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

A red, irritated eye can be hard to ignore. Whether you're dealing with itching, watering, swelling or discomfort, it's not always easy to tell what's causing your symptoms. 

Two of the most common culprits? Pink eye and stye. So, what do you do about it?

We asked Dr. Hali Pearce, family medicine doctor at Ascension Sacred Heart Primary Care at Davis Highway about the difference between the two.

Although pink eye and styes can share some symptoms, they affect different parts of the eye — and they often need different types of treatment. 

“The biggest clue to whether you have a stye or pink eye is location,” says Dr. Pearce.

Pink eye vs. stye

Knowing what’s causing your eye symptoms is the first step to getting the right treatment. Here’s how to tell the difference between pink eye and a stye. 

Pink eye (also called conjunctivitis) 

• Affects the clear membrane that covers the white part of your eye and lines the inside of your eyelids
• Looks like pink or redness on your eyeball itself 
• Usually causes itching, watering or discharge across the surface of your eye

Stye (also called a hordeolum)

• Develops along your eyelid itself, often near the base of your eyelash 
• Looks like a pimple-like bump on your eyelid 
• Can cause pain, tenderness, eyelid swelling and tearing 

"A common misconception is that having a red or irritated eye means you have pink eye,” says Dr. Pearce. “But a stye, allergies, dry eye and other conditions can cause similar symptoms, which is why it's important to pay attention to where you’re experiencing the irritation and whether your symptoms are improving over time." 

What is pink eye?

Pink eye happens when the conjunctiva — the thin, clear membrane covering the white part of your eye and the inside of your eyelids — becomes inflamed.

When this tissue becomes irritated or infected, blood vessels become more visible. That can make your eye look pink or red.

Some types of pink eye are contagious, like those caused by a viral or bacterial infection. Other types aren’t contagious and are caused by allergies or exposure to irritants, like smoke or chemicals.

Depending on the cause, pink eye can affect one eye or both eyes.

Pink eye symptoms

Symptoms of pink eye may include:

• Redness or a pink appearance in the white part of the eye
• Itching, burning or irritation
• Watery or tearing eyes
• A gritty sensation, as though something is in your eye
• Eye discharge that may be clear, white, green or yellow
• Crusting around the eyelids or lashes, especially after sleeping

The exact symptoms often depend on what's causing the inflammation. For example, allergic pink eye often causes itching and watery eyes, while bacterial pink eye may cause thicker discharge. 

What causes pink eye?

You can develop pink eye can develop for several reasons, including:

• Viral infections (yep, the same ones as a common cold)
• Bacterial infections
• Allergies to pollen, dust, pet dander or other allergens
• Irritants like smoke, chlorine or certain chemicals
• Contact lens-related irritation or infection

Viral and bacterial pink eye can be contagious. Allergic pink eye and irritation-related pink eye, on the other hand, aren’t. 

Because some forms of pink eye can spread from person to person, hygiene is important, reminds Dr. Pearce. Wash your hands regularly, avoiding touching your eyes and try not to share towels, washcloths or eye makeup with others.

Pink eye treatment

The treatment for pink eye depends on what’s causing it to begin with:

Viral pink eye 

Viral pink eye usually improves on its own. Most mild cases clear in 7 to 14 days, though some can take 2 to 3 weeks (or longer.) 

“Viral conjunctivitis is the most common type of eye infection,” saysDr. Pearce. “It may come with cold or flu-like symptoms.” 

Antibiotics won’t cure viral pink eye, so usually the best thing to do is wait it out. Just be careful, since as long as you have symptoms, it’s contagious. 

Bacterial pink eye 

Bacterial conjunctivitis can improve without antibiotics, especially if your symptoms are mild. But sometimes, it requires treatment. 

Sometimes bacterial pink eye will clear up in 2 to 5 days without treatment, but it can take up to 2 weeks to go away completely. 

“If you have pink eye that’s caused by a bacterial infection, you may need antibiotic eye drops or ointment, or oral medications, which you’ll need a healthcare provider to prescribe,” saysDr. Pearce.

