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Alexa Englehart

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About Author — Alexa currently lives in sunny San Diego, California. When not writing, she enjoys running, hiking, swimming, horseback riding, and reading.

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Pink Eye vs. Allergies: What’s the Difference?

Your eyes are incredibly sensitive to irritants and microbes. While red eyes can come from not getting enough sleep or just not blinking enough, they can also be a sign of infections or disorders. Pink eye is one of the most common ailments to your eyes, but many people have trouble distinguishing between pink eye and regular seasonal allergies.

While the symptoms can overlap, they are two distinct health issues. Getting the right treatment requires the right diagnosis. Let’s take a look at pink eye and seasonal allergies and what sets the two apart.
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Why Your Eyes Turn Red

The whites of your eyes are known as the sclera. The sclera is actually home to thousands of blood vessels that are normally constricted, making them nearly invisible. This maintains the white color that you normally see.

However, when you have something in your eye or suffer something that causes inflammation in your eyes, the blood vessels dilate, becoming more apparent. This creates the redness that is characteristic to many ocular ailments, including pink eye, dry eyes, allergies, and more.

What is Pink Eye?

Pink eye, also known as conjunctivitis, refers to a contagious infection in the conjunctiva of your eye. This is the thin mucus layer that lines the outsides of the white area of your eye. Pink eye is one of the most common eye ailments.

Each year, doctors report over 3 million cases of pink eye in the United States. While it can affect anyone of any age, it is most common in children and their parents and teachers as schools often make the perfect environment for contamination and spreading the disease.

Causes of Pink Eye

When most doctors say “pink eye,” they are referring to its viral form. Viral conjunctivitis is the most common form of pink eye and is most commonly caused by adenovirus, a virus normally responsible for causing upper respiratory infections and sore throats. In rarer instances, viral pink eye may be caused by:

  • Herpes simplex virus
  • Picornavirus
  • Varicella zoster virus
  • Poxvirus

Next to viruses, bacteria are the next leading cause of pink eye. Staphylococcus and Streptococcus are the bacteria most often implicated in conjunctivitis. These bacteria are usually associated with food poisoning and strep throat, respectively.

In rare instances, bacterial pink eye has been caused by the bacteria responsible for chlamydia and gonorrhea. In these cases, the mother may be a carrier of the bacteria and pass it down to her newborn during birth, but most hospitals are required to put drops of ointment in the infant’s eyes to prevent this form of pink eye.

The Symptoms of Pink Eye

The main symptom of pink eye is the reddish, pink shade in the eyes and eyelids caused by inflammation and irritation. Some other general symptoms of pink eye include:

  • Swelling in the sclera or inside the eyelids
  • General irritation in the eyes and eyelids
  • Eye discharge
  • Crusting on the lashes and eyelids
  • Increased amount of tears
  • Eyes that feel itchy or burning
  • Greater sensitivity to light
  • Feeling grit in the eyes
  • Sensation that you have something stuck in our eyes

Symptoms can also change based on the cause of the infection. Viral conjunctivitis often causes a clear discharge that may make you look like you have watery eyes or you’re crying more. Viral pink eye may also cause swelling or tenderness in the area in front of the ears, a sign that the virus has spread to the lymph nodes in the area. You may also experience cold-like symptoms, including a runny nose, sinus congestion, and coughing.

Bacterial conjunctivitis features a thicker, stickier discharge that appears yellow, gray or green in color. This discharge is thick enough to paste your eyelids together when you wake up. Bacterial pink eye also tends to come with mild pain, and the upper eyelid may appear droopy due to swelling (a condition called pseudoptosis). Bacterial pink eye can affect one or both eyes.

Treating Pink Eye

When it comes to treating viral forms of pink eye, you generally will not require medication. Antibiotics only work on bacteria, so there’s no point in administering them with a viral infection. If your case of viral pink eye is caused by herpes or other severe virus, your doctor may prescribe antiviral medication. Your doctor may also prescribe lubricating eye drops to soothe irritation and ease discomfort, but mainly you will require plenty of bed rest. Your pink eye should run its course within seven days to two weeks.

Bacterial conjunctivitis can be quickly and easily treated using antibiotics, which can be administered in the form of topical ointments or eye drops. Antibiotics are highly effective with bacterial forms of pink eye. You should see drastic improvements in symptoms and comfort within 24 hours after first applying the antibiotic treatment.

If you also experience ear ache, coughing, runny nose, and other symptoms that might suggest that the infection has spread, your doctor may prescribe oral antibiotics, which can help to eliminate the pink eye and the overall bacterial infection.

What are Seasonal Allergies?

Switching gears, let’s look at seasonal allergies. About 8 percent of adults in America suffer from seasonal allergies, which is also known as seasonal allergic rhinitis or hay fever. Despite the name, seasonal allergies can happen all year round, though they tend to be less common in the winter.

