What Is Commonly Misdiagnosed as Pink Eye?

What Is Commonly Misdiagnosed as Pink Eye

Pink eye, or conjunctivitis, is a common eye condition that causes redness, itchiness, and discharge in the eyes. While it’s often straightforward to identify, there are several other eye conditions that can mimic the symptoms of pink eye, leading to misdiagnosis. In this article, we’ll explore some of the conditions commonly misdiagnosed as pink eye, their symptoms, and how they differ from conjunctivitis.

What is Pink Eye?

Before delving into conditions commonly mistaken for pink eye, let’s briefly understand what pink eye is. Pink eye, or conjunctivitis, is an inflammation of the conjunctiva, the thin, transparent layer of tissue that lines the inner surface of the eyelid and covers the white part of the eye. It can be caused by viruses, bacteria, allergens, or irritants. The hallmark symptoms of pink eye include:

  • Redness in the white of the eye and inner eyelids.
  • Itchiness or irritation in one or both eyes.
  • Excessive tearing.
  • Discharge from the eyes, which may be watery or contain pus.
  • Crusting of the eyelids or lashes, especially after sleep.

While pink eye is often mild and resolves on its own within a week or two, it can be highly contagious, especially if caused by a virus or bacteria. Prompt diagnosis and appropriate treatment can help alleviate symptoms and prevent spreading the infection.

What Is Commonly Misdiagnosed as Pink Eye?

  • Allergic Conjunctivitis:

Allergic conjunctivitis shares many symptoms with infectious pink eye, such as redness, itching, tearing, and a gritty sensation in the eyes. It occurs when the conjunctiva becomes inflamed due to exposure to allergens like pollen, pet dander, dust mites, or certain foods. Unlike infectious pink eye, allergic conjunctivitis is not contagious and is often accompanied by other allergic symptoms like sneezing, nasal congestion, and a runny or itchy nose.

Treatment for allergic conjunctivitis typically involves avoiding allergens when possible and using antihistamine eye drops or oral medications to relieve symptoms. Cold compresses can also provide temporary relief from itching and inflammation.

  • Dry Eye Syndrome:

Dry eye syndrome occurs when the eyes do not produce enough tears or when tears evaporate too quickly. It can cause symptoms similar to pink eye, including redness, irritation, and a gritty or burning sensation in the eyes. Other symptoms may include blurred vision, sensitivity to light, and excessive tearing (a reflex response to dryness).

Unlike pink eye, which often presents with discharge, dry eye syndrome usually does not cause significant discharge unless there is a secondary infection. Factors such as aging, hormonal changes, environmental conditions, certain medications, and underlying health conditions can contribute to dry eye syndrome.

Treatment for dry eye syndrome aims to lubricate the eyes and improve tear production. This may involve using artificial tears, prescription eye drops, or ointments. In severe cases, procedures such as punctal plugs or intense pulsed light therapy may be recommended.

  • Blepharitis:

Blepharitis is a chronic condition characterized by inflammation of the eyelids, particularly at the base of the eyelashes. It can cause symptoms similar to pink eye, including redness, itching, irritation, and crusting of the eyelids. In some cases, blepharitis can lead to recurrent styes (localized infections of the eyelid glands) or meibomian gland dysfunction (a common cause of evaporative dry eye).

Unlike pink eye, which primarily affects the conjunctiva, blepharitis primarily affects the eyelids and eyelash follicles. It can be caused by bacterial overgrowth, skin conditions such as rosacea or seborrheic dermatitis, or eyelash mites (Demodex).

Treatment for blepharitis typically involves gentle eyelid hygiene, including warm compresses, eyelid scrubs, and lid massages to clean the eyelids and remove debris and bacteria. In some cases, antibiotic or steroid medications may be prescribed to reduce inflammation and manage bacterial overgrowth.

  • Corneal Abrasion:

A corneal abrasion is a scratch or injury to the cornea, the clear, dome-shaped surface that covers the front of the eye. It can cause symptoms similar to pink eye, including eye redness, pain, tearing, light sensitivity, and a feeling of something in the eye (foreign body sensation). Corneal abrasions can occur due to trauma, such as rubbing the eye excessively, getting foreign objects in the eye, or wearing contact lenses improperly.

Unlike pink eye, which primarily affects the conjunctiva and typically presents with discharge, corneal abrasions primarily affect the cornea and may not involve significant discharge unless there is a secondary infection.

Treatment for corneal abrasions aims to promote healing and prevent infection. This may involve using lubricating eye drops or ointments to keep the eye moist, wearing a protective eye patch, and avoiding activities that could further irritate the cornea. In some cases, antibiotic eye drops may be prescribed to prevent or treat infection.


While pink eye is a common and usually benign condition, it’s essential to consider other potential causes when evaluating patients with similar symptoms. Conditions like allergic conjunctivitis, dry eye syndrome, blepharitis, and corneal abrasions can mimic the symptoms of pink eye but require different approaches to diagnosis and treatment.

If you or someone you know experiences persistent eye redness, irritation, or other concerning symptoms, it’s essential to seek evaluation by a healthcare professional, preferably an eye specialist. Proper diagnosis and management can help alleviate symptoms, prevent complications, and ensure optimal eye health and vision. Remember, early intervention is key to maintaining healthy eyes and enjoying clear vision for years to come.

Written by Amy Fischer

Amy, a registered dietitian at the Good Housekeeping Institute's Nutrition Lab, brings a wealth of expertise to nutrition, health content, and product testing. With a journalism degree from Miami University of Ohio and a master's in clinical nutrition from NYU, she's a versatile expert. Prior to joining Good Housekeeping, Amy worked as a cardiac transplant dietitian at a prominent NYC hospital and contributed to clinical nutrition textbooks. Her background also includes PR and marketing work with food startups.

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