Bacterial conjunctivitis is also highly contagious.

Allergic pink eye 

When pink eye is caused by allergies (think smoke or pet dander), it tends to get better once you remove the allergen. If you’re unable to avoid the allergen, allergy medications or medicated eye drops can usually help relieve your symptoms.

While your eye is healing, the following at-home remedies may give you some relief:

• Applying a cool compress to the closed eye
• Using artificial tears
• Keeping your eye area clean
• Avoiding contact lenses until symptoms have resolved or your doctor says it’s safe
• Avoiding eye makeup and lotions around your eye until your symptoms improve
  
  

What is a stye?

A stye, also known as a hordeolum, is a small, painful lump that forms along the edge of your eyelid. Styes usually look like a pimple and develop near the base of your eyelashes.

Styes are often the result of an oil gland or hair follicle in your eyelid becoming blocked and infected. 

“Although they can be uncomfortable, styes are generally harmless and will often improve on their own,” says Dr. Pearce.

Stye symptoms

Common signs of a stye include:

• A red, painful bump on the eyelid
• Swelling of the eyelid
• Tenderness around the affected area
• Redness near the bump
• Increased tearing
• A sensation that something is in your eye

A stye typically affects one small area of the eyelid instead of causing widespread redness across the white of the eye (like with pink eye).

What causes a stye?

Most styes develop when bacteria enter a blocked oil gland or hair follicle along the eyelid.

You’re more likely to develop a style if you do any of the following: 

• Touch your eyes with unwashed hands
• Remove your makeup each night
• Use old or contaminated makeup
• Are prone to chronic eyelid inflammation (blepharitis)
• Follow poor contact lens hygiene
• Quit smoking

Good hygiene can go a long way to prevent eye infections.

“Always wash your hands with soap and water before touching your eyes, take off any makeup before bed and clean your contacts thoroughly, or, if they’re disposable lenses, don’t wear them longer than recommended,” says Dr. Pearce. 

What is commonly mistaken for a stye?

Several conditions can look similar to a stye, including:

• Chalazion, a hard, usually painless lump caused by a blocked oil gland
• Pink eye, particularly when redness and irritation are present
• Blepharitis, which causes inflammation along the eyelid 
• Eyelid cysts and other noncancerous growths

Dr. Pearce notes that, “If you get a stye, it’s not uncommon for the oil gland to become affected. When that happens, you may also develop a chalazion.” 

If your bump doesn't improve, continues to grow or keeps returning, make sure to have it looked at by your doctor.

Stye treatments

Most styes improve on their own within a few days to two weeks. The most effective at-home treatment is applying a warm compress on the affected eyelid for 10 to 15 minutes, several times a day. 

“The warmth of the compress will help open blocked oil glands and encourage the stye to drain on its own,” explainsDr. Pearce.

Other at-home remedies that can help are:

• Keeping the eyelid area clean
• Avoiding eye makeup until the stye heals
• Avoiding contact lenses if your eye is irritated

It's important not to touch, squeeze, pop or try to drain a stye yourself. This can make the infection worse and damage your eye, addsDr. Pearce.

When to see a doctor about pink eye or a stye 

When you aren’t sure if you have a stye, pink eye or another eye condition, Dr. Pearce recommends focusing less on diagnosing yourself and more on monitoring your symptoms. 

See a healthcare provider right away if you have:

• Eye pain
• Sensitivity to light
• Blurry vision or other vision changes
• Intense redness in or around the eye
• Redness or swelling that spreads beyond the eyelid
• Symptoms that get worse instead of better after a few days
• Eye redness, pain or discharge while wearing contact lenses
• Repeated styes or eye infections

These symptoms can point to a more serious eye condition that requires immediate evaluation.

“You know your body best. If something seems off, go get checked out,” urges Dr. Pearce. “Your provider can determine what’s causing the problem and recommend the best course of action.”

Next steps and helpful resources

• Meet Hali Pearce, DO
• Learn more about primary care 
• Schedule an appointment at Ascension Sacred Heart Primary Care at Davis Highway