Pink Eye vs. Red Eye: Which one is worse?

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Difference between Pink Eye and Red Eye

The conjunctiva is the mucous membrane covering the sclera – the white of the eye – composed of a rare stratified columnar epithelium. Its function is to produce mucus and tears which lubricate the eye.

The conjunctiva is divided into three parts: palpebral or tarsal conjunctiva which lines the eyelids, bulbar or ocular conjunctiva covering the sclera and Fornix conjunctiva which connects the former two.

Disorders of the conjunctiva are common eye diseases. They include conjunctivitis – an inflammation of the conjunctiva, pterygium – benign growth of the conjunctiva, subconjuctival hemorrhage and conjunctivitis due to parasites as the acanthamoeba, herpes simplex, zoster, chlamydia and gonococcus among others.

Let’s take a closer look at pink eye and red eye.

Pink Eye
Red Eye


Pink eye is the common name given to viral conjunctivitis due to the fine diffuse pinkness visible on the conjunctiva.

Red eye may refer to conjunctivitis or to bloodshot eyes. It is caused by the increase of blood flow in the superficial layer of the conjunctiva, sclera – the white of the eye and episclera – the outermost layer of the sclera.


Pink eye is caused by adenoviruses and is associated with viral upper respiratory infections such as sinus congestion. Common symptoms include bilateral watery discharge, epiphora, follicular conjunctival reaction and erythema – redness of the skin caused by increased blood flow in the capillaries irrigating the skin. Eyelids may swell and it may be painful for a patient to look at bright lights when dealing with this type of infection.

The signs which help to identify red eye are the redness of the sclera, sensations of itching, burning or scratching. Symptoms which indicate a serious infection associated with red eye are: blurry vision, mild irritation, local scratchiness and photophobia – excessive sensitivity to light.


There is no evidence supporting the use of antiviral agents to cure pink eye. Instead, it is recommended that patients use cold compresses and lubricants for 4 to 8 times during the day. In cases of severe itching, topical vasoconstrictors and antihistamines can be used 4 times a day. To prevent bacterial infection while the eye is weakened, a topical astringent or antibiotic should be prescribed.

Artificial tears can be used for the treatment of red eye as they have a lubricating effect on the eye. Cold compresses constrict the blood vessels if used a few times a day. Itching can be prevented with vasoconstrictors and antihistamines. Vasoconstrictors reduce the redness of the eye, but they should be used with caution to avoid rebound redness.

Similarities and Differences

  • Pink eye is the common name for viral conjunctivitis. The red eye condition is caused by the increase of blood flow in the superficial area on the conjunctiva, sclera and episclera.
  • Symptoms of pink eye are viral upper respiratory infections, bilateral watery discharge. Symptoms of red eye are: redness of the sclera and sensations of itching. Blurry vision, mild irritations appear in more severe cases.
  • Treatment for pink eye and red eye include: artificial tears, vasoconstrictors and antihistamines and cold compresses.

Which one is worse?
  • Pink Eye
  • Red Eye

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