This article is reviewed, corrected, and approved by: Dr. Joshua Collins M.D. | MRCP। FRCP

Conjunctivitis, commonly known as pink eye or red eye, is a common eye condition that causes inflammation or infection of the conjunctiva. However, there are several other eye conditions that can be misdiagnosed as pink eye due to similar symptoms.

It is essential for someone to understand the difference between pink eye and other eye diseases to ensure accurate diagnosis and appropriate management. By understanding the distinct characteristics of each condition, individuals and healthcare professionals can make rational decisions regarding treatment and care.

This article aims to shed light on what is commonly misdiagnosed as pink eye. Also, information on various eye diseases, including pink eye syndrome, highlights their symptoms, causes, and available treatment options.

1. Allergic Conjunctivitis

A woman suffering from allergic conjunctivitis. Credits: ReviewsFellas©

Allergies from things like pollen, dust mites, pet dander, or medicine can cause allergic conjunctivitis. This happens when the immune system reacts to something in the eyes, causing redness and irritation.

Symptoms of Allergic Conjunctivitis

  • Redness
  • Itching
  • Watery discharge
  • Burning or stinging sensation
  • Allergic Conjunctivitis affects both eyes

Usually accompanied by other allergic symptoms

  • Sneezing
  • Nasal congestion
  • Itchy throat

Management involves

  • Identifying allergens
  • Avoiding triggers for the reaction

Over-the-counter antihistamine eye drops or artificial tears can help relieve the symptoms. In more severe cases, prescription medications like antihistamines or corticosteroids may be necessary.

2. Dry Eye Syndrome

A man showing his dried eye. Credits: ReviewsFellas©

This eye condition occurs when there is insufficient production of tears or when tears evaporate too quickly, causing discomfort and irritation due to inadequate lubrication of the eyes.

As we age, hormones change, medications are taken, screen time is increased, and environmental factors contribute to Dry Eye Syndrome. Individuals with autoimmune disorders or who have undergone certain eye surgeries may also be at higher risk.

Dry Eye Syndrome can mimic Pink Eye symptoms, leading to misdiagnosis. Symptoms include redness, itching, blurred vision, light sensitivity, fatigue, dry or gritty sensation in the eyes. They worsen in low-humidity environments, like air-conditioned rooms.

Dry Eye Syndrome symptoms

  • Redness
  • Itching
  • blurred vision
  • Light sensitivity
  • Fatigue in the eyes
  • Dry or gritty sensation
  • Symptoms worsen throughout the day or in low-humidity environments

Factors Contributing to Dry Eye Syndrome

  • Aging
  • Hormonal changes
  • Medications
  • Increased screen time
  • Environmental factors
  • Autoimmune disorders
  • Certain eye surgeries

Treatment focuses on

  • Improving tear production and retention
  • Managing symptoms

Treatment options

  • Artificial tear drops or ointments
  • Moisture goggles
  • Good eyelid hygiene

Lifestyle changes

  • Regular breaks from screens
  • Using a humidifier
  • Adhering to the recommended proper eye care for you.

3. Bacterial or Viral Infections

An infected eye with a painful lump at the bottom. Credits: ReviewsFellas©

Viral and bacterial infections in the eye are common conditions that can be mistaken for Pink Eye due to similar symptoms. However, proper diagnosis is crucial as treatment approaches differ significantly.

Bacterial Conjunctivitis, caused by bacteria like Staphylococcus or Streptococcus, typically results in redness, itching, and a sticky yellow or even deep-colored substance discharge from the eyes. Viral Conjunctivitis, on the other hand, is caused by viruses, often associated with the common cold or upper respiratory infections.

Bacterial Conjunctivitis

  • Redness, itching, sticky yellow or green discharge from the eyes
  • Can affect one or both eyes
  • Highly contagious
  • Antibiotic eye drops or ointments prescribed for treatment

Viral Conjunctivitis

  • Redness, watery discharge, gritty sensation in the eyes
  • Often associated with common cold or respiratory infections
  • Usually resolves within a week or two
  • Severe cases may require antibiotic eye drops
  • Identifying the cause may require professional assessment and lab tests

Prevention measures

  • Regular handwashing
  • Avoid touching the eyes
  • Refrain from sharing towels, pillows, or makeup.

4. Subconjunctival Hemorrhage

Zoomed in view of Subconjunctival Hemorrhage. Credits: ReviewsFellas© 

Blood is present under the conjunctiva in this condition, known as subconjunctival hemorrhage. Because of the redness it shows, it is often confused with Pink Eye. Unlike Pink Eye, Subconjunctival Hemorrhage is not caused by infection or inflammation.

Instead, it occurs when small blood vessels on the surface of the eye rupture, leading to the leakage of blood. This can be triggered by minor trauma, excessive coughing or sneezing, rubbing the eyes forcefully, or even high blood pressure.

Causes of Subconjunctival Hemorrhage

  • Not caused by infection or inflammation.
  • Results from rupture of small blood vessels on the eye surface
  • Triggers: minor trauma, excessive coughing or sneezing, forceful eye rubbing, high blood pressure.

