Red eyes or pink eyes can be symptoms of several eye diseases that could range from simple to more serious conditions.
That said, several eye conditions can be misdiagnosed as Pink eye. While it’s common among masses to attribute different eye conditions to pink eye. But in reality, eyes can suffer from different conditions ranging from allergies to dry eye syndrome and even Covid-19 infection.
In this post, we will explore the potential conditions that are often misdiagnosed as pink eye. But before we proceed any further, a word of caution – if you suspect an eye disease and are unsure of its cause, get immediate medical help. Under no condition should you self-medicate.
What Causes Redness In Eyes?
Our eyes are fragile organs, susceptible to a vast variety of ailments and damages. Infection, allergies, and other conditions like dust, pollen, etc. can irritate the eyes and create discomfort.
These conditions can lead to the inflammation of the conjunctiva – a thin membrane that covers the eyeballs. Its primary function is to protect the eye’s health from external irritants like dust, bacteria, and viruses. Likewise, it also keeps the eyes lubricated and prevents eye dryness.
When the conjunctiva is inflamed the white part of the eye (sclera) appears red or pink. A condition that is commonly referred to as pink eye.
What causes pink eye [conjunctivitis]?
Pink eye is an acute and chronic inflammation of the conjunctiva. The most common culprits of Pink Eye are bacteria and viruses.
Keratoconjunctivitis epidemica also referred to as adenovirus conjunctivitis is the most common form of viral conjunctivitis. It’s highly contagious and caused by adenovirus types 8, 19, 37 etc.
Blepharitis and keratoconjunctivitis are other causes of viral Conjunctivitis. It’s caused by herpes simplex viruses (HSV) and is more common in neonates.
Keratoconjunctivitis also causes pink eyes. It’s caused by zoster viruses (VZV) and the condition is highly contagious.
Chlamydia Conjunctivitis also known as swimming pool conjunctivitis is caused by chlamydia of serotype DK. It causes redness, swelling, and excessive tears in the eyes.
Gonococcal conjunctivitis, also known as gonoblenorrhoe is a contagious eye infection that causes redness. Sexual intercourse in adults is the primary source of infection when eyes come in contact with infected liquid.
Possible Eye Conditions that Are Commonly Misdiagnosed as Pink Eye
Pink eye can result from bacterial and viral infections, but it can also be mistaken for several other eye conditions. Therefore it’s essential to know that the condition is not pink eye, but something else. It will help speed up the diagnosis and get the necessary treatment. Let’s take a look at some common ailments that are misdiagnosed pink eye;
- Allergic Conjunctivitis
In some people, allergens such as pollen, pet dander, dust mites, etc. can trigger allergic reactions in the eyes. When that happens the conjunctiva can swell up or become red. It can be mistaken as pink eye due to very similar symptoms.
Allergic Conjunctivitis can be further decided in subcategories like;
- Perennial conjunctivitis (PAC)
- Seasonal allergic conjunctivitis (SAC)
- Keratoconjunctivitis vernalis (VKC)
- Giant papillary conjunctivitis (GPC)
- Atopic keratoconjunctivitis (AKC)
- Ocular pemphigoid
Ocular pemphigoid involves autoimmune conjunctivitis, marked by conjunctiva atrophy and more significant corneal scarring. Symptoms might include excessive redness, tearing, and eye irritation. However, ocular pemphigoid can potentially damage the cornea which rarely happens in the case of normal infectious conjunctivitis.
- Dry Eye Syndrome
Eyes need to be hydrated all the time for proper functioning. But certain conditions can impair the ducts’ ability to produce enough tears which can cause Dry Eye Syndrome. Lack of tear production can cause severe irritation of the eye, discomfort, and Pink eye-like symptoms.
- Contact Lens Related Pink Eye
Sometimes even contact lenses can lead to pink eye-like symptoms. The condition is known as contact lens-related keratitis and can be misdiagnosed as Pink Eye.
- Redness in eyes
- Pain and discomfort
- Heightened light sensitivity
- Discomforting feeling like something is the eye
Correct lenses and proper lens hygiene usually clear the condition and often no medical treatment is required.
The inflammation of the Cornea, the transparent front part of the eye is termed as Keratitis. It can be both infectious and noninfectious and causes pink eye-like symptoms. The cause of Keratitis can be infections, eye injury, and foreign body in the eye. Improper usage of lenses can also lead to Keratitis. In any case, Keratitis leads to inflammation of the cornea which needs prompt medical attention.
- Subconjunctival Hemorrhage
Subconjunctival Hemorrhage refers to a condition where blood is present under the conjunctiva. Sudden or severe sneezing, vomiting, and excessive rubbing of the eye can lead to subconjunctival hemorrhage. Ruptured blood vessels due to shock lead to bleeding that appears as a bright red spot in the clear lining of the eye. However, unlike infectious conjunctivitis, it doesn’t produce symptoms like itching, discharge etc.
Anterior Uveitis or Iritis is the inflammation of the uvea. It’s the middle layer of the eye that includes the iris, choroid, and ciliary body. Several factors like autoimmune disease, infections, and injury can lead to Uveitis.
- Redness and itching
- Light Sensitivity
- Impaired Vision
It can be easily misdiagnosed as Pink Eye however, proper examination and assessment are critical to address Uveitis effectively.
The inflammation of the Episcleral, the thin layer between the conjunctiva and the white part of the eye (Sclera) is termed Episcleritis. It can cause redness and mild discomfort in the eye and may be mistaken for Pink Eye.
- Corneal Abrasion
A scratch or an injury to the cornea is referred to as corneal abrasion. It can manifest as redness, bloody patch, itching, and pain. The most common causes of corneal abrasion are foreign bodies and excessive rubbing. In any case, corneal abrasion needs immediate medical attention for its proper containment and treatment.
- Covid 19-Related Pink Eye
Covid 19 can also cause eye redness in some individuals. A study published in the American Association of Opthalmology indicates a possible link between eye redness and COVID-19 in some affected people. As per WebMed, around 1% to 3% of individuals suffering from Covid 19 will get this eye.
Redness in the eyes, itching, or discharge are the common symptoms of infectious conjunctivitis, also known as Pink Eye. But several conditions including Episcleritis, Ocular pemphigoid, etc. can also be misdiagnosed as Pink Eye. Therefore, if you suffer from an eye infection or disease, it’s prudent to get evaluated by a doctor to determine the possible cause and the right treatment.
- Keen M, Thompson M. Treatment of Acute Conjunctivitis in the United States and Evidence of Antibiotic Overuse: Isolated Issue or a Systematic Problem? Ophthalmology. 2017 Aug;124(8):1096-1098. [PubMed]