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What is Pink Eye?

Pink eye is one of the most commonly referenced eye infections, but do you know what it is?

The answer might surprise you, there really is no one definition for pink eye! Pink eye can be caused by several different things which all require different treatment methods. Getting a proper diagnosis and thus proper treatment is crucial to ensure prompt healing and prevention against worsening infection.

What is Pink Eye?

“Pink eye” is more of a blanket statement—like saying you have a sore throat—it is best to focus on different signs and symptoms, and to seek medical care from an eye doctor specifically—not an urgent care, primary care doctor, or the ER unless an eye doctor is not accessible.

Pink eye is indeed an eye infection, medically called “conjunctivitis”, but there are several different causes. The term pink eye is more of a descriptive factor as the eye literally looks pink, and sometimes even red. Therefore, a better term for pink eye would simply be an eye infection (or conjunctivitis).

Eye infections can be caused from bacteria, fungi, viruses, and sometimes even allergies. Each of these four main categories have their own treatment regimens and the treatment for one category can actually make the symptoms of another category worse!


True or False: Common Misconceptions of Pink Eye

Before we get into specifics, here are some things we regularly hear as eye doctors about pink eye—some hold some truth while others are quite false!

Pink eye is only a problem of childhood.

Answer: False! Pink eye can occur in at any age.


Pink eye is caused from someone farting in your face.

Answer: While this statement holds some truth, it is not completely correct. Fecal matter and flatulence are the body’s way of getting rid of wastes—this can include bacteria which are one of the many causes of pink eye. So could someone farting in your face cause pink eye?Yes, but it is not the typical cause.


Pink eye is very contagious.

Answer: Sometimes. Some forms of pink eye are contagious whereas others are not.


Once you have pink eye once, you’ll never get it again.

Answer: False. There is no “immunity” to pink eye. You can have it once or you can have it multiple times—although we recommend if this is a commonly recurrent issue you discuss it with your eye doctor.


My brother had pink eye a year ago and he still has some left over eyedrops. I can use those to clear up my pink eye, right?

Answer: Very false! Please do not do this, your pink eye could be very different from someone else’s, and therefore the treatment regimens are quite different.


Signs and Symptoms of Pink Eye

Since the cause of pink eye is variable, the signs and symptoms of it also vary. However, some of the most common complaints associated with pink eye include:

-Itchy Eyes

-A pink or red appearance to the eyes

Eye discharge—typically yellow, green, or white in color

-Waking up with eyes “crusted shut”

-A swollen appearance of the eyes

-Occasionally eye pain

-Occasionally reduced vision


Common Causes of Pink Eye

As briefly noted before, there are four major categories of pink eye—bacterial, viral, allergic, and fungal.

Bacterial Pink Eye

Bacterial pink eye is what is seen most frequently in children. The two most common culprits are Staph and Strep.

While Staph and Strep sound intimidating, they are actually part of the normal bacterial flora, meaning they exist naturally within the body and typically do not cause problems.

When Staph and Strep become imbalanced or travel to an area outside of their normal body organ they can cause infections like pink eye.

The reason bacterial pink eye is seen so commonly in children is due to their lifestyle. In general, children touch more things than adults—shared toys, shared school supplies, sports equipment, grass, dirt, playground equipment, etc. Children have also been known to wash their hands less frequently than adults—the combination of the two can easily result in an increase in bacteria numbers and thus lead to infections.

Bacterial pink eye has a few unique characteristics to help differentiate it from other pink eye causes. Bacterial pink eye usually affects both eyes and will produce a yellow/green discharge. The eyes may be crusted close upon awakening and you may have difficulty keeping your eyes open due to irritation and light sensitivity.

Bacterial pink eye is indeed contagious, so if you suspect your child has a bacterial eye infection it is best to keep them away from other children and call your eye doctor as soon as possible to initiate treatment and lessen the spread.

Since bacterial pink eye is contagious, it can be spread to adults, especially those who have children or work with children regularly. It is always advisable to wash hands frequently to help limit the spread of bacteria.

Bacterial pink eye is also seen frequently in contact lens wearers who might not have the best contact lens hygiene care routine.

Contact lens associated bacterial infections are serious, if you think you may have pink eye and wear contacts you should discontinue contact lens wear immediately.

