Eye Infection Symptoms: Common Types and Urgent Signs

Eye infection symptoms include redness, itching, swelling, discharge, pain and problems with vision, in one eye or both. The pattern depends on which part of the eye is infected: the inside of the eyelid and the white of the eye in pink eye, an oil gland at the edge of the eyelid in a stye, or the cornea, the clear front of the eye, in keratitis. An infected cornea needs prompt care, because left untreated it can lead to vision loss. Eye pain, light sensitivity, blurred vision or intense redness are reasons to see a doctor, and at our office they mean a same-day urgent visit; when we're closed, go to an emergency room.

Key takeaways

An eye infection can bring redness, itching, swelling, discharge, pain or vision changes, and which part of the eye is infected shapes the pattern.
Watery discharge points to viral pink eye, thick pus that can stick the lids together to bacterial, and a painful lump at the lid edge to a stye.
Eye pain, light sensitivity, blurred vision or intense redness calls for a same-day visit, or an emergency room when we're closed.
Call 911 at any hour for sudden loss of vision in one or both eyes, even if your sight comes back.

Which type of eye infection do I have?

Symptoms overlap. The National Eye Institute notes that even the cause of pink eye can be hard to figure out, because the symptoms are usually the same. These are the usual patterns, and an exam confirms which one you have.

Infection	Where it is	Typical signs	When to be seen
Viral pink eye	Inside of the eyelid and white of the eye	Watery discharge, sometimes with a cold; usually starts in one eye and spreads to the other within days	Same day (an emergency room when we're closed) if you wear contacts, recently scratched the eye, or have pain, light sensitivity, blurry vision or intense redness; otherwise if not better after a few days, or getting worse
Bacterial pink eye	Inside of the eyelid and white of the eye	Thick pus that can stick the eyelids together	Same as viral pink eye
Stye	An oil gland at the edge of the eyelid	A painful, red, swollen lump like a pimple at the lid edge	Right away if redness and swelling spread to the cheek or face (an emergency room when we're closed)
Cellulitis around the eye	Deeper layers of the skin of the eyelids and face	Red, swollen, painful, warm skin, sometimes with fever and chills	Same day (an emergency room when we're closed); immediately if the redness spreads quickly, a fever starts or your vision changes
Bacterial keratitis	Cornea	Eye pain, redness, blurred vision, light sensitivity, tearing, discharge	Same day (an emergency room when we're closed)
Herpes simplex keratitis	Cornea	Eye pain, redness, blurred vision, light sensitivity, watery discharge; can come back	Same day (an emergency room when we're closed)
Shingles near the eye	Skin of the face, sometimes the eye	A painful rash on one side of the face	Same day if the rash is near the eye (your doctor or an urgent care clinic when we're closed)

Is it viral or bacterial pink eye?

Pink eye, or conjunctivitis, causes swelling and redness of the inside of the eyelid and the white of the eye. Most of the time a virus or bacteria is the cause, and viral pink eye is the most common type.

Discharge is one clue. With viral pink eye it is usually watery, and the infection can come with a cold, flu or other respiratory infection. It usually starts in one eye and spreads to the other within days. Bacterial pink eye usually makes thick pus that can stick the eyelids together, and it sometimes comes with an ear infection.

Allergies cause pink eye too. Allergic pink eye usually affects both eyes and can itch intensely, and you can't pass it to anyone else. Our eye allergies page covers that kind.

Viral and bacterial pink eye spread very easily. Wash your hands often, try not to touch or rub your eyes, and don't share pillows, towels, makeup or glasses. Antibiotics don't help viral pink eye. For bacterial pink eye they can speed up healing, though they aren't always needed. Our pink eye guide explains how each kind is treated.

Is it a stye, or is the infection spreading?

A stye, or hordeolum, is an infection of an oil gland at the edge of the eyelid, usually caused by staph bacteria. It looks like a pus-filled lump or pimple at the lid edge and causes pain, swelling and redness.

Most styes go away on their own. A warm, wet cloth held on the eyelid for 5 to 10 minutes several times a day helps, and you should never squeeze a stye. Our stye page explains why some people keep getting them.

Swelling that spreads past the lid needs attention right away. If the redness and swelling extend beyond your eyelid to your cheek or other parts of your face, contact your eye doctor immediately, or go to an emergency room when the office is closed. Redness, swelling and pain that spread through the skin can be a sign of cellulitis. It is a common bacterial infection of the deeper layers of the skin, and doctors treat it with antibiotics. The CDC advises getting medical attention immediately if a red area of skin spreads quickly or you develop a fever or chills.

What are the signs of a corneal infection?

