Posted: Jan 19, 2014 8:00 AM
Pink eye is one of the most common (and contagious) back-to-school illnesses. But, did you know not all pink-eyes require antibiotic eye drops?

Last week, I discussed five of the most common back-to-school illnesses. Pink eye is high on that list. Eye discharge is one of those conditions that leaves everyone running for the hills. Or, at the very least, phoning their child's pediatrician.

The important thing parents should know about pink eye is that they are not all the same. Here's the run down on the four different shades of pink eye.


This is the variety of pink eye (aka conjunctivitis) that will have the thick, white/yellow/green eye discharge. And not just upon wakening. The hallmark of this kind of pink eye is the thick and persistent eye discharge. The whites of the eyes are typically red and children are uncomfortable from the irritation.


Pink eye from a virus is usually preceded by cold symptoms such as runny nose or cough. Although children can wake up with their eye (or eyes) sealed shut, the actual discharge from the eye is thin and watery. Their eyes often feel like they're burning or that there is something in there (like sand).


Allergic conjunctivitis is the result of exposure to a particular allergen such as pollen or cat dander. Their eyes are extremely itchy and the discharge is once again clear and watery. Children with this type of pink eye typically have a history of seasonal allergies or other known allergy.


A direct injury to the eye can cause pain, redness, and discharge. It's always important to determine if your child could have somehow injured their eye when pain and discharge of the eye suddenly appears. Corneal abrasions are fairly common in children and could mimic pink eye.

In addition, any chemical irritation to the eye could cause these symptoms as well. When in doubt, seek immediate medical attention.

Special consideration: Conjunctivitis in newborns

Tearing and discharge in a newborn could be infectious, or more commonly be a blocked tear duct. The former needs prompt diagnosis and treatment while the later responds (with time and patience) to gentle massage of the inner aspect of the eye.


In all cases of pink eye, a cool compress will relieve itching and irritation as well as help in removing any discharge.

  • Bacterial conjunctivitis will require antibiotic eye drops. Be sure to complete the full course and after 24 hours since the start of these drops, your child is clear to return to school.

Tip for administering eye drops^ Have your child lie down. Even if her eyes are closed, place the drops in the inner corner of her eye. Once she opens her eyes, the drops will flow in.

  • Viral pink eye will resolve on its own (typically within 1-2 weeks). Since the thin watery discharge can persist, knowing when to send your child back to school can be tricky. But, just like the common cold, a viral conjunctivitis should not keep your child from school for any prolonged amount of time.
  • Allergic conjunctivitis is best treated by addressing allergen avoidance and medical treatment as necessary for allergies (oral and/or topical antihistamines). If trauma or chemical conjunctivitis is suspected, let your child's pediatrician know immediately. Evaluation for a corneal abrasion or foreign body may be necessary.


With regards to the infectious types (viral and bacterial), judicious hand washing is your best defense. Wash all bedding and towels to prevent spread among family members and to prevent reinfection.

Dr. Mom's Bottom Line^ Pink eye is an extremely common childhood affliction. But remember, they are not all created equal. Now you know how to distinguish the four different shades.

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