Bacteria like cool, moist environments—like contact lens cases. Therefore, if you do not regularly clean your contact lens case prior to putting in the saline and contacts for overnight storage, bacteria could be lurking in the case and hence latch on to your contacts overnight.

Contact lens bacterial pink eye presents similarly to regular bacterial pink eye, however it can be more detrimental to vision as contact lens wearers are more prone to small, unnoticeable scratches (corneal abrasions) since there is something going in and out of the eye regularly.

When bacteria seep into these small abrasions and fester, it makes the eye infection much more miserable to the individual and can be more difficult to treat. Thus, contact lens wearers who have pink eye often report more pain, watery eyes, and a decrease in vision.

Bacterial eye infections are usually treated with antibiotic eye drops. In these cases, you normally want to avoid steroid eye drops, as steroids weaken the immune system to decrease inflammation and therefore result in the eyes having less of a resistance to the bacteria. Taking steroids and not antibiotics, therefore, can cause bacteria to proliferate exponentially and create a much more severe infection.


Viral Conjunctivitis and Pink Eye

Viral pink eye is more commonly seen in adults—especially in times of stress. Viral pink eye tends to be a little less concerning than bacterial, but it is still irritating and seeing your eye doctor is always a good idea.

Viral pink eye can affect only one eye or both eyes. It does not usually have discharge—if it does the color will usually be clear to mildly white.

The two most common causes of viral pink eye are adenovirus and herpes simplex virus.

Adenovirus is one of the common culprits of flu-like symptoms. If you are experiencing a sore throat, sneezing, fatigue, or other common cold symptoms, be sure to relay this information to your eye doctor.

Adenovirus pink eye is contagious for the first few weeks of the disease, but later becomes non-contagious.

Herpes Simplex related pink eye is the other major viral culprit of eye infections.

Herpes is a scary sounding diagnosis to hear, but in all actuality, it is not something to fret over. There are two subtypes of herpes simplex—type 1 is what causes cold sores and is typically the cause of Herpes simplex eye infections. The majority of the population would actually test positive for Type 1 Herpes Simplex Virus.

Type 2 is the sexually transmitted disease—just because you hear “herpes” does NOT necessarily mean you have the STD form.

Herpes viral pink eye is not typically contagious, it is mostly just annoying to the individual. It is commonly seen in times of stress—before a big exam, an important work meeting, during pregnancy, while planning a wedding, etc.

Lastly, a current area of viral pink eye research is with the COVID-19 epidemic. There has been a reported increased in pink eye cases, however there has not yet been many studies proving or disproving a connection between the two. It is definitely a topic to keep an eye on in the future.

Regardless of cause, viral eye infections tend to be self-limiting, meaning the body will take care of them on its own with due time. However, there are cases of more stubborn or severe viral pink eye in which treatment by your eye doctor will be necessary.

Viral pink eye needs to be treated with an anti-viral eye drop—antibiotics and steroids will not help in these situations. Again, steroid eye drops can actually make viral pink eye worse for the same reason it can worsen bacterial pink eye.


Allergy Related Pink Eye

Allergies are another common cause of pink eye. Allergies can be seasonal from pollen, grass, hay, etc. or can be from contact with certain materials including cosmetics, lotions, contact lens solutions, soaps, or even laundry detergent!

Allergic pink eye is not contagious whatsoever and almost always affects both eyes. It often presents with excessive watering, eye swelling, and occasionally white stringy mucous. The #1 complaint with allergic pink eye is itchiness.

If allergies are what is causing your pink eye, antibiotics and anti-virals will not help. Usually your eye doctor will prescribe an over-the-counter allergy eye drop such as Pataday or Zaditor, but sometimes this method of treatment is not enough.

Your eye doctor may recommend a prescription-grade allergy eye drop or a steroid eyedrop to help weaken the immune response and dampen inflammation (the underlying cause to your allergic pink eye).

It is also recommended if you have tried using any new cosmetics, lotions, soaps, etc. that you discontinue use in case it is the underlying agitator. If you wear contact lenses those should also be discontinued until your allergies clear up.


Fungal Pink Eye

Out of all four categories of pink eye, fungal is the most rare but also the most serious.

