You are probably very familiar with pink eye, or conjunctivitis. Forms of pink eye that spread easily to others—bacterial and viral—often make the rounds among children in schools and daycares, and among adults in the workplace. When someone has pink eye, it’s hard to hide the telltale symptoms: red, swollen and watery eyes, maybe with crusty eyelashes and eye discharge or pus. However, there are other eye conditions—some harmless and some more serious—that can make your eyes equally red, itchy, watery or painful. Your ophthalmologist can determine what is causing these annoying and potentially vision-threatening symptoms.
Common Eye Conditions Resembling Pink Eye
There are many conditions other than pink eye that cause red, swollen and watery eyes. Here are some of the most common, and generally less serious, culprits of these symptoms.
Dry eye
One of the most common eye problems, dry eye can make your eyes red, itchy and watery. This annoying condition develops when your eyes aren’t making enough tears or the right quality of tears. Tears keep your eyes healthy and comfortable. Anyone can get dry eye, though it is more common among women, particularly after menopause.
Allergies
Another very common cause of red, itchy eyes is allergies. Your eyes may be affected by something in the air (environmental allergies), or by a reaction to a medication. The result: bloodshot, scratchy and watering eyes.
Blepharitis
Blepharitis affects the skin around the eyelashes, leading to red, swollen and sore eyes. Tiny particles that look like dandruff may also stick to the base of the eyelashes. Bacteria, eyelid oil gland problems or even tiny mites can cause this uncomfortable condition.
Contact lens wear
If you wear contact lenses, you may find your eyes become red, scratchy and watery. This can happen if you wear contacts for too long, irritating your eyes.
In some cases, an infection may have developed from wearing contacts, leading to red, painful eyes that don’t feel better after removing your contact lenses. See your eye doctor right away if this happens.
Subconjunctival hemorrhage
Have you ever looked in the mirror and discovered a spot of blood on the white of your eye? That bright red eye may shock you, but usually it is a harmless subconjunctival hemorrhage. This happens when tiny blood vessels in the white of your eye—the conjunctiva—break open and bleed. This is usually painless and goes away within a few days.
Stye
When a small, painful bump develops at the base of your eyelid or inside your eyelid, usually it is a stye (sometimes called a hordeolum). A very common condition, styes make your eyelid red and painful, and your eyes feel scratchy and irritated. Most styes are caused by a bacterial infection.
Pinguecula and pterygium
Pinguecula and pterygium can grow on the clear covering of the white part of your eye. Pinguecula, a yellowish tissue, usually grows on the side of the eye near your nose, but can develop on the other side too.
The fleshy tissue of a pterygium (with tiny blood vessels) may start as a pinguecula and can start small or grow large enough to cover part of the cornea. Like with pink eye, your eyes may be red, and feel itchy and gritty.
When Red Eyes Signal Serious Eye Problems
Many conditions that look like pink eye are harmless, however, there are other more serious eye problems that mimic pink eye too. If you have symptoms of these conditions, it is important to call your ophthalmologist. Here are some of those eye problems:
Uveitis (iritis)
Uveitis happens when the middle layer of the eyeball—called the uvea—gets inflamed (red and swollen). The most common type of uveitis, called iritis, happens when the iris (the colored part of your eye) becomes inflamed. Uveitis can affect the front, middle or back of the eye. Symptoms include having red eyes (with or without pain), being sensitive to light, having blurry vision and seeing dark floaters in your field of vision. The symptoms may come and go, or they may remain and gradually become worse. If left untreated, uveitis can damage eye tissue and lead to permanent vision loss.
Keratitis
If you develop an open sore on your cornea, it is called keratitis (also known as a corneal ulcer). This painful condition makes your eye red, sore and watery. Your eye may also have pus or other discharge similar to conjunctivitis, and you may feel like something is in your eye. An infection often causes keratitis, but other eye problems such as dry eye can lead to this condition too. It is very important to treat this eye infection as soon as possible, or it can lead to serious vision problems or blindness. This is even more urgent if you are a contact lens wearer.
Angle closure glaucoma
Glaucoma, an eye disease that damages your optic nerve, is often called the “silent thief of vision.” This is because people usually don’t notice any symptoms in glaucoma’s early stages. However, a type of glaucoma called angle closure glaucoma can lead to symptoms that warn of serious eye problems, including possible blindness.
Angle closure glaucoma happens when someone’s iris is very close to the part of the eye that drains fluid. The iris can end up blocking this tiny drain. Many people develop angle-closure glaucoma slowly with no symptoms at first. They will only notice a problem when they notice they are losing vision, or they have what is called an acute attack. This attack happens when the iris completely blocks the “drain,” and eye pressure rises very quickly.
Red eye, severe pain in the eye and blurry vision are hallmarks of an angle closure glaucoma attack, but could be mistaken for pink eye in the earliest stages. People who suffer an angle closure attack usually also feel sick to their stomach, see rainbows or halos in their vision, and have a very bad headache. This attack is a serious emergency. You should call your ophthalmologist right away or you might go blind.
Dacryocystitis
Our eyes produce tears in a gland called the lacrimal gland. From this gland, tears drain through a duct into the nasal cavity. In some cases, this duct becomes blocked. When that happens, tears begin to back up, leading to swelling of the tear duct. You may notice this painful swelling near the inside corner of the eye. Eventually an infection can develop. This is called dacryocystitis.
Similar to pink eye, dacryocystitis can affect babies, children and adults. Like pink eye, symptoms include swollen, red eyes, tearing and discharge from the eye, and even pain in and around the eye. A fever may also develop. It is important to call your ophthalmologist if you have these symptoms. The infection must be treated right away to prevent vision loss.