What Is Commonly Misdiagnosed as Pink Eye?

Recognize the eye conditions that mimic pink eye, their symptoms, and how to tell them apart for correct diagnosis and treatment.

By Sneha Tete, Integrated MA, Certified Relationship Coach

Created on Sep 25, 2025

Recognize the eye conditions that mimic pink eye, their symptoms, and how to tell them apart for correct diagnosis and treatment.

It’s easy to assume a red, irritated eye is simply pink eye (conjunctivitis). With symptoms like redness, itching, and discharge, pink eye is one of the most recognized eye problems. However, a surprising number of other eye conditions cause similar symptoms and are frequently misdiagnosed as pink eye. Receiving the correct diagnosis is crucial to ensure you get effective treatment and prevent complications—especially since some lookalike conditions can threaten your sight if not treated promptly.

Understanding Pink Eye (Conjunctivitis)

Pink eye, or conjunctivitis, is the inflammation of the thin, clear tissue covering the white part of the eye and lining the inside of the eyelid. It is most often caused by an infection (viral or bacterial) or allergies. Despite being common, not every case of red, irritated eyes is due to conjunctivitis, so recognizing when symptoms may point to another problem is key for your eye health.

Typical Pink Eye Symptoms

Redness in one or both eyes
Itching or a gritty feeling
Watery eyes
Discharge – clear and watery (often in viral or allergic pink eye), or thick yellow/green (usually bacterial)
Eyelid crusting and sticking shut after sleep, especially with bacterial pink eye
Sensitivity to light in more severe cases
Swelling of eyelids or mild discomfort

Because so many other eye problems share these symptoms, it’s important to understand the lookalike conditions often confused with pink eye.

Common Conditions Mistaken for Pink Eye

Several eye diseases mimic the appearance or symptoms of pink eye but require very different approaches in treatment. Below are the most common issues—what sets them apart from conjunctivitis, and when to seek professional care.

1. Allergic Conjunctivitis

This form of eye irritation is triggered by allergens like pollen, dust mites, pet dander, or mold rather than bacteria or viruses. Its symptoms include:

Red, watery, and itchy eyes, often with swelling
Usually affects both eyes at the same time
May be accompanied by sneezing or a runny nose
Symptoms may improve with antihistamines or allergy treatments

Unlike infectious pink eye, allergic conjunctivitis is not contagious and may recur during allergy seasons or with specific exposures.

2. Dry Eye Syndrome

Dry eyes develop when the eyes do not produce enough quality tears or tears evaporate too quickly. This leads to:

Redness and irritation
Burning or gritty sensation
Occasional blurred vision
Little to no discharge (unlike bacterial pink eye)

Chronic dry eye often worsens in dry, windy, or air-conditioned environments. Artificial tears or prescription medications may be needed, and eye doctors can help determine if dry eye is the cause of your symptoms.

3. COVID-19-Related Conjunctivitis

Some people infected with the novel coronavirus (COVID-19) develop conjunctivitis. In these cases:

Red, watery, irritated eyes
Symptoms usually appear with other signs of COVID-19 (fever, cough, body aches, trouble breathing)
May be hard to distinguish from viral pink eye on appearance alone

If you have eye redness and are experiencing respiratory symptoms or have suspected COVID-19 exposure, seek healthcare guidance promptly.

4. Uveitis

Uveitis is inflammation of the eye’s middle layer (uvea) and is a more serious, sight-threatening issue. Symptoms can include:

Redness (often with a violet or deeper hue)
Moderate to severe eye pain, not just mild discomfort
Blurred or decreased vision
Light sensitivity (photophobia)
May affect just one eye

Uveitis is often associated with autoimmune conditions or infections. Because it can lead to vision loss if not treated promptly, seek immediate medical evaluation if symptoms fit this profile.

5. Keratitis

Keratitis is an inflammation or infection of the cornea (the clear front window of the eye), frequently caused by bacteria, viruses, fungi, or parasites. It can result from contact lens misuse. Common symptoms are:

Severe eye pain
Redness and discharge
Blurry vision
Excessive tearing
Light sensitivity
A feeling of something “stuck” in the eye

Keratitis is a medical emergency—vision can be permanently damaged. Contact your eye doctor quickly if you have these symptoms, especially with contact lens wear.

6. Stye (Hordeolum)

A stye appears as a painful, swollen lump on the edge of the eyelid. It’s caused by a blocked or infected oil gland and has these features:

Redness, tenderness, and localized swelling
May produce pus or appear like a pimple
Usually one area of the eyelid (unlike diffuse eye redness)
Can cause eyelid crusting or mild irritation

The condition is usually harmless, responding to warm compresses. However, persistent or worsening symptoms should be checked by a doctor.

7. Blepharitis

Blepharitis is chronic inflammation of the eyelid margins, often caused by bacteria or blocked oil glands. Symptoms may include:

Red, swollen, and itchy eyelids
Flaking, dandruff-like debris at the base of the eyelashes
Burning, stinging, or gritty feelings in the eyes
Crusting or matting of eyelashes upon waking

Unlike pink eye, blepharitis is long-lasting and often recurs. Good eyelid hygiene and prescribed treatments can control the symptoms.

8. Subconjunctival Hemorrhage

A subconjunctival hemorrhage is an outpouring of blood under the conjunctiva (the clear tissue over the white of the eye). It is characterized by:

A bright red patch on the white part of the eye
No pain, itching, discharge, or vision changes
Usually caused by minor trauma, coughing, or sneezing

While its appearance can be alarming, this condition is typically harmless and resolves without treatment within two weeks.

