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Pink Eye and Blepharitis – What's the Difference?

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Eye infections and inflammation can seriously impact our quality of life, even when they have low clinical significance. Pink eye, also called conjunctivitis, is very common. The conjunctiva is a thin, transparent membrane that covers the insides of both upper and lower eyelids, plus the whites of the eyes. It provides a smooth, protective layer that makes blinking and eye movements comfortable – or at least, that's what it does when it's healthy. This membrane can become inflamed with viral or bacterial infection, or from allergies. Conjunctivitis generally feels like sand in the eyes, with redness, tearing, discharge, and general discomfort. Itching may be the primary symptom if the cause is allergies.

There are different types of eye drops used to treat conjunctivitis, depending on the cause. Some cases are due to the herpes simplex virus, which also causes cold sores. Anti-viral eye drops are available for this possibility. If the infection is bacterial, then antibiotic eye drops or ointment may be prescribed. Anti-allergy and steroid eye drops can be used to treat allergic conjunctivitis.

The vast majority of pink eye cases will clear up by themselves. But you should call your eye doctor if you have any of the following:
1. Loss of vision
2. Eye pain
3. Drainage
4. Symptoms that fail to improve within 1 – 2 weeks
5. Worsening of symptoms after an initial doctor's visit.

Blepharitis is a bit different; it is an inflammation of the margins of the eyelids, at the roots of the eyelashes. It feels similar to pink eye, but it may include crusting around the eyelashes. It is generally caused by bacterial infection, abnormal oil gland secretions, or a combination. You should call your doctor immediately if you have loss of vision, eye discharge, or severe symptoms. For mild cases, lid hygiene may be sufficient:
1. Use a warm compress twice daily for at least 5 minutes at a time. You can use a clean washcloth wet with warm water; wring out the excess water and hold the cloth on your eyelids with eyes closed.
2. After the warm compress treatment, put a drop of tear-free baby shampoo on the wash cloth. With eyes closed, gently massage the base of the eyelashes, then rinse.
3. Repeat this for several days to see if the irritation decreases. If not, call your eye doctor.

Prevention for both conjunctivitis and blepharitis is good hygiene. Clean hands, towels, and anything else that may touch your eyes is the best way to fight infections. You may want to see an allergist for skin testing if you have allergic conjunctivitis.


Sharon Fekrat, M.D. and Jennifer Weizer, M.D., editors, “All about Your Eyes: A Practical Guide in Plain English from the Physicians at the Duke University Eye Center”, Duke University Press, 2006.

Linda Fugate is a scientist and writer in Austin, Texas. She has a Ph.D. in Physics and an M.S. in Macromolecular Science and Engineering. Her background includes academic and industrial research in materials science. She currently writes song lyrics and health articles.

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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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