Keratitis is inflammation of the cornea, and infections related to contact lenses are its most common cause. Bacterial keratitis causes eye pain, redness, blurred vision, light sensitivity, excessive tearing and discharge. Left untreated, it can lead to vision loss or even blindness.

If you wear contacts and these symptoms start, take your lenses out and call your eye doctor right away, or go to an emergency room when the office is closed. Our keratitis guide covers causes and recovery.

The herpes simplex virus can also infect the cornea, in people with or without contact lenses. HSV keratitis causes eye pain, redness, blurred vision, light sensitivity and watery discharge, and people who have had it are at risk of it coming back. Treatment is usually eye drops or antiviral medicine taken by mouth.

Shingles on the face can affect the eye and cause vision loss. At our office, a shingles rash on the forehead, eyelid or tip of the nose is a same-day call (when we're closed, see your doctor or an urgent care clinic that day); see our page on shingles and the eye.

Which eye infection symptoms need care today?

The CDC and the National Eye Institute list these as reasons to see a doctor, and we see them the same day:

Eye pain, light sensitivity, blurred vision or intense redness
Blurry vision or light sensitivity that doesn't improve when you wipe away discharge
Pink eye symptoms while you wear contact lenses, or after a recent scratch to the eye
Symptoms that haven't improved after a few days, or that are getting worse
Pink eye symptoms when you have a health condition that weakens your immune system, like cancer or HIV

Two more belong on the same-day list: redness and swelling that spread from the eyelid to the cheek or face, and a shingles rash on the forehead, eyelid or tip of the nose.

A newborn with discharge from the eye or puffy red eyelids needs a doctor now, or an emergency room if the office is closed, because pink eye can cause serious health problems for newborn babies.

During office hours (Monday 10am to 5pm, Tuesday to Friday 8am to 5pm), call 310-828-2010 for a same-day urgent eye care visit. Outside office hours, go to an emergency room for intense eye pain or a change in vision, for a painful, red, light-sensitive eye if you wear contacts, or for red, swollen skin around the eye that spreads quickly or comes with a fever or chills.

For a shingles rash near the eye when we're closed, see your doctor or an urgent care clinic the same day: antiviral medicines help most when you start them as soon as the rash appears. For sudden loss of vision in one or both eyes, call 911 at any hour, even if your sight comes back: sudden trouble seeing can be a sign of stroke.

How we check eye infections at Cohenmehr Optometry

Eye infections can worsen quickly and may threaten vision, so they are on our list of problems seen the same day at urgent eye care. Our Los Angeles eye doctors evaluate and manage bacterial and viral conjunctivitis, corneal infections and contact lens-related infections, starting with a slit lamp exam of the eye.

Treatment follows the type and severity of the infection. For pink eye, that means antibiotic drops when the exam supports a bacterial cause, comfort care while a virus runs its course, and contact lenses out until the eye is clear.

Painful lid bumps, such as styes, are seen the same day. For shingles near the eye, we examine you the same day and coordinate antiviral care with your physician. When a specialist is needed, we coordinate the referral and send your records the same day.

Questions patients ask

What is keratitis?

Keratitis is inflammation and swelling of the cornea, the clear front cover of the eye. Infectious keratitis can be caused by bacteria, viruses, fungi or parasites. Keratitis can also happen without infection, after an eye injury, from wearing contact lenses too long, or from a foreign body in the eye. Left untreated, it can lead to serious complications that may permanently damage your vision. Our keratitis page covers treatment and recovery.

Is pink eye itchy?

It often is. Itchy or burning eyes are among the most common symptoms of pink eye, along with pink or red eyes, watery eyes, and white, yellow or green discharge. When we examine a red eye, intense itching with both eyes involved points us toward allergy, and our eye allergies page covers that kind of pink eye.

What is herpes zoster ophthalmicus?

Herpes zoster ophthalmicus is shingles that affects the ophthalmic division of the trigeminal nerve, one of the nerves of the face. It can cause eye problems, some sudden and some long-lasting, including vision loss. At our office, a shingles rash on the forehead, eyelid or tip of the nose is a same-day call (when we're closed, see your doctor or an urgent care clinic that day), and our shingles and the eye page covers treatment and follow-up.

What causes an eye infection?

Bacteria, fungi and viruses cause eye infections, which can affect one eye or both. Pink eye, one of the common ones, is often due to an infection and is very contagious, and children get it frequently. Treatment depends on the cause and can include compresses, eye drops, creams or antibiotics, which is why an exam comes first.

Sources

Written by

Dr. Kevin Cohenmehr, OD

Medical eye care: glaucoma, diabetic eye exams, macular degeneration and eye infections, plus vision therapy for children. A graduate of UCLA and SUNY College of Optometry.

About Dr. Kevin →

Eye Infection Symptoms: How to Tell the Common Types Apart