9. Contact Lens Irritation

Poor contact lens hygiene or overwear can irritate the eyes, causing:

Redness, burning, and discomfort
Watery eyes
Rare discharge (unless complicated by infection)
Symptoms usually resolve after removing lenses and resting the eyes

If redness persists, see your eye care provider to check for underlying infection or corneal damage.

10. Ocular Rosacea

This chronic disorder mainly affects adults prone to rosacea (facial redness). In the eyes, it can lead to:

Red, irritated eyes
Burning, stinging, and dryness
Crusty eyelids and visible blood vessels
Frequent styes or chalazia (blocked glands)

Ocular rosacea may be misdiagnosed as pink eye, but it requires different management to prevent eye surface damage.

11. Corneal Ulcers

Corneal ulcers—open sores on the cornea—are serious and require immediate care. Symptoms can mimic pink eye, but are often worse:

Severe eye pain
Redness and discharge
Vision changes
A visible spot on the cornea

Corneal ulcers occur more in contact lens wearers and may result from infection or trauma. Untreated, they can cause scarring and permanent vision loss.

When Should You See an Eye Doctor?

While many people manage mild red or irritated eyes on their own, some symptoms mean you should seek prompt professional care. See an eye doctor if you experience:

Severe eye pain or sensitivity to light
Blurred or sudden loss of vision
Symptoms that don’t improve within a few days
Profound redness, especially with discolored patches or pus
History of autoimmune disease or exposure to serious infection (such as COVID-19)

Getting the right diagnosis protects your vision and eye health. Never hesitate to seek medical evaluation when symptoms are severe, worsening, or unusual.

How Are Eye Conditions That Mimic Pink Eye Diagnosed?

Eye doctors use several tools to distinguish between pink eye and other look-alike conditions:

Review of your symptoms and medical history
Examination with special lights and magnifiers
Testing eye secretions for bacterial or viral pathogens
Allergy testing or tear production studies
Assessment of contact lens use and hygiene

Correct identification is essential, since some conditions (like uveitis or keratitis) can become emergencies if treatment is delayed.

Frequently Asked Questions (FAQs)

Can pink eye symptoms go away without treatment?

Mild viral or allergic conjunctivitis may resolve on its own. Bacterial cases and severe or long-lasting symptoms often require prescription treatment. Eye infections and inflammatory diseases not caused by conjunctivitis need specific management.

How can I tell if my red eye is from allergies or infection?

While both allergies and infection can cause red, watery eyes, allergic conjunctivitis often involves intense itching and occurs with other allergy symptoms (runny nose, sneezing) and typically affects both eyes. Infections may cause thicker discharge, crusting, and sometimes affect only one eye at first.

Can I treat eye redness with over-the-counter medicines?

Some cases, like mild allergies or dryness, respond to over-the-counter artificial tears or antihistamine drops. If symptoms persist or worsen, or if theres thick discharge, pain, or vision loss, see an eye care professional immediately.

Is pink eye contagious?

Viral and bacterial pink eye are both contagious and can spread easily in schools, households, and workplaces. Allergy-related or non-infectious causes of eye redness are not contagious.

What precautions can help prevent spreading or worsening eye symptoms?

Wash hands frequently and avoid touching your eyes
Do not share towels, makeup, or pillows
Replace makeup or contact lenses if recommended after infection
Avoid wearing contact lenses until symptoms are gone and a doctor has cleared their use

Summary Table: Eye Conditions Often Mistaken for Pink Eye

Condition	Key Features	Distinguishing Signs
Allergic Conjunctivitis	Red, itchy, watery eyes (both eyes), allergy symptoms	Not contagious, improves with antihistamines
Dry Eye	Redness, gritty feeling, burning	Minimal discharge, worse in dry air
Keratitis	Severe pain, blurred vision, redness	Contact lens/trauma history, urgent
Uveitis	Pain, light sensitivity, blurred vision, redness	Autoimmune links, vision risk
Stye (Hordeolum)	Painful lump on eyelid, localized swelling	Surface lump, responds to warm compresses
Blepharitis	Red, swollen, flaky lids; crusting	Chronic, affects eyelid margins
Subconjunctival Hemorrhage	Bright red patch, no pain/discharge	Resolves on own, not infectious
Ocular Rosacea	Red, irritated eyes, crusting, stye risk	History of facial rosacea, chronic
Contact Lens Irritation	Redness, burning, discomfort	Improves with lens removal/rest
Corneal Ulcer	Severe pain, vision changes, spot on cornea	Medical emergency, vision risk
COVID-19-Related Pink Eye	Red, watery eyes with COVID symptoms	Other COVID signs (fever, cough)

Takeaways

Not all red, irritated eyes are due to pink eye. Many other conditions share symptoms but require different care.
If eye symptoms are severe, worsening, involve vision loss or don’t respond to basic care in a few days, see an eye doctor immediately.
Proper diagnosis ensures correct treatment and protects long-term eye health and vision.

References

Author

Sneha TeteBeauty & Lifestyle Writer

Sneha is a relationships and lifestyle writer with a strong foundation in applied linguistics and certified training in relationship coaching. She brings over five years of writing experience to thebridalbox, crafting thoughtful, research-driven content that empowers readers to build healthier relationships, boost emotional well-being, and embrace holistic living.

Read full bio of Sneha Tete