If you’re experiencing symptoms of both an eye and ear infection, a doctor may evaluate you for conjunctivitis-otitis syndrome. This involves co-occurring conjunctivitis (“pink eye”) and otitis media (middle ear infection).

This syndrome was first coined more than 40 years ago. It’s not known exactly how common conjunctivitis-otitis syndrome is. Considered separately, both bacterial acute conjunctivitis and otitis media are extremely common in young children.

Learn more about this infection, including the common symptoms and causes, as well as the possible treatment options a doctor may consider.

Conjunctivitis-otitis syndrome may cause a combination of eye- and ear-related symptoms.

Symptoms of bacterial pink eye may include:

  • redness of the white parts of your eyes
  • swelling in your eyes and eyelids
  • large amounts of thick eye drainage
  • eyes that may glue shut from thick pus
  • crusty eyes
  • sensitivity to light
  • blurry vision

Additionally, you may experience symptoms of a middle ear infection like:

  • ear pain
  • ear drainage
  • hearing problems due to fluid buildup in the ears
  • tugging at ears (in babies and young children)

It’s also possible to experience non-ear or eye symptoms. These include:

  • fever
  • nasal drainage
  • cough
  • fatigue

Conjunctivitis-otitis syndrome is caused by a bacterial infection. While most cases are attributed to Haemophilus influenzae, other possible bacterial strains that can cause this condition include Moraxella catarrhalis and Streptococcus pneumoniae.

While not all causes of pink eye are related to bacterial infections, most middle ear infections are. If you’re experiencing symptoms of both pink eye and an ear infection, a doctor will likely evaluate you for conjunctivitis-otitis syndrome.

Can ear infections cause conjunctivitis?

An ear infection does not directly cause pink eye.

Bacterial conjunctivitis sometimes develops with ear infections. These are both related to the same bacteria that may spread to different areas of the body.

While anyone may develop conjunctivitis-otitis syndrome, it’s most common among children.

It’s also important to consider that most middle ear infections occur in infants and toddlers ages 6 to 15 months old. Cleft palate and Down syndrome may also increase the risk of middle ear infections in children.

Other possible risk factors include working at or attending day care facilities, not washing hands thoroughly or frequently enough, and wearing contacts (because this involves frequent contact between your hands and your eyes).

Complications from pink eye and middle ear infections are not common. But if left untreated, the bacterial infection may spread to the inner ear, brain, or spinal cord. Hospitalization is likely needed in such cases.

Untreated bacterial conjunctivitis involving more virulent organisms may separately increase your risk of developing inflammation and damage to the cornea, which could lead to permanent visual disability. Complications from otitis media are also uncommon but can sometimes cause damage to your eardrum and the bones inside your ear.

Since a bacterial infection causes conjunctivitis-otitis syndrome, a doctor will typically prescribe antibiotics. This may involve a combination of oral antibiotics as well as antibiotic eye and ear drops, depending on the severity of your infection.

Once you begin taking antibiotics, pink eye symptoms should improve within a few days, while those associated with a middle ear infection may improve within 2 to 3 days.

Additionally, an over-the-counter pain reliever like acetaminophen (Tylenol) or ibuprofen (Advil) may be recommended to help alleviate any pain or fever you might be experiencing.

Having symptoms of both pink eye and a middle ear infection at the same time could be signs of a bacterial infection that needs treatment. It’s best to see a doctor for a proper diagnosis rather than to wait and see if the symptoms clear up on their own.

You should also consider getting medical help if:

  • your symptoms are worsening after 2 to 3 days
  • your condition does not improve within a few days despite treatment
  • you’re experiencing significant pain and discharge in your eyes
  • you have worsening pain in your ears, as well as hearing problems

It’s important to obtain a proper diagnosis of this bacterial infection so you can obtain the right treatment. Also, keep in mind that antibiotics are not effective for viral and fungal infections.

To diagnose conjunctivitis-otitis syndrome, a doctor will ask you about your symptoms and also look for signs of a bacterial infection in your eyes and ears.

For an ear exam, a doctor will use an otoscope to look inside the ear canal. They’ll take note of signs of otitis media, such as redness and swelling, as well as fluid buildup behind your eardrum.

Signs of otitis media can also help them determine that your pink eye is caused by a bacterial infection. Compared with viral forms of pink eye, bacterial versions also cause thicker eye discharge.

While not common, some doctors order lab tests to help confirm the presence of bacterial infection. This involves taking small samples of eye and ear discharge via a cotton swab and sending them out to a laboratory for analysis.

A doctor may also assess you for symptoms of sinusitis (sinus infection), which may also occur with this condition. Nasal drainage that persists longer than 10 days is common with conjunctivitis-otitis. Other symptoms of sinusitis include congestion and sinus pain.

Conjunctivitis-otitis syndrome describes the co-occurrence of both pink eye and a middle ear infection. This is attributed to a bacterial infection and tends to be most common in young children.

If you or your child are exhibiting symptoms of both pink eye and a middle ear infection, it’s important to see a doctor for help. They can determine whether you have conjunctivitis-otitis and prescribe antibiotics to clear the bacterial infection and prevent possible complications.