Fungal pink eye is commonly transmitted from contact with trees, bushes, soil, or other organic substances. For example, when doing yard work a tree branch snaps back and hits your face. You may not have any obvious cuts or injuries, but the fungus can transfer to the eye and cause a serious infection.

Unique symptoms to a fungal pink eye are pain and cloudy vision. You may have some discharge and the eye itself may appear white and cloudy instead of clear.

If you have pink eye and have been out hiking, doing yard work, swimming in a lake, or other outdoorsy activities and suspect you may have a fungal infection you need to call your eye doctor immediately as fungal infections can be permanently sight threatening.

Your eye doctor will want to get you started on an intense anti-fungal treatment program to get the situation under control as quickly as possible.


What Should I Do if I Think I Have Pink Eye?

As you can see, different causes of pink eye are treated quite differently. Without proper treatment your pink eye could get worse and even become sight threatening.

Eye doctors have many special, unique tools in office to look at your eyes and determine what the underlying cause is—therefore it is best to have your eye doctor handle your pink eye situation. When you call to make an appointment you should be prepared to answer the following questions:

-Are both eyes involved, or just one?

-When did you first notice your eye was bothering you?

-Is there any discharge? If so, what color is it? Is there a lot of discharge, or just a little bit?

-Are you in any eye pain?

-Can you still see well, or is your vision affected?

Based on your answers to these questions, your eye doctor will already have a decent idea as to what is going on. He or she will therefore determine how urgent the matter is and fit you into the schedule accordingly.

If the doctor says he or she cannot get you in until the following day or two, do not panic! Your eye doctor knows best, if it is an emergency they will find a way to fit you in ASAP. Many eye doctors even have an after-hours emergency number for eye-related problems, so always call us first!


Our eye doctors at Eye Theory in Houston, TX excel in the prescription of contact lenses, glasses and various eye diseases.  Call our optometrist at 832.831.7386 or schedule an appointment online if you would like to learn more about pink eye.  Our eye doctor, Dr. Jonathan Tsao, provides the highest quality optometry services and eye exams in the Midtown, Downtown, Museum District, Montrose, East Downtown, and Southside Commons (Southside Place) vicinities of Houston, Texas.

When Should My Child’s First Eye Exam Be?

When it comes to your child’s health, it seems like there are hundreds of recommendations and doctors to visit—but when should your child begin to see an eye doctor?

The Eyes and Human Development

As noted before, we know there are many different recommendations out there. With our friend Dr. Google it can be hard to determine what exactly is the best schedule to follow and when to go to what doctor.

However, when you think about it more closely, proper eye health is required for good vision—if vision is poor it can make life quite difficult.

If your child has poor eyesight from birth—they likely will not be able to recognize that his or her vision is poor, as it is what they have always known. He or she will not be able to tell you that they cannot see well, but instead will think that is simply how the world looks.

Poor vision, therefore, can cause a child to struggle in more aspects in life than just school work. Thus, it is important to have a first eye exam prior to entering school-aged years.

Think about a toddler learning to walk. If he or she cannot see where they are going—this toddler may be afraid to walk around and ultimately come to avoid the task. The same can be applied to other aspects of life as well. If a young child cannot see effectively, they may not be able to recognize family members, feed themselves, play with toys, etc.

Essentially, your baby could be trying to learn how to encounter the world for the first time through extreme blur—this would be a difficult task for anyone to overcome, let alone a baby! This could prolong their developmental milestone track and cause parental stress and worry.

While you might think the most appropriate doctor to see is a developmental therapist, the solution could be as simple as your baby just needing a pair of glasses.

Pediatricians and Eye Exams

A common statement heard from many parents is that they take their children regularly to see pediatricians and the pediatrician performs a vision screening—so why is it recommended to take my child to see an eye doctor?

This is a very fair question. Pediatricians go through schooling to learn about the human body in its entirety. They go through medical school first, and then at least three additional years of schooling to specialize in patient care for the younger population.

The human body is extremely complex with many different moving parts that must be evaluated within a 20 minute exam slot. Thus, when your child sees a pediatrician, the doctor is doing a simple screening looking for major eye health problems (cancers, malformations, obvious eye turns, infections, etc.), and then moving on to the next test.

