Pink Eye: What a Video Visit Can and Cannot Do

Waking up to a red, watery eye can quickly turn into a scramble. You may need to know whether your child can go to school, whether you need antibiotic drops, or whether you should stop wearing your contact lenses.

Pink eye, or conjunctivitis, is one of the most common eye problems in both children and adults. It happens when the thin membrane covering the white of the eye and inside of the eyelid becomes inflamed. Depending on the cause, it can look and feel similar to several other eye conditions.

Some cases of pink eye can be evaluated through a telehealth visit. Others can't. Understanding the difference can help you decide whether pink eye treatment online is a reasonable option or whether you need an in-person exam.

TL;DR: Key Takeaways

• Pink eye, or conjunctivitis, has several possible causes, including viruses, bacteria, allergies, and irritants.
• Most cases of viral pink eye improve without antibiotics because antibiotics do not treat viral infections.
• Bacterial pink eye may respond to antibiotic eye drops when a clinician considers them appropriate.
• Symptoms alone can't always confirm the exact cause. Telehealth can help assess common cases, but some situations need an in-person examination.
• Contact lens wearers, people with vision changes, severe pain, light sensitivity, eye injuries, or symptoms that do not improve may need in-person evaluation.
• For back to school illness, school and daycare policies vary. They generally consider whether a child is well enough to participate and whether they can limit the spread of infection.

Have red-eye symptoms and want a clinician to help you decide next steps? Book a $39 online urgent care visit with August AI. A US-licensed clinician can review your symptoms and photos and determine whether treatment is appropriate or whether an in-person exam is needed, with same-day pharmacy pickup available across all 50 states.

The visit does not guarantee a prescription, and medication costs are separate. For vision changes, severe eye pain, light sensitivity, eye injury, symptoms in a very young infant, or other concerning eye symptoms, seek in-person care rather than a telehealth visit.

What is pink eye and what causes it?

Pink eye happens when the conjunctiva, the thin, clear layer over the white of the eye and inside of the eyelid, becomes inflamed. It's usually called conjunctivitis in medical settings.

There are several common causes:

Viral conjunctivitis: The most common cause of infectious pink eye, often occurring with a cold or upper respiratory infection.

Bacterial conjunctivitis: Less common than viral, but a possible cause, particularly in young children.

Allergic conjunctivitis: Caused by allergens like pollen or pet dander, and typically affects both eyes.

Irritant conjunctivitis: Caused by smoke, chemicals, or contact lens problems.

Symptoms may include redness, watering, itching or burning, mucus or crusting on the lashes, mild swelling, and occasionally light sensitivity.

Because these symptoms can overlap between causes, it isn't always possible to tell exactly what's causing pink eye from a photo or description alone.

What can a video visit for pink eye actually do?

A telehealth visit can be useful when pink eye is likely a routine, uncomplicated case.

During a video visit, a clinician may:

• Ask about your symptoms and how long you've had them.
• Look at your eye through the camera or ask you to send clear photos.
• Ask about contact lens use, allergies, recent illness, and injury.
• Ask about vision changes, pain, or light sensitivity.
• Determine whether your symptoms fit a common cause of pink eye.
• Recommend home care or symptom relief.
• Prescribe antibiotic eye drops when they consider them appropriate for suspected bacterial pink eye.
• Advise you when an in-person exam or urgent care is needed instead.

Many cases of viral conjunctivitis improve on their own within one to two weeks. The CDC notes that most cases of conjunctivitis get better on their own without treatment, particularly viral cases.

For allergic conjunctivitis, treatment may focus on avoiding triggers, antihistamines, or other allergy medications rather than antibiotics.

What a video visit cannot do

Telehealth also has real limits when it comes to eye problems.

A clinician can't:

• Perform a slit-lamp examination.
• Test vision with clinical equipment.
• Check eye pressure.
• Assess the back of the eye.
• Physically examine the eye and eyelid up close.
• Reliably rule out injuries, foreign bodies, or corneal problems remotely.

For some eye conditions, an in-person examination is important to make the correct diagnosis or rule out a more serious problem.

The American Academy of Ophthalmology notes that certain symptoms warrant evaluation by an eye-care professional rather than trying to manage the problem at home or through telehealth.