Depending on the allergen that triggers symptoms, you may experience allergies during more than one season. Mold, pet dander, dust, and other indoor allergens can also trigger an allergic reaction.

What Causes Seasonal Allergies?

Allergic rhinitis happens when your immune system thinks that a normally harmless substance is actually dangerous. The body responds by releasing histamines and other chemicals into your bloodstream as an attempt to defend your system. These histamines and chemicals are what produce the symptoms of seasonal allergies.

Think of histamines as your bodyguards. They are created in your mast cells and help your body get rid of things that may bother you or cause you harm. Despite what they do to you, they are ultimately beneficial to your health and natural defenses.

They begin the process of removing allergens from your body or off the surface of your skin through any means necessary. This unfortunately means sneezing, coughing, crying, or itching.

When histamines are first released, they boost blood flow to the area where the allergens have taken affect. This triggers the process of inflammation, which signals your immune system to send other chemicals to begin repairs and healing.

The substances that trigger your allergies vary from person to person and season to season.

  • Spring: Trees, particularly birch, cedar, poplar, and horse chestnut
  • Summer: Grasses, like ryegrass, and weeds
  • Fall: Pollen from ragweed, nettles, and mugwort
  • Winter: Mainly indoor allergens, including mold, dust mites, cockroaches, and pet dander

Symptoms of Seasonal Allergies

If you have allergies, you have probably shown symptoms for several years. Allergies can also lead to ear infections and sinusitis. The most common symptoms for allergic rhinitis include:

  • Constant sneezing, especially after waking up in the morning
  • Runny or stuffy nose
  • Red, irritated eyes
  • Watery, itchy eyes
  • Postnasal drip
  • Itchiness in your throat, sinuses, and ear canals
  • Ear congestion
  • Drainage from your nose, which usually appears clear and watery but may become thick and cloudy and yellowish in color if you develop a sinus or nasal infection

More severe symptoms of allergic rhinitis that are less common include:

  • Headaches
  • Wheezing
  • Coughing
  • General shortness of breath or difficulty breathing

Treatments for Seasonal Allergies

Many of the treatments surrounding seasonal allergies revolve around avoiding the allergens that trigger a reaction. This includes:

  • Using air filters in your home to remove pollen and other airborne particles
  • Checking local weather forecasts for pollen
  • Remaining indoors or limiting outdoor time when pollen counts are high
  • Wearing a dust mask outside, particularly on windy days
  • Avoiding cigarette smoke

If avoiding seasonal allergies is difficult or impossible, your doctor can prescribe medication to help ease symptoms, including steroid nasal sprays. Your doctor may also advise you to take over-the-counter antihistamines and decongestants, including combinations of:

  • Cetirizine (Zyrtec)
  • Phenylephrine (Benadryl)
  • Diphenhydramine
  • Acetaminophen
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Allergic Conjunctivitis

As you can see, many of the symptoms of seasonal allergic rhinitis overlap with pink eye, making it easy to mix the two conditions up. What makes the two even more confusing is that pink eye may be caused by allergens.

Allergic conjunctivitis combines the symptoms of pink eye and seasonal allergies. That means red, watery, irritated eyes accompanied by:

  • Itchy nose
  • Sneezing
  • Scratchy throat
  • Stuffiness
  • Sensitivity to light

Allergic pink eye occurs in both eyes, but it’s not contagious at all.

How Can You Tell the Difference?

Symptoms can be a big help in differentiating between pink eye and allergic rhinitis. The symptoms for pink eye generally center entirely around the eyes. The symptoms for allergies can center more around your ears, nose, and throat and general congestion.

The best way to know for sure is to get a professional diagnosis from your doctor. With conjunctivitis, diagnosis involves a physical examination of the symptoms and an in-depth look at your personal health history. The diagnosis can be assessed via an online doctor visit, and lab tests generally are not necessary.

However, if your doctor suspects a more severe form of viral or bacterial pink eye, they may take a sample of your eye discharge. This can help your doctor better identify the specific virus and bacteria to determine a proper course of treatment.

For allergic rhinitis, your doctor will consider your symptoms and your personal history, and perform a physical examination. Your doctor can also perform tests to determine exactly what allergens may trigger a reaction. With a skin test, your doctor will put small amounts of different allergens on your skin to see if it causes any sort of reaction. Your doctor may also order other lab tests to determine any potential allergens.

Part of good health is knowing what makes you feel unwell. If you experience either pink eye or allergies, see one of PlushCare’s top-tier doctors online now to get yourself checked out and treated as soon as possible.

Read more on our Pink Eye Series:

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Pink Eye Symptoms & Treatments

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