What are the signs and symptoms of bacterial conjunctivitis (pink eye)?

Updated: Jan 03, 2019
  • Author: Karen K Yeung, OD, FAAO; Chief Editor: Andrew A Dahl, MD, FACS  more...
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Signs and symptoms of bacterial conjunctivitis, beyond injected and edematous (inflamed) conjunctiva, include the following:

  • Follicles are more often a sign of ocular viral infections; may also occur with chronic allergic or hypersensitivity conjunctivitis
  • Papillae on the injected tarsal conjunctiva, also seen in viral conjunctivitis and ocular allergy (see below)
  • Discharge: More purulent than in viral conjunctivitis, with more mattering (generally white, green, or yellow mucous discharge) of the eyelid margins and greater associated difficulty prying the eyelids open following sleep; patients may report waking up with their eyes “glued” shut
  • Enlarged preauricular lymph node: Common in viral conjunctivitis and unusual in bacterial conjunctivitis, although found in severe bacterial conjunctivitis caused by N gonorrhoeae
  • Eyelid edema: Often present in bacterial conjunctivitis, but mild in most cases; severe eyelid edema in the presence of copious purulent discharge raises the suspicion of N gonorrhoeae infection

See Clinical Presentation for more detail.

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