When you should not rely on a video visit for pink eye

Some symptoms need in-person evaluation, either urgently or as soon as possible. See a clinician in person, or seek urgent care, for:

• Significant eye pain.
• Changes in vision.
• Increased sensitivity to light.
• Redness that is severe or worsening.
• Symptoms that are getting worse rather than improving.
• Symptoms that do not improve after several days.
• Any eye injury.
• A foreign object in the eye.
• Redness in a very young infant.
• A weakened immune system with eye symptoms.
• Contact lens use with red, painful eye symptoms.

Contact lens wearers should stop wearing lenses if they develop pink eye symptoms and be evaluated in person, because contact lens use can raise the risk of corneal complications.

If you're not sure whether you need urgent care or emergency care, see our guide on urgent care vs ER: how to decide in 60 seconds.

Pink eye in kids and back to school illness

Pink eye is common in children, particularly in daycare and school settings.

Parents often want to know two things: whether pink eye means the child needs an antibiotic, and when the child can safely go back to school. Neither answer is one-size-fits-all.

Not every case of pink eye in children is bacterial. Many are viral, and viral cases typically don't need antibiotics. A clinician can help determine whether antibiotic drops are appropriate.

School and daycare policies also vary. Some may have specific rules about when a child can return after developing conjunctivitis, while others focus more on symptoms and whether the child is well enough to participate.

A school or daycare policy does not determine whether antibiotics are medically necessary. Antibiotics should be used when a clinician determines that they are appropriate for the suspected cause.

Check your school or daycare's policy so you know what documentation, if any, may be needed before your child returns.

Basic hygiene can help reduce the spread of infectious pink eye. Wash hands often, avoid touching or rubbing the eyes, clean frequently touched surfaces, and don't share towels, pillowcases, eye makeup, or eye drop bottles.

For very young children, the decision between telehealth and in-person care should take the child's age, symptoms, and overall condition into account. Infants with eye redness or discharge should be evaluated by a clinician, with the urgency depending on their age and symptoms.

For more on when telehealth works well for children and when it doesn't, see our guide on telehealth for kids: when a video visit is enough.

When telehealth is appropriate for adults with pink eye

For otherwise healthy adults, telehealth can be a reasonable first step when symptoms suggest a routine case of pink eye.

For example, telehealth may be a reasonable starting point when:

• Symptoms are mild.
• There's no significant pain or vision change.
• There's no eye injury.
• You're not wearing contact lenses.
• The symptoms fit a common pattern of viral, bacterial, or allergic pink eye.

Telehealth is less appropriate when your symptoms suggest something more serious, when you have a chronic eye condition, when you're a contact lens wearer with an acute red eye, or when you've had symptoms for more than a week without improvement.

Your clinician may also recommend an in-person visit if the symptoms don't fit a clear pattern.

What treatment options might a clinician recommend?

Treatment depends on the likely cause of pink eye.

Viral pink eye: Usually improves on its own. Care may focus on symptom relief, such as cool compresses, artificial tears, and hygiene to prevent spread.

Bacterial pink eye: Antibiotic eye drops or ointments may be prescribed when a clinician considers them appropriate. Antibiotics do not treat viral conjunctivitis.

Allergic pink eye: Treatment may focus on avoiding triggers, using cool compresses, and taking antihistamines or other allergy medications when appropriate.

Irritant pink eye: Care usually involves removing the irritant and rinsing the eye when appropriate. Chemical exposures can require prompt medical attention, particularly if symptoms continue after rinsing.

Not all pink eye cases need medication. Some can be managed with home care while the eye recovers.

Conclusion

Pink eye treatment online can be a reasonable option for common, straightforward cases. A US-licensed clinician can review your symptoms and photos, help identify the likely cause, and recommend treatment or home care when appropriate.

Telehealth isn't the right choice for every eye problem. Serious symptoms, contact lens use with a red painful eye, vision changes, significant pain, injury, or persistent symptoms need in-person evaluation.

For children, especially infants and very young children, in-person care can be more appropriate than a video visit. Older kids and adults with typical, mild pink eye symptoms may be well-suited to telehealth, but the clinician should still be able to identify when a case needs a hands-on exam.