Primary symptom

  • Bright red patch on the white part of the eye
  • No pain, discharge, or change in vision associated with Subconjunctival Hemorrhage
  • Blood is naturally reabsorbed by the body over time, and redness fades
  • Subconjunctival Hemorrhage is not contagious and doesn't require specific treatment
  • Generally harmless and resolves within 1-2 weeks

Treatment Option

  • Need to consult professional medical advice for accurate diagnosis and treatment of Subconjunctival Hemorrhage or Pink Eye.

Pink eye vs Stye vs Allergies

Here are key differences between three common conditions i.e. stye vs pink eye vs allergies:


Pink Eye (Conjunctivitis)

Allergies

Stye (Hordeolum)

Definition

Inflammation or infection of the conjunctiva

Immune system reaction to allergens

Eyelash oil gland infection

Causes

Viruses, bacteria, allergens, irritants

Certain medications, dust mites, pollen, dust mite dander

Bacterial infection (Staphylococcus aureus)

Symptoms

Redness, itching, tearing, discharge, crusty eyelashes upon waking, sensation of something in the eye

Redness, itching, tearing, burning or stinging sensation in the eyes, swelling and puffiness around the eyes, runny or stuffy nose, sneezing, nasal congestion, itchy throat, coughing

Red, swollen lump on the eyelid, pain or tenderness, sensitivity to light, swelling of the eyelid, blurred vision (if the stye affects the cornea)

Contagiousness

Viral/bacterial pink eye: highly contagious

Allergies: not contagious

Highly contagious, especially in bacterial cases through touching, sharing makeup, or contaminated towel or belongings

Treatment

Viral: No specific treatment, resolves on its own in 1-3 weeks; Bacterial: Antibiotic eye drops/ointment; Allergic: Antihistamine eye drops/medication, lubricating eye drops for relief

Avoiding allergens, antihistamine eye drops or medications, nasal sprays, decongestants, corticosteroids, immunotherapy (allergy shots), avoidance measures

Viral: No specific treatment, resolves on its own in 1-3 weeks; Bacterial: Antibiotic ointment or drops; Warm compresses to promote drainage and healing; Avoid squeezing or popping the stye; Maintain good eyelid hygiene

Prevention

Frequent handwashing, avoiding touching the eyes, not sharing personal items; Vaccination (if available)

Avoiding allergens, using allergen-proof bedding, keeping windows closed, using air purifiers, wearing sunglasses or protective eyewear, regularly cleaning to remove dust and allergens

Frequent handwashing, avoiding rubbing or touching the eyes, avoiding using old or contaminated makeup

When to Seek Medical Attention

Persistent symptoms, severe pain, vision problems, or risk of spreading the infection

Persistent symptoms, significant discomfort, interference with daily activities, worsening symptoms

Persistent symptoms, increasing pain, difficulty opening or closing the eye

Symptoms of Common Eye Disease

  • Allergies: Red, itchy, watery eyes; may also have a runny nose, sneezing, and coughing
  • Styes: Red, swollen bump on the eyelid; may be painful
  • Iritis: Redness, pain, and decreased vision in one or both eyes
  • Keratitis: Redness, pain, and blurry vision.
  • Blepharitis: Red, flaky, or crusty eyelids; may also have dry eyes.

Treatment for each condition

  • Allergies: Antihistamines, eye drops, or allergy shots.
  • Styes: Warm compresses, antibiotic ointment, or antibiotics (oral).
  • Iritis: Pain relievers, anti-inflammatory eye drops, or oral steroids.
  • Keratitis: Antibiotic eye drops or ointment, pain relievers, and warm compresses
  • Blepharitis: Warm compresses, lid hygiene, and antibiotic eye drops.

Best Eye Drops For Pink Eye

You can find some pink eye relief drops on the market. Before choosing any of them, it would be best for you to know how they work and did they interact with your eyes or not. Some pink eye relief drops are-

  1. Artificial tears: These lubricating eye drops provide moisture and alleviate dryness and irritation associated with pink eye. They are safe to use for both viral and bacterial infections. Popular brands include Refresh, Systane, and Blink.
  2. Antihistamine eye drops: Antihistamine eye drops block histamine and alleviates symptoms of allergic conjunctivitides, like itching and redness. Alaway, Pataday, and Zaditor are common OTC eyedrop brands (best over the counter medicine for pink eye).
  3. Decongestant eye drops: Decongestant eye drops like Visine, Clear Eyes, and Naphcon-A can reduce redness and irritation in pink eye by shrinking blood vessels. But don't use them for too long, or they can dry out your eyes.

Watch and Learn Fascinating Details About Conjunctivitis (Pink Eye)

The Bottom Line

Eye conditions commonly misdiagnosed as pink eye include Allergic Conjunctivitis, Dry Eye Syndrome, Bacterial or Viral Infections, and Subconjunctival Hemorrhage. It is important to understand the distinctions between these conditions to ensure accurate diagnosis and appropriate treatment.

I have gathered a complete list of eye conditions to help you know the distinctions between each illness. My aim was to give you useful information that can help lower the chance of having any eye problems in the future.