pink eye. It is not contagious and will usually affect both eyes at the same time.

The symptoms of pink eye include:

  • red eyes
  • dry or itchy eyes
  • eye watering or discharge
  • crusting on the eyelids or lashes, which may be worse in the morning
  • swelling around the eyelids
  • the feeling that something is stuck in the eye

As toddlers and children may not always be able to tell adults about their symptoms, parents and caregivers should look out for:

  • frequent eye rubbing
  • the child waking up with discharge or crust around the eyes
  • dislike of bright lights

Newborns who get pink eye will usually develop symptoms within 1 day to 2 weeks after birth. Their eyelids will look red and puffy and may be tender.

Pink eye can be a symptom of COVID-19. In some cases, pink eye is the only symptom of COVID-19. It can also develop after COVID-19 has improved. Research suggests that 1–6% of people with COVID-19 develop pink eye.

However, a 2022 study found that pink eye due to COVID-19 was more likely to occur in just one eye, rather than both eyes. The study found that 78% of participants had pink eye in just one eye, while 22% had it in both.

If there is a possibility conjunctivitis could be a symptom of COVID-19, a person should seek testing. They should avoid contact with others until getting the test result.

Learn more about COVID-19 and conjunctivitis.

Most cases of pink eye are mild and get better on their own without treatment. This means most people do not need to contact a doctor for pink eye.

However, in some cases, people may need medical attention. A person should contact a doctor if they experience:

  • moderate or severe eye pain
  • blurred vision
  • sensitivity to light
  • intense redness in one or both eyes
  • symptoms that do not improve or become worse

A person should also speak with a doctor if they have pink eye and a weakened immune system, due to conditions such as HIV or medical treatments that affect immunity.

If a person experiences any of the following symptoms, they should seek urgent medical help:

  • changes in vision, such as flashing lights or loss of vision
  • severe headache and nausea
  • an injury or something stuck in their eye
  • one pupil that is larger than the other

These symptoms may suggest a more serious condition that could be an emergency.

Newborns with pink eye should receive medical attention straight away, as neonatal conjunctivitis can become very serious if the cause is an infection.

Treatment for pink eye varies depending on the cause.

Viral or bacterial conjunctivitis

Many cases of viral pink eye will go away without medical treatment. Cold compresses and lubricating eye drops may help with the symptoms until they get better.

Viral pink eye will not respond to antibiotics. It will typically resolve within 1–2 weeks, but it may take up to 3 weeks to fully heal.

If a person has bacterial pink eye, a doctor may recommend antibiotic ointment or drops. These can help the infection clear up faster and reduce complications.

Mild bacterial pink eye usually lasts 7–10 days without treatment, or may improve within 3–4 days of starting antibiotics.

To help prevent the infection from spreading to both eyes, a person should try to avoid touching or rubbing their eyes. When applying a compress or eye drops, a person should always wash their hands with soap before and after touching the eye area.

A person should not reuse any items that have been in contact with the eye, such as face cloths, towels, or makeup brushes, without cleaning and sterilizing them first. It is also important not to share these items with others. A person should also avoid wearing eye makeup and contact lenses until the symptoms go away.

Allergic conjunctivitis

If the cause of pink eye is allergies, a person can ease their symptoms by limiting their exposure to allergens. A doctor may also prescribe medications such as antihistamines or steroid eye drops, if it is difficult to avoid the trigger.

Neonatal conjunctivitis

Doctors will usually give newborns drops or ointments within 2–3 hours of their birth to help prevent pink eye. If it develops, a doctor may recommend using a saline solution to rinse the baby’s eyes and administering antibiotics if the cause is a bacterial infection.

If the cause is a blocked tear duct, a caregiver can massage the area between the baby’s eye and nose to help. A doctor may recommend surgery if the blocked tear duct has not cleared up by the time the baby is 1 year old.

Pink eye in both eyes is common. In fact, conjunctivitis usually affects both eyes. Treatment for pink eye will vary depending on the type of infection. Home remedies can help with viral pink eye while the symptoms get better, but if the infection is bacterial, antibiotics may help.

To prevent pink eye from spreading between eyes or to other people, a person should avoid touching their eye and they should wash their hands regularly.