Infective conjunctivitis is an infection of the thin skin (the conjunctiva) on the front of the eye. It is very common and often starts in one eye but then spreads to the other.
What is conjunctivitis?
Conjunctivitis is a particularly long word for a simple and common condition. The conjunctiva is the thin covering (like a very thin skin) that covers the white part of the eyes and the underside of the eyelids. '-itis' is the medical 'add-on' term for inflammation.
Conjunctivitis is a very common condition in which one or both eyes become red or pink and may be sticky or watery. Almost everyone will have experienced it several times and will be familiar with the symptoms of sensation of grittiness and discomfort in the eyes, with redness and discharge. Read more about the symptoms of conjunctivitis.
Who gets it and why?
Anyone can get conjunctivitis. However, simple bacterial conjunctivitis is particularly common in children, whilst viral conjunctivitis is more common in adults.
Viral conjunctivitis is the most common overall cause of infectious conjunctivitis. Bacterial conjunctivitis is the second most common cause of infectious conjunctivitis.
Discover more on the topic of causes of conjunctivitis.
What's the treatment?
Most episodes of infective conjunctivitis settle down in less than a week with simple self-management. That means that in many cases, you don't need medical help at all. Antibiotics are only occasionally needed.
Learn more about how conjunctivitis is treated.
What else do I need to know?
The image below shows how the conjunctiva runs over the surface of the white part of the eye and over the underside of the eyelids.
You will see that the conjunctiva does not cover the coloured part of the eye (the iris) and the dark, circular part of the eye (the pupil). This part of the eye is the cornea. The cornea is much more sensitive than the conjunctiva. Infection or inflammation of the cornea is called keratitis and it is a more serious condition.
Infection of the conjunctiva causes mild symptoms only. As the conjunctiva does not cover the part of the eye that lets light in for vision, conjunctivitis should not affect your vision. The only exception to this is if you have a lot of discharge in your eye and it smears over the surface - but in this case it should clear on blinking or wiping.
Infective conjunctivitis is usually a harmless condition, although it is fairly contagious, and so it is helpful to know how best to manage it in order to settle it down quickly and avoid passing it on to others. An exception to this rule is conjunctivitis in a newborn baby. This is different to the common 'sticky eye' of newborn babies, and needs urgent attention from a doctor
If the infection is severe or does not settle then antibiotics may be needed. A healthcare professional, including a pharmacist, will be able to advise.
Severe pain, or change in your vision that is not caused by smearing, would suggest a condition affecting the cornea rather than the conjunctiva, and this should always be seen by a healthcare professional.
Does a child with conjunctivitis need to stay off school?
Guidance from Public Health England (PHE) states that children do not need to be excluded from school or from childcare if they have infective conjunctivitis, unless there is an outbreak of several cases. This is because conjunctivitis is a mild condition which represents no danger to others, whilst breaks in school attendance affect your child's learning.
Some nursery and daycare facilities take the view that conjunctivitis is, nevertheless, a nuisance for other parents, and is more easily passed amongst small children who tend to have close physical contact with one another. They may ask you to keep your child at home until the eye is no longer red or sticky, in order to prevent other parents being affected or annoyed. They do, of course, have a right to enforce such rules. However, many realise that this can put working parents into a difficult situation, and so they take a more relaxed view.
If an outbreak occurs, with many cases, the school or childcare centre should seek advice from a PHE or other health professional.
Further reading and references
Guidance on infection control in schools and other childcare settings; Public Health England (September 2017)
Sheikh A, Hurwitz B, van Schayck CP, et al; Antibiotics versus placebo for acute bacterial conjunctivitis. Cochrane Database Syst Rev. 2012 Sep 12(9):CD001211. doi: 10.1002/14651858.CD001211.pub3.
Conjunctivitis - infective; NICE CKS, August 2015 (UK access only)
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