How long is pink eye contagious after starting medication

Preventing the Spread of Conjunctivitis

Viral and bacterial conjunctivitis (pink eye) are very contagious. They can spread easily from person to person. You can greatly reduce the risk of getting conjunctivitis or spreading it to someone else by following some simple steps for good hygiene.

If You Have Conjunctivitis

If you have conjunctivitis, you can help limit its spread to other people by following these steps:

• Wash your hands often with soap and warm water for at least 20 seconds. Wash them especially well before and after cleaning, or applying eye drops or ointment to, your infected eye. If soap and water are not available, use an alcohol-based hand sanitizer that contains at least 60% alcohol to clean hands. (See CDC’s Clean Hands Save Lives! website for tips on proper handwashing.)
• Avoid touching or rubbing your eyes. This can worsen the condition or spread it to your other eye.
• With clean hands, wash any discharge from around your eye(s) several times a day using a clean, wet washcloth or fresh cotton ball. Throw away cotton balls after use, and wash used washcloths with hot water and detergent, then wash your hands again with soap and warm water.
• Do not use the same eye drop dispenser/bottle for your infected and non-infected eyes.
• Wash pillowcases, sheets, washcloths, and towels often in hot water and detergent; wash your hands after handling such items.
• Stop wearing contact lenses until your eye doctor says it’s okay to start wearing them again.
• Clean eyeglasses, being careful not to contaminate items (like hand towels) that might be shared by other people.
• Clean, store, and replace your contact lenses as instructed by your eye doctor.
• Do not share personal items, such as pillows, washcloths, towels, eye drops, eye or face makeup, makeup brushes, contact lenses, contact lens storage cases, or eyeglasses.
• Do not use swimming pools.

If You Are Around Someone with Conjunctivitis

If you are around someone with conjunctivitis, you can reduce your risk of infection by following these steps:

• Wash your hands often with soap and warm water for at least 20 seconds. If soap and warm water are not available, use an alcohol-based hand sanitizer that contains at least 60% alcohol to clean hands. (See CDC’s Clean Hands Save Lives! website for tips on proper handwashing.)
• Wash your hands after contact with an infected person or items he or she uses; for example, wash your hands after applying eye drops or ointment to an infected person’s eye(s) or after putting their bed linens in the washing machine.
• Avoid touching your eyes with unwashed hands.
• Do not share items used by an infected person; for example, do not share pillows, washcloths, towels, eye drops, eye or face makeup, makeup brushes, contact lenses, contact lens storage cases, or eyeglasses.

Avoid Getting Sick Again

In addition, if you have conjunctivitis, there are steps you can take to avoid re-infection once the infection goes away:

• Throw away and replace any eye or face makeup or makeup brushes you used while infected.
• Throw away disposable contact lenses and cases that you used while your eyes were infected.
• Throw away contact lens solutions that you used while your eyes were infected.
• Clean extended wear lenses as directed.
• Clean eyeglasses and cases that you used while infected.

Follow these tips to keep your eyes healthy when wearing contact lenses.

Vaccines can prevent some infections associated with conjunctivitis

There is no vaccine that prevents all types of conjunctivitis. However, there are vaccines to protect against some viral and bacterial diseases that are associated with conjunctivitis:

• Rubella
• Measles
• Chickenpox
• Shingles
• Pneumococcal
• Haemophilus influenzae type b (Hib)

Conjunctivitis caused by allergens or irritants is not contagious unless a secondary viral or bacterial infection develops.

• Definition
  • What Is Pink Eye (Conjunctivitis)?
• Symptoms
  • What Are Symptoms of Pink Eye (Conjunctivitis)?
• Causes
  • What Causes Pink Eye (Conjunctivitis)?
• Diagnosis
  • How Is Pink Eye (Conjunctivitis) Diagnosed?
• Treatment
  • What Is the Treatment for Pink Eye (Conjunctivitis)?
• Guide
  • How Do You Know When Pink Eye Is No Longer Contagious? Topic Guide

What Is Pink Eye (Conjunctivitis)?

Bacterial pinkeye stops being contagious shortly after you start antibiotics, but viral pinkeye may be contagious for up to two weeks.

Pink eye (conjunctivitis) is an inflammation of the conjunctiva, the thin membrane that lines the inner surface of the eyelids and the whites of the eyes (called the sclera). 

There are five main types of conjunctivitis: 

• Viral
• Bacterial
• Allergic
• Toxic (also called toxic keratoconjunctivitis)
• Nonspecific

What Are Symptoms of Pink Eye (Conjunctivitis)?

