What is Commonly Misdiagnosed as Pink Eye?

The most common misdiagnoses of pink eye is conjunctivitis.

Pink eye is a condition where the eye is experiencing pain, redness, and in most cases serious itchiness. If you are wondering if you or one of your children has pink eye, it is a good idea to also look into other similar conditions. When you are wondering what is commonly misdiagnosed as pink eye, consider all of the variables related to eye infections, infectious pink eye, and overall eye health.

Understanding the Difference in Common Symptoms

An allergic response, sinus problems, the common cold, and other illnesses could all look like pink eye, but not be pink eye. It is important to understand what is causing the redness of the eyes in order to understand what is commonly misdiagnosed as pink eye.

What is Pink Eye?

The condition of pink eye or conjunctivitis occurs when the whites of the eye are a pink or red color, which may be accompanied by swelling and additional redness around the eye area. Sometimes a slight blurry vision may occur but a conjunctivitis misdiagnosis is very common.

The Most Common Diagnoses For Pink Eye

A conjunctivitis misdiagnosis is common, and if you suspect pink eye, you will want a good eye doctor to go through a thorough examination, ruling out any inflammatory condition, optic nerve damage, anterior uveitis, or other possible issues that could explain what is commonly misdiagnosed as pink eye.


Conjunctivitis is known as redness of the eye and is among the most common complaints in urgent care and primary care offices see as many as 80 percent of all cases. It is a very common diagnosis that costs the United States as much as $857 million annually.

Allergic Reactions for Pink Eye

Allergic reactions that people think are pink eye happen often. Many other conditions look like pink eye too. Sometimes, pink eye can be the sign of something much worse.

COVID Pink Eye

The condition known as COVID pink eye has become very common in recent years. In cases such, COVID comes before pink eye and contributes to conjunctivitis. It is estimated that approximately one to three percent of people that have COVID-19 will also get conjunctivitis or COVID pink eye.

How is COVID Pink Eye transmitted?

The reason for this is that COVID-19 is transmitted through bodily fluids, and when sinuses are affected by the COVID-19 virus, the eyes may become infected. Someone that has COVID can rub their eyes and pink eye will be the result. In some cases, pink eye may be the first symptom that sends a patient for COVID testing if the symptoms of a runny nose are not tended to quickly.

Allergic Conjunctivitis

Allergies are another leading diagnosis that gets missed when someone thinks they may have pink eye. When someone is allergic to pollen or dust, it is common for the eyes to experience itchiness, burning, and red coloration. Conjunctivitis is known as an inflammation of the eye tissue known as conjunctiva.

For people who have allergic pink eye, they may wake up with an eye discharge around the eye area. If you have allergic triggers in your home or sleeping area, you may not have a form of pink eye that needs a diagnosis with antibacterial or antiviral treatment.


If you have a white bump or spot on your eye that is filled with pus, accompanied by some droopiness of the eyelid, it could be a stye instead of pink eye. Styes are similar to acne in the eyes and can easily be treated with warm compresses. Such cases must not necessarily result from conjunctivitis; however, if symptoms persist for longer than expected, consulting an ophthalmologist would be advised.

Inflammation of the Iris

Inflammation of the iris is also commonly misdiagnosed as pink eye. In this condition, known as iritis, the middle layer of tissue in the eye between the white of the eye and the retina is infected. In this condition, you will also see redness but may also experience pain.

Vision issues

It is unlikely that the common condition of conjunctivitis is going to cause eye pain, but iritis will. You will also experience vision issues and light sensitivity issues with iritis. It is easy to distinguish iritis from conjunctivitis because it is the eye tissue that notes the difference. In iritis, it is a different layer of the eye that is infected then it is with conjunctivitis.

Infected Cornea

When the cornea is infected, it is called keratitis. Keratitis is another condition that falls in the category of what is commonly misdiagnosed as pink eye. This is much less common than conjunctivitis, however, but poses a bigger threat to the eye than pink eye does. Like iritis, increased pain and decreased vision are common markers of keratitis.

The most common cause of this condition is contacts that have not been worn properly. For many people, that occurs when contacts have been worn while sleeping. This issue will lead to a red eye misdiagnosis or pink eye misdiagnosis a lot. This is why it is important to be mindful of your hand to eye contact and to wash your hands properly. If you have itchy eyes, do not scratch the affected area because it could become highly contagious.

How to Tell if You May Have Pink Eye

There are a few different ways to know if you have pink eye. Seeing a doctor or an ophthalmologist is the best way to learn if you have pink eye, but there are symptoms you can look for that will give you an idea. Pink eye will occur in different stages, and the symptoms of pink eye often occur in a specific order.

Viral infection symptoms of Viral Conjunctivitis

With COVID-19 and bacterial conjunctivitis, symptoms of viral conjunctivitis can be found in both yet have different stages of progression.

In the early stages of viral pink eye, you are going to be experiencing other viral symptoms like you would with the cold or the flu. You may experience congestion and coughing and have a runny nose.

Watery discharge from eyes

For pink eye to also be present, you will also notice that one eye is more watery than the other. It may even feel like that eye is itchier or feels like it is scratchy. You will begin to notice that the white part of the watery eyes are going to look red or pink. Because this is a very contagious problem, you want to watch both eye conditions and other symptoms. You won’t see drainage or discharge with viral pink eye.

Crustiness around eyelids in bacterial conjunctivitis

The pus associated with bacterial conjunctivitis is going to start as white, and within a few days will look yellow or green. In this kind of pink eye you are also going to experience crustiness around the eyelids by the middle stages of the problem.

Medical Treatments for Pink Eye

If you think you have pink eye, the most common treatment for it to start is washing your eye or rinsing it with a saline solution. In the case of bacterial pink eye, antibiotics, and antibacterial eye drops are the ideal solution.

It is important that bacterial conjunctivitis is determined first, and that other treatment options be considered.

Viral conjunctivitis is much more difficult to treat than bacterial conjunctivitis. If there are more serious symptoms, such as those found in COVID pink eye, those symptoms must be treated as well. In many cases, antihistamines can help with both viral and allergic pink eye.

Don’t Take It Lightly

Eye redness, irritated eyes, blurred vision, possible vision loss, a severe form of red eyes, inner eyelid irritation, swollen lymph nodes, outer layer crustiness, a thin layer of mucus and many other similar symptoms need to be closely monitored by a healthcare provider, an eye doctor or yourself.

Pink eye can be commonly caused by numerous things but the result of it can be quite severe. Vision problems with an infected eye may require different treatments, which is why getting a doctor’s approval for the proper diagnosis is important

Sean Byers, MD

Sean Byers, MD

Sean Byers is currently a Resident in the Internal Medicine program at UTMB. He studied at the University of Queensland School of Medicine as well as received his Master’s in Public Health with a focus in epidemiology and biostatistics at the University of Southern California. His background is in biology, computer science, public health, and internal medicine.

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  1. https://www.cdc.gov/conjunctivitis/index.html
  2. https://www.ncbi.nlm.nih.gov/books/NBK541034/
  3. https://www.webmd.com/eye-health/covid-19-and-your-eyes
  4. https://www.sciencedirect.com/science/article/abs/pii/S0161642017304153