It can be difficult to differentiate pink eye symptoms from dry eye symptoms because they both involve red, swollen eyes. But there are certain ways the eye conditions differ, and you’ll want to also consult your eye doctor.

Woman looking at her eyeShare on Pinterest
Westend61/Getty Images

Itchy, red eyes can be caused by allergies, infections, or even just a lack of moisture. While they can be an indicator of more serious medical conditions, red eyes can also naturally resolve on their own in some cases.

With so many possibilities, it’s no wonder you’re unsure of what’s happening with your eyes.

Pink eye and dry eye are two common reasons for red eyes. They may appear very similar, but they have different causes and potentially require different treatments. Being able to tell them apart often comes down to recognizing specific symptoms, and we’re here to help you with that.

Dry eye is a condition that occurs when your tear ducts don’t produce enough tears or aren’t able to maintain a normal layer of tears to coat your eyes.

Pink eye, also known as conjunctivitis, occurs when there’s an infection or swelling in your conjunctiva — the thin, transparent membrane that lies over the inner surface of the eyelid and covers the white part of your eye.

This is what your eyes may look like depending on which of the conditions you’re experiencing:

Pink eye and dry eye comparisonShare on Pinterest
Pink eye often causes purulent discharge. Viruses, bacteria, or allergies can cause pink eye. Dry eyes are often itchy and watery. CeltStudio/sruilk/Shutterstock

While both conditions can make your eye appear red, one of the biggest differences between the two is that pink eye more often includes an intense itching sensation. This is because pink eye is typically caused by allergens, chemicals, or viruses. On the other hand, dry eye often feels like there’s some grit in the eye, because of the lack of lubrication.

Here’s a breakdown of some of the other common symptoms associated with pink eye and dry eye:

Signs and symptomsPink eyeDry eye
Eyes appear redXX
Itchy feelingX
Light sensitivityXX
Gritty feeling X
Watery eyes/tearingXX
Mucus discharge and crustingX
Puffy/swollen eyelidsXX
Blurred/hazy visionXX
Frequently chronicX

When you have dry eye, the eye’s surface becomes inflamed over time due to the lack of moisture. It can cause the eye to sting or burn. Your eye may also feel tired or like it has a grain of sand caught in it.

Mild dry eye doesn’t usually result in serious complications. But if the dry eye is severe or persistent enough, it may result in scarring or scratches to the cornea.

In pink eye, the blood vessels in the conjunctiva become inflamed as a result of the infection or swelling giving the eye a red or pink color. Your eyes may itch and have a stringy discharge.

Pink eye typically clears up after exposure to the allergen, chemical, or virus ends. In most cases, there are no long-term complications, but it’s important to follow up with your doctor if it doesn’t clear up in the expected time frame to ensure that no damage to the inner eye occurs.

Having severe dry eye may increase the possibility of developing pink eye.

Tears help to protect the surface of the eye from infection and inflammation, so if you don’t have adequate tears, you may be at a higher risk for conjunctivitis.

It’s worth noting, however, that at least one study suggests that dry eye may not actually increase one’s risk of getting an eye infection.

People with pink eye as well as those with dry eye may benefit from lubricating eye drops and anti-inflammatory medications.

Antibiotics may be prescribed for a bacterial infection in the eye. However, the Centers for Disease Control and Prevention (CDC) points out that antibiotics won’t improve pink eye (viral conjunctivitis).

Antibiotics also won’t typically be prescribed for dry eye, as it’s generally due to a lack of tears and not an infection.

Treating dry eye

Treatment for dry eye is often dependent on the exact reason for the dry eye.

Your doctor might suggest over-the-counter or prescription eye drops. There are also anti-inflammatory medications like cyclosporine (Restasis), which may be prescribed.

If eye drops and medications are not effective, your doctor may suggest inserting plugs to block the drainage holes in the corner of your eyes.

Some other things that may improve dry eye include:

  • using a humidifier
  • avoiding smoky and windy areas
  • taking omega-3 fatty acid supplements
  • limiting time spent in front of the computer and television
  • using special contact lenses intended for people with severe cases of dry eye

Treating pink eye

Treatment for pink eye also depends upon the cause:

  • Bacterial conjunctivitis: This may require antibiotics if it’s severe or doesn’t go away on its own in about a week. These are frequently given in the form of prescription eye drops.
  • Viral conjunctivitis: Without treatment, this usually resolves in about a week. You may wish to use lubricating drops or cold compresses to help with eye discomfort, though.
  • Allergic conjunctivitis: This may benefit from an antihistamine to stop the inflammation. Loratadine (Claritin) and diphenhydramine (Benadryl) are two over-the-counter options, as well as antihistamine drops like Alaway, Zaditor, or Patanol.

You should avoid wearing contacts if you have pink eye until it fully clears up.

When to seek medical care

If your vision is reduced or you feel eye pain, it’s important to seek out immediate medical care. You may want to consider medical care when:

  • pink eye does not improve in 2 to 3 days on medication or after a week if untreated
  • eye swelling/tenderness increases and signs of infection like a fever occur
  • you recently scratched your eye

Both pink eye and dry eye are common conditions that can make your eyes feel itchy and uncomfortable. While dry eye is typically due to a lack of tears and may be chronic, pink eye involves inflammation that should hopefully clear up quickly.

It’s important to talk with your doctor if your red eye gets worse or persists so that they can determine the exact reason and provide you with the appropriate treatment.