Can pink eye cause a fever?

You’re shivering one minute and sweating the next. A fever can be a sign you caught the latest flu that’s circulating in the community. However, this unpleasant symptom can accompany many different conditions, including conjunctivitis, the medical term for pink eye.

“Conjunctivitis could stem from a viral infection, and when this occurs, someone may also have other symptoms such as fever, body aches, nasal discharge, and cough,” says Edgar Navarro Garza, MD, a board-certified pediatrician at Harbor Health in Austin, Texas.

Does pink eye cause a fever?

It’s not uncommon to have a fever with conjunctivitis. However, the fever is related to the triggering virus or bacteria—not the conjunctivitis itself, explains Dan Murauski, DO, Director of Wellness Optimization and Longevity at Case Integrative Health in Chicago.

There are three main types of pink eye:

• Viral conjunctivitis is an eye infection caused by a virus such as adenovirus (the common cold) or coronavirus, which also causes fever and sore throat.
• Bacterial conjunctivitis is an eye infection caused by bacteria that may have entered the eye through contact lens wear, air pollutants, or touching a contaminated surface before touching your eye.
• Allergic conjunctivitis is eye irritation caused by a reaction to specific allergens, such as pollen or dust mites. It may be accompanied by sneezing.

If you have viral or bacterial pink eye, the virus or bacteria causing your conjunctivitis may also cause fever. That’s because fever is simply a sign of immune system activation. You get a fever when your body is fighting against a virus or bacterial infection.

According to Dr. Garza, most conjunctivitis-related fevers resolve within 48 hours. He recommends consulting a healthcare provider if you have pink eye with a fever that lasts more than five days.Get medical advice at the onset of conjunctivitis to determine if you need to be seen. 

What are the symptoms of pink eye with a fever?

Pink eye symptoms vary depending on the type. Viral and bacterial conjunctivitis can cause a fever, but the most common cause of fever with pink eye is a virus.

Along with fever, “patients may experience cold-like symptoms such as a runny nose, sinus congestion, or coughing. These may be followed by having one eye getting more watery than the other,” says Nerissa Dimailig, APRN, an advanced practice registered nurse at Valley Oaks Medical Group in Nevada.

As the infection sets in, you will experience some or all of these common pink eye symptoms:

• Watery eyes
• Red eyes (pink or redness of the white part of the eye)
• Itchy, irritated, or burning eyes
• Stickiness or crusting around the eyes

Because viral and bacterial pink eye require different treatments, it is essential to determine which conjunctivitis you might have. “Eye discharge with viral and allergic conjunctivitis is usually clear or mucoserous. The eye discharge on bacterial conjunctivitis is pus-like and thicker,” says Dr. Garza.

How to treat a fever with pink eye

“Managing fever with and without pink eye will be the same, and that includes staying hydrated, using cool wraps, and taking a fever-reducing medication,” says Dr. Garza. Common over-the-counter fever reducers include Tylenol (acetaminophen) and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen.

Fever is most common with viral pink eye. The pink eye will go away once the virus has run its course, usually within a couple of weeks. The following home remedies can be used to relieve symptoms of viral pink eye:

• Eye massage with a washcloth soaked in warm water
• Warm compresses on the eye area
• Eye lubricant drops (such as Artificial Tears)
• Decongestant eye drops
• Avoiding eye makeup and contact lens use

Pink eye caused by a bacterial infection may not go away on its own. “Bacterial conjunctivitis usually requires antibiotic treatment,” says Dr. Murauski. With antibiotics, symptoms should improve in one to two days.

Risk factors for a fever with pink eye

“Those with weakened immune systems, such as young children and the elderly, are more at risk for developing a fever with conjunctivitis,” says Dr. Murauski. “Young children are vulnerable because their immune systems are not fully developed, making it harder for their bodies to fight off infections. The elderly may have weakened immune responses due to age, increasing their susceptibility.”

Viral conjunctivitis is very contagious, which is why it’s so common in school and daycare settings. Avoid close contact with an infected person, practice frequent handwashing, and avoid sharing towels or pillowcases with anyone with pink eye.

When to see your healthcare provider

Most cases of pink eye go away on their own. But pink eye can become chronic, meaning it has not resolved after four weeks.

Dimailig suggests calling your healthcare provider if you experience:

• Pain with eye movement
• Extreme sensitivity to light
• Thick drainage from the eye
• Eyelid swelling

Dr. Murauski says to consider a trip to the ER if these symptoms accompany your pink eye:

• Vision changes
• Intense eye pain
• High fever

While complications from pink eye are uncommon, they can be significant. Dr. Garza says eye pain along with pink eye could be a sign of elevated eye pressure, which can lead to vision loss. See an ophthalmologist or go to an emergency room immediately if you’re experiencing eye pain and pink eye symptoms.

Another example of a dangerous complication is when a type of sudden-onset bacterial pink eye (called primary meningococcal conjunctivitis) turns into meningitis. Though rare, this is a serious, potentially life-threatening condition. If your pink eye develops very quickly or causes significant pain, contact your healthcare provider or be seen at the nearest ER to rule out meningitis-related conjunctivitis.