Pink Eye in Children and Adults

Key Differences, Risks & Management

Why Understanding Age Difference Matters?

While pink eye (conjunctivitis) can affect anyone, the causes, risks and management may vary between children and adults. Recognising these differences helps optimise care and minimise complications.

Conjunctivitis in Children

  • Infectious conjunctivitis is very common in children, especially preschool age.

  • Bacterial forms are more frequent in children than in adults, often presenting with sticky yellow/green discharge and eyelids stuck together on waking.

  • Viral conjunctivitis may accompany colds or upper respiratory infections.

  • Schools and daycare settings facilitate spread — hygiene, hand-washing and exclusion policies are important.

What About Adults?

  • In adults, viral conjunctivitis tends to dominate (~80% of acute cases) and may be associated with conjunctival follicles, discomfort, and watery discharge.

  • Allergic and irritant conjunctivitis may also be more prominent in adults with exposure to cosmetics, contacts or chemical irritants.

  • Contact lens wearers face higher risk of complications (e.g., keratitis) if conjunctivitis is mis-managed.

    Key Differences in Presentation & Risk

      Discharge Type

      Childeren

      Often thicker, green/yellow (Bacterial)

      Adults

      Often watery/clear (Viral/Allergic)

      Contagion risk

      Childeren

      High — schools/daycare spread

      Adults

      High if viral/bacterial, but often adults recognise the onset sooner

      Need for antibiotic

      Childeren

      Higher consideration in children due to bacterial likelihood

      Adults

      Generally more conservative: viral is more common

      Complication Risk

      Childeren

      Less frequent contact-lens use

      Adults

      Higher risk if using contacts

      Management Strategies by Age Group

      • Children:

        • Encourage thorough hand-washing, avoid eye-rubbing, separate towels.

        • Bacterial forms may warrant antibiotic drops per clinician assessment.

        • Viral forms: symptomatic relief (cold compresses, artificial tears).

        • Monitor for complications — corneal involvement, vision change.

      • Adults:

        • For viral/irritant conjunctivitis: conservative care (cold compress, artificial tears, avoid contacts until resolved).

        • For allergic: antihistamine drops or removal of trigger.

        • Contact lens wearers should remove lenses until eye is clear; if symptoms worsen, see eye care professional to exclude keratitis.

        Special Considerations & Warnings

        • Children under 2 years with conjunctivitis require special caution and medical review.

        • Contact lens wearers: red eye + discharge = urgent review — risk of sight-threatening complications.

        • If worsening pain or vision loss, or if systemic illness present (fever, swollen lymph nodes), urgent ophthalmology referral is needed.

        Take-away for Parents & Adults

        Understanding that the cause of pink eye differs by age helps tailor management and minimise unnecessary treatments (e.g., antibiotics when viral cause likely). With prompt hygiene and appropriate care, most cases resolve without lasting issues.

        • References

                • Pediatric Conjunctivitis: A Review. MDPI.

                • The Conjunctivitis Conundrum – Review of Optometry.

                • Pink Eye – Mayo Clinic.

                • Healthdirect – Conjunctivitis (Australia).

                • Effect of Topical Antibiotics on Acute Infective Conjunctivitis. JAMA Network.

                • Conjunctivitis: A Review. RACGP.

                • Conjunctivitis (Bacterial and Viral). ESHT NHS PDF.

                Your Health, Your Way — With DocTel

                Discover a new era of healthcare with DocTel. Our platform is designed to provide you with personalized, convenient, and compassionate care. Take the first step towards a healthier you by booking a consultation today.

                Book a Consultation