Pink eye vs. stye: What’s the difference?

When your eye is red, irritated and uncomfortable, figuring out what’s wrong can be challenging. Pink eye and styes are two common eye conditions with similar symptoms but different causes and treatments. Understanding the difference helps you get the proper care at the right time.

Mount Nittany Health ExpressCARE provider, Kaliah Reeves, CRNP, shares valuable insight and distinction between the two.

What is pink eye?

Pink eye, medically known as conjunctivitis, is an inflammation of the conjunctiva — the thin, clear tissue that lines the inside of your eyelid and covers the white part of your eye. When the small blood vessels in the conjunctiva become inflamed, they become more visible, giving the eye a pink or reddish appearance.

Pink eye types

There are three main types of pink eye:

• Viral conjunctivitis: The most common type, caused by viruses like those responsible for the common cold. It’s highly contagious and often affects both eyes.
• Bacterial conjunctivitis: Caused by bacteria, this form can cause serious damage if left untreated. It often produces more discharge than viral pink eye.
• Allergic conjunctivitis: Triggered by allergens like pollen, dust or pet dander. This type isn’t contagious and often occurs seasonally.

Pink eye symptoms

Common symptoms of pink eye include redness in the white of the eye or inner eyelid and increased tear production. You might notice a thick yellow discharge with bacterial pink eye or a watery discharge with viral or allergic types. Many people experience an itchy or burning sensation, blurred vision and sensitivity to light.

Other symptoms include a gritty feeling in the eye, swollen eyelids and crusting of the eyelashes, especially when you first wake up in the morning.

Pink eye causes

Pink eye most commonly stems from viral infections, similar to those that cause the common cold. Bacterial infections are another frequent cause. Environmental triggers like allergens (pollen, dust mites, pet dander) and chemical irritants (chlorine, air pollution) can also lead to pink eye.

Poor contact lens habits, such as wearing them too long or improperly cleaning them, increase your risk. Sometimes, a foreign object in the eye can cause similar inflammation.

What is commonly misdiagnosed as pink eye?

Several conditions can mimic pink eye symptoms, leading to misdiagnosis:

• Dry eye syndrome
• Allergic reactions
• Blepharitis (inflammation of the eyelids)
• Foreign body in the eye
• Iritis (inflammation of the iris)
• Chemical irritation

How to treat pink eye

“If you’re having symptoms of pink eye (red eye, discharge, irritation), it’s important that a healthcare provider evaluates you to determine the cause,” says Kaliah. “We’ll likely ask you questions, like if you have been experiencing any cold symptoms such as cough, congestion, sore throat or fever.

“We’ll want to know if you have had any injury to your eye, if you wear contact lenses, if you’re experiencing any allergy symptoms, etc.,” she continued. “Once we collect a thorough history from you and do an exam, we can likely determine the cause and therefore provide the best treatment.”

Treatment depends on the type of pink eye you have:

• Viral conjunctivitis: No specific treatment; it typically clears up on its own in 7-14 days. Cold compresses and artificial tears can help manage symptoms while you heal.
• Bacterial conjunctivitis: Treatment is antibiotic eye drops or ointments prescribed by a healthcare provider. Symptoms usually improve after 24-48 hours of starting treatment.
• Allergic conjunctivitis: Avoid allergens when possible and use antihistamine eye drops or oral medications to control symptoms.

At-home remedies for pink eye

While waiting for pink eye to resolve, several at-home measures can provide relief:

1. Apply a clean, cold compress to your eyes several times a day to reduce inflammation
2. Use artificial tears (over-the-counter eye drops) to relieve dryness and flush irritants
3. Remove contact lenses until your eyes completely heal
4. Avoid eye makeup during the infection
5. Prevent spreading by not sharing towels or washcloths
6. Wash your hands frequently, especially before and after touching your eyes

When to seek care for pink eye

While some cases of pink eye resolve on their own, it’s important to seek medical attention to diagnose your condition correctly. Additional symptoms that may prompt a visit to your provider include:

• You have moderate to severe pain in your eye
• Your vision becomes blurred or decreased
• You’re sensitive to light
• Your symptoms worsen or don’t improve after a few days
• You have a weakened immune system
• You have a pre-existing eye condition

“Contact lens wearers can have complications from pink eye,” Kaliah explained. “We also pay special attention to any newborn showing signs of pink eye.”

What is a stye?

A stye (or hordeolum) is a small, painful lump that forms on or inside the eyelid. It develops when an oil gland at the edge of the eyelid becomes infected with bacteria.

Unlike pink eye, which affects the eye itself, styes are generally localized infections that look like a small pimple on the eyelid and can be quite tender.

Stye types

There are two main types of styes:

• External hordeolum: Forms at the base of an eyelash, appearing as a small bump on the outside edge of the eyelid where the eyelash meets the lid.
• Internal hordeolum: Develops inside the eyelid, creating a bump often visible from the underside of the eyelid.

Stye symptoms

The hallmark of a stye is a small, painful red bump along the edge of the eyelid, often resembling a pimple. This comes with localized swelling of the eyelid and tenderness when touched. Most people experience pain specifically in the affected eyelid rather than inside the eye itself.

Additional symptoms include:

• Increased tearing
• Crusting around the eyelids
• Sensitivity to light
• Foreign body sensation when blinking

Stye causes

Styes typically develop due to a bacterial infection, most commonly Staphylococcus bacteria. These infections often occur when oil glands in the eyelids become blocked and infected. Poor eyelid hygiene contributes significantly to stye formation, as does the habit of touching your eyes with unwashed hands.

Cosmetic practices can also increase your risk:

• Using old or contaminated eye makeup
• Leaving eye makeup on overnight
• Sharing eye makeup with others
• Incorrectly applying eyeliner or other eye cosmetics

What is commonly misdiagnosed as a stye?

Several eyelid conditions share characteristics with styes, leading to potential misdiagnosis:

• Chalazion (non-infectious blockage of an oil gland)
• Blepharitis (a chronic condition that causes inflammation of the eyelid margins)
• Eyelid cysts
• Small skin tags
• Basal cell carcinoma (rarely)

How to get rid of a stye

Most styes heal on their own within a week or two. “If you have concerns for a stye, you can typically try a warm compress first, but if it’s not improving, we recommend an evaluation,” Kaliah said.

At-home remedies for styes

The cornerstone of stye treatment at home includes:

1. Apply warm compress to the affected eye for 10-15 minutes, 3-4 times daily
2. Gently massage the area after applying a warm compress to help drainage
3. Keep the eyelid clean
4. Avoid wearing eye makeup or contact lenses while healing
5. Never squeeze or pop a stye—this can spread the infection
6. Wash your hands frequently and avoid touching your eyes

When to seek care

While most styes resolve with home treatment, certain situations require professional medical attention. Consult a healthcare provider if:

• The stye doesn’t improve within a week
• Vision changes occur
• The redness and swelling spread beyond the eyelid to the cheek or other parts of the face
• Pain becomes severe
• The stye bleeds or recurs frequently
• You have multiple styes at once

If you think you might have pink eye or a stye, visit Mount Nittany Health ExpressCARE to be seen fast without an appointment.