Most cases need no antibiotic. Knowing which red eyes are not conjunctivitis matters more.
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Conjunctivitis is inflammation of the thin membrane covering the white of the eye and the inside of the eyelids. It makes the eye look red or pink, gritty and watery. Most cases are viral, settle by themselves, and need no antibiotic.
But the more important job of this page is to help you recognise when a red eye is not conjunctivitis — because several conditions that threaten sight begin the same way.
The features that mean it is something else:
Any of those needs same-day eye assessment, not eye drops.
And one rule that matters more than any other here: if you wear contact lenses and your eye is red, take the lenses out and get seen the same day. A contact lens wearer with a red eye can have a corneal infection that damages sight within days. Being handed chloramphenicol without an examination is exactly the wrong outcome.
These matter more than anything above:
Usually adenovirus, often with a cold. Extremely contagious — it spreads through households, schools and workplaces via hands and surfaces, and remains infectious while the eye is watering.
Common in children. More likely where discharge is thick and the lids are stuck together in the morning.
Pollen, house dust mite, animals, and reactions to eye drops or cosmetics. Travels with hay fever and allergic rhinitis.
Chlorine, smoke, dust, and — commonly — preservatives in eye drops used long term, which produce a red irritable eye that people then treat with more drops.
We can take a full history and see the eye on video, which distinguishes most causes. What we cannot do is examine the eye with a slit lamp or stain the cornea — and where that is what is needed, we will say so and direct you rather than prescribing.
Two routes worth knowing, both often faster and better than a GP for eye problems:
It resolves in one to two weeks and antibiotics do nothing for it. Supportive treatment:
Most cases settle within a week without treatment. Chloramphenicol drops shorten it modestly and are reasonable where discharge is heavy, symptoms are troublesome, or someone is immunosuppressed. Not automatic, and not appropriate for every red eye.
A sticky eye in a baby with a blocked tear duct is common and usually harmless. But a red or discharging eye in a baby under one month needs same-day assessment, and we will arrange that rather than treating remotely.
Seek same-day eye assessment — optometrist, eye casualty or A&E — for:
Call 999 or go to A&E immediately for:
Book an appointment for:
Viral conjunctivitis is extremely contagious:
There is no need to keep a child off school for conjunctivitis, and national guidance does not require exclusion. Hand hygiene matters far more than exclusion. Some schools still ask — it is worth knowing the guidance says otherwise.
Use preservative-free preparations. Preservatives in regularly used drops are themselves a common cause of a chronically red, irritable eye — which then gets treated with more drops. A frequent and entirely avoidable cycle.
Chloramphenicol eye drops have been available over the counter since 2005, cost a few pounds, and a pharmacist can supply them without an appointment. Your NHS GP treats conjunctivitis free.
More usefully: most conjunctivitis needs no treatment at all. The majority is viral, most bacterial cases settle within one to two weeks by themselves, and antibiotic drops shorten that only modestly. Bathing the eye with cooled boiled water costs nothing and is the actual treatment for the viral kind.
So we would generally tell you not to pay for this.
Where a consultation is genuinely worth it is deciding whether it is conjunctivitis at all — which is exactly the question a pharmacy counter is least equipped to answer. Pain rather than grittiness, any change in vision, marked light sensitivity, or a red eye in a contact lens wearer all point somewhere else, and some of those threaten sight.
A red eye that is painful, affecting vision, or in a contact lens wearer needs assessing in person the same day, and we will direct you there rather than prescribe.
NICE Clinical Knowledge Summary, Conjunctivitis — infective, is the principal reference. It is explicit that most infective conjunctivitis is self-limiting, that antibiotics offer modest benefit, and that delayed or no prescribing is appropriate for mild cases in otherwise well adults.
NICE CKS, Conjunctivitis — allergic, covers the distinction that matters most in practice, since itch-dominant presentations need antihistamine or mast-cell-stabiliser drops rather than an antibiotic.
The Royal College of Ophthalmologists guidance on the acute red eye sets out the features requiring urgent assessment — pain, photophobia, reduced visual acuity, an irregular pupil, and contact lens wear — which underpin the safety advice on this page.
NICE CKS also addresses ophthalmia neonatorum, conjunctivitis in the first month of life, which is treated as urgent regardless of appearance.
Usually not. Most conjunctivitis is viral, and antibiotics do nothing for it — and even bacterial conjunctivitis mostly settles within a week on its own. Drops are reasonable where discharge is heavy or symptoms are troublesome, but chloramphenicol is considerably over-used, and a red eye that is not settling needs examining rather than a second bottle.
Take the lenses out now, and get the eye examined the same day. A red eye in a lens wearer can be a corneal infection, which can damage vision within days. Do not simply use drops and carry on. Discard the lenses and the case, and do not wear lenses again until 24 hours after everything has fully settled.
Four features. Pain rather than grittiness. Light hurting. Vision reduced or blurred. Redness forming a ring around the iris rather than spread across the white. Conjunctivitis is uncomfortable and gritty, not painful, and it does not affect vision. Any of those four means same-day eye assessment.
Yes. National guidance does not require exclusion for conjunctivitis, and hand hygiene matters far more than keeping a child at home. Some schools still ask, so it is worth knowing what the guidance actually says.
For a red eye, an optometrist is often the better first stop. Most high street practices run an urgent eye service, can examine the eye properly with a slit lamp, and can usually see you the same day — generally free. They can see things we simply cannot over video, and this is one of the few areas where we will routinely point you elsewhere first.
A more useful question than it sounds. Itch means allergy; grit means infection. Allergic conjunctivitis affects both eyes, itches persistently and responds to antihistamine drops rather than antibiotics — and rubbing makes it distinctly worse.
The drops may well be the problem. Preservatives in regularly used eye drops are a common cause of chronic redness and irritation — and people naturally respond by using more. Switching to preservative-free preparations breaks the cycle. Worth reviewing rather than continuing.
In a baby over a month, a sticky eye is usually a blocked tear duct — common, harmless, and it resolves by itself in most infants during the first year. But a red or discharging eye in a baby under one month needs same-day assessment, because some infections acquired at birth can damage the eye very quickly.
August 23, 2026
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It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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