This of course is not to say that pediatricians are not doing enough—they are experts in children medical care of course! However, the eye is so complex that doctors of optometry spend 4 years studying just eyes, and look at so much more than just a glasses prescription! Why not leave the vision examination to a specialist who is trained to pick up on subtleties and has the proper equipment to conduct various tests specific solely to the eyes?

What do Eye Doctors do Special During Pediatric Eye Exams?

Eye doctors not only have more advanced and specialized equipment to evaluate children’s eyes, but they also go through special schooling to assess children’s eyes.

An infant eye exam begins with your typical history questions—asking about length of pregnancy, complications that occurred during birth, and if applicable, developmental milestones. It is important to come prepared with this information as this information is crucial for eye development timelines and can lead your eye doctor to watch more closely for subtle signs and changes in your baby’s eyes.

For example, a baby that was born prior to 37 weeks (pre-mature) is at higher risk for eye turns (called strabismus), refractive errors (i.e. will need correctional glasses), and other eye health problems. This is not absolute—so do not panic reading this! It is just another reason as to why it is important to visit an eye doctor early in life rather than waiting until school-aged years.

After the history, your eye doctor will look at your child’s eye alignment to evaluate if he or she has an eye turn and ensure the eye muscles are working properly.

Next, the eye doctor will look at your child’s light reflex. This is how eye doctors can look into a patient’s eyes and determine if he or she needs a glasses prescription without verbal feedback.

The eye doctor will hold some lenses in front of your child’s eyes while shining a light into them quickly. The light is reflected off the back surface of the eye. With lenses, the eye doctor is able to neutralize this light reflex to come up with the appropriate glasses prescription (if needed).

The last major test during an eye exam is dilation. Dilation is important because it allows the doctor to use a special magnifying lens to look into the back structures of the eye and ensure everything is healthy and has developed properly.

It is important to catch any disease early, while it may be unlikely for a major problem to be uncovered in your child, it is always better to be safe when it comes to your child’s health.

What are Abnormalities Eye Doctors May Find During the Eye Exam?

A large majority of children will get the all-clear and be perfectly healthy with no treatment necessary from their first eye exam. Your eye doctor will then give you an updated timeframe and likely will not need to see your child again until reaching the school-aged years, unless another concern comes up in the meantime.

There are, however, several different abnormalities that may be detected during your child’s initial eye exam—initiating treatment for said abnormalities will be a lifechanging improvement for your child.

One such abnormality could be the need for glasses. A child who cannot see well may lash out, anger easily, or appear to be developmentally delayed. This could simply be out of frustration due to seeing the world as a blurry mess.

Many children need glasses—especially in today’s world with a drastic rise in myopia (near-sightedness). If your child needs glasses it is nothing to panic about, and there are many great options for flexible, comfortable glasses even for babies!

Another reason as to why eye exams are crucial for your young ones is due to a problem called amblyopia. In short, amblyopia is caused by the brain “shutting off” one eye. It can be caused from one eye seeing well and the other eye seeing poorly, an eye turn, or a structural abnormality such as an excessively droopy eyelid or trauma.

The crucial years for eye development range from birth to about 7 years of age. During this time, if amblyopia is caught, there is a much better likelihood of treatment working to “turn the eye back on” and prevent permanent decreased vision in the problem eye.

Amblyopia can be tricky to detect because your child might appear to see well, as their good eye is taking lead and allowing them to see “alright”. Eye doctors are trained to watch very closely for this problem; the earlier it is caught the better the outcome is for your child.

Other problems eye doctors watch for are eye turns, cancers, glaucoma, and other retinal diseases (the retina is the back most structure of the eye responsible for transmitting vision from the eye to the brain).

At What Age is the Eye Exam Recommended for my Child?

A safe recommendation is for your child to have his or her first eye exam around 6 months of age. If the eye doctor sees a concern it is easy to initiate treatment at that time, or if it is something that should be monitored they may recommend you bring your child back in to see them every year.

If everything looks good at this initial visit, your doctor will likely recommend you return for your child’s next visit when they get closer to starting school—around the age of 4-5 years.