Symptoms of pink eye (conjunctivitis) include: 

• Eye redness
• Discharge
• May be watery or thick
• May be yellow, white, or green, and usually continues to drain throughout the day
• Affected eye often is crusty and stuck shut in the morning
• Eye irritation
• Burning, sandy, or gritty feeling in one eye
• Cold symptoms (viral conjunctivitis)
• Swollen lymph nodes (glands)
• Fever
• Sore throat
• Runny nose
• Itching of both eyes (allergic conjunctivitis)

See an eye specialist (ophthalmologist or optometrist) if you suspect pink eye and have the following signs or symptoms that may indicate a more serious condition: 

• Eye tenderness
• Problems seeing clearly
• Difficulty keeping the eye open 
• Sensitivity to light
• Severe headaches with nausea
• Recent trauma to the eye
• Use of contact lenses

What Causes Pink Eye (Conjunctivitis)?

Causes of pink eye (conjunctivitis) include: 

• Viral infections 
  • Most cases of infectious conjunctivitis are viral in adults and children
  • Highly contagious
  • Typically caused by a virus that can cause the common cold
  • Spread by contact, usually after an infected person touches their eye and then touches an object 
• Bacterial infections
  • Highly contagious
  • Bacterial conjunctivitis is more common in children than in adults
  • Spread by contact, usually with objects which have come into contact with the infected person's eye secretions
  • Often affects multiple people in a classroom or household
• Allergies
  • Caused by airborne allergens that come in contact with the eye
• Toxic 
  • A chronic inflammation of the surface of the eye from an offending agent, usually a preservative or a medication
• Nonspecific conditions
  • Dry eye
  • Irrigation after a chemical splash
  • Foreign body irritation (e.g., dust, eyelash) 

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How Is Pink Eye (Conjunctivitis) Diagnosed?

Pink eye (conjunctivitis) is diagnosed with a physical examination of the eye. The diagnosis of pink eye is often made based on the presence of symptoms such as eye redness and discharge, and the patient’s vision is normal with no evidence of other eye conditions such as keratitis, iritis, or angle-closure glaucoma.

Swabbing the eye for culture, stains, and direct antibody or polymerase chain reaction (PCR) testing is usually only used in uncommon or chronic cases that do not get better on their own or respond to treatment.

There is a rapid (10-minute) test for conjunctivitis caused by adenoviruses but it often is not covered by insurance so it is not widely used. 

What Is the Treatment for Pink Eye (Conjunctivitis)?

Treatment for pink eye (conjunctivitis) depends on the cause. 

Viral conjunctivitis treatment: 

• Viral conjunctivitis is usually contagious for two weeks after the symptoms first appear, for as long as the eyes are red
• A general rule of thumb is: if the eyes are red, it can spread
• Irritation and discharge worsen for three to five days before improving, and symptoms can persist for two to three weeks
• Topical antihistamine/decongestant eye drop to relieve eye irritation 
• Drops are available without a prescription in most pharmacies
• Patients should be careful to avoid spreading the viral infection from one eye to the other
• Drops should be applied to the affected eye only and hands should be washed thoroughly after application
• Warm or cool compresses may be used as needed

Bacterial conjunctivitis treatment: 

• Bacterial conjunctivitis is considered no longer contagious after 24 hours of antibiotic treatment
• Antibiotic eye drops or ointment
• Ointment is generally preferred for young children
• Treatment can help shorten the duration of symptoms when started early
• Redness, irritation, and eye discharge should begin to improve within 24 to 48 hours 
• Most cases go away on their own even if no treatment is used
• Contact lens wearers should not wear lenses the first 24 hours of treatment, or until the eye is no longer red
• The contact case should be discarded and the contacts disinfected overnight or replaced (if disposable)

Allergic conjunctivitis treatment:

• Eye drops that contain naphazoline-pheniramine, ketotifen, olopatadine, and others

Toxic conjunctivitis treatment:

• Removal of the offending agent
• Stop use of any topical eye medications 
  • Don’t stop taking any prescribed eye medications without first talking to your doctor, especially glaucoma drops, because an increase in eye pressure may cause irreversible vision loss

Nonspecific conjunctivitis treatment:

• This type of pink eye usually goes away within a few days without treatment
• Lubricant drops or ointments may help the eye feel better as it heals
• Antibiotic or steroid eye drops/ointments are not recommended unless there is an accompanying bacterial infection or inflammation

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