Once reaching school-age, it is recommended to bring your child in for an eye exam yearly. This is to watch for changes and initiate any necessary treatment as early as possible to prevent the issue from progressing.

Is There Anything I Should Watch for in my Child Before the Eye Exam?

As a parent we know you have many concerns and are quite busy. However, the following is a list of signs that indicate you should make an appointment with your local eye doctor:

  • Excessive squinting
  • Inability to focus on a target (toy, bottle, face, etc.)
  • Visible eye turn (can be constant or only seen sometimes)
  • Excessively droopy eyelids
  • If the black part of your child’s eye appears white (especially in pictures)

If you notice one or more of these signs in your child, it does not necessarily mean something is wrong, but could be a sign of something more serious going on. Your local eye doctor would be more than happy to see your little-one and make sure he or she is setup to live their happiest, most-successful life.

Our eye doctors at Eye Theory in Houston, TX excel in the prescription of contact lenses, glasses and diagnosis of various eye diseases.  Call our optometrist at 832.831.7386 or schedule an appointment online if you would like to learn more about a pediatric eye exam.  Our eye doctor, Dr. Jonathan Tsao, provides the highest quality optometry services and eye exams in the Midtown, Downtown, Museum District, Montrose, East Downtown, and Southside Commons (Southside Place) vicinities of Houston, Texas.

When Should My Child Get an Eye Exam?

There are many recommended health care appointments for children, and a comprehensive eye examination with an eye doctor is an important part of these. It may be confusing as to when you should bring your child for an eye examination and what can be done at each age.

This article will explore expert recommended guidelines for children’s eye examination intervals and what to expect from these appointments. In addition, the information here may be different if our optometrist finds certain conditions that they want to watch more closely.

0 – 2 Years: One Eye Examination Between 6 – 12 Months of Age

Although young and unable to do a typical eye examination, infants are able to have their eyes examined for various entities that can affect their development. After birth, hospital staff check for basic eye functioning and any noticeable diseases, like infections or the media of the eyes not being clear.

Our optometrist can check the eyes again between 6 – 12 months of age, where they are doing simple objective tests to check again for opacities in the eyes, glasses prescriptions that are outside of normal levels and can impact development, eye turns that require prompt treatment, etc.

These are short appointments that can do a great deal for a child if an issue is found.


3 – 5 Years: At Least One Eye Exam Between 3 – 5 Years of Age

As the child grows older, a more thorough eye examination is possible that can more precisely determine variables like the glasses prescription, which can be increasingly important as the child begins school.

This can be quite important as changes in the eyes that are not likely to be noticed by parents, like different refractive errors between the two eyes, can lead to amblyopia, or “lazy eye.” Amblyopia results when an eye does not have a clear image during the childhood years until age 9, causing the brain to not develop proper connections to that eye.

If the problem is corrected before age 9, proper function can develop, but if correction occurs afterwards, then there may be residual lack of vision in that eye.


6 – 18 Years: Once Before First Grade Then Annually Thereafter

As kids grow older into school, sports, and other activities, closely looking after their vision remains important. Even once we are beyond the ages where amblyopia could be a problem, optional correction of refractive error is important to optimize learning.

Treatment of errors in how the eyes focus, and how they work and move together, are also important for school and, especially, homework. Contact lenses may become important for sports and other extracurriculars like performances.

If a child is nearsighted, methods exist to reduce the rate that their prescription grows, leading to a smaller prescription overall when they finish growing.

Parents sometimes believe that if there is an issue with their child’s vision, they will be able to see it themselves, and put off routine eye care for their kids.

On the other hand, when an issue is found in an eye examination that was not previously known about, some parents blame themselves for not bringing their children in sooner. The best way to avoid this feeling, and to maintain the eye health of our kids, is to just simply get their eyes examined at proper intervals.


Our eye doctors at Eye Theory in Houston, TX excel in the prescription of contact lenses, glasses and various eye diseases.  Call our optometrist at 832.831.7386 or schedule an appointment online if you would like to set up an eye exam for your child.  Our eye doctor, Dr. Jonathan Tsao, provides the highest quality optometry services and eye exams in the Midtown, Downtown, Museum District, Montrose, East Downtown, and Southside Commons (Southside Place) vicinities of Houston, Texas.