Pink eye treatment in Koh Phi Phi
A red, gritty eye that was weeping by morning and has glued itself shut overnight. It moves through a hostel dorm with remarkable efficiency, and on an island where everyone swims in the same bay and shares the same dive masks it moves faster still. Pink eye treatment in Koh Phi Phi starts with working out whether this is viral, bacterial or allergic, because only one of the three needs drops.
The three kinds, and how they differ
Viral conjunctivitis is the commonest. Watery discharge, often starting in one eye and moving to the other after a day or two, frequently with a cold or sore throat alongside. Extremely contagious, and it resolves on its own in one to two weeks.
Bacterial conjunctivitis produces thick yellow or green discharge, and the eyelids genuinely stick together overnight. It responds to antibiotic drops, though many mild cases would clear anyway.
Allergic conjunctivitis affects both eyes at once, itches intensely rather than feeling gritty, and comes with sneezing or a runny nose. Antibiotics do nothing for it; antihistamine drops help within hours.
The red flags that are not conjunctivitis
Conjunctivitis is irritating rather than dangerous. These are different and need looking at the same day:
- Genuine pain rather than grittiness
- Blurred vision, or any change in vision
- Sensitivity to light strong enough to make you squint
- Redness concentrated in a ring around the coloured part of the eye
- A pupil that looks a different size or shape
- Any history of the eye being struck or scratched
Contact lens wearers with a red painful eye deserve particular urgency. A corneal ulcer can develop quickly and threatens vision, and it is far more common in warm water and humid conditions. Take the lenses out and keep them for us to look at rather than throwing them away.
Why it spreads so well here
Dorm rooms, shared bathrooms, shared towels, and a group of people all swimming in the same water at the same times.
Then the diving specifics: rental masks passed between customers, and a rinse tank that a whole boat of gear goes through. A mask that has not been properly disinfected between users is an efficient way to move an eye infection around a dive group, and viral conjunctivitis survives on surfaces for hours.
Swimming pools contribute where they are under-chlorinated, and the sea contributes after heavy rain when run-off reaches the bay.
How to stop giving it to everyone
Wash your hands considerably more than feels necessary, and particularly after touching your face.
Do not share towels, pillowcases or flannels — use your own and wash them hot. Throw away any eye make-up in use and do not share it. Stay out of the pool and the sea while the eye is discharging.
Tell your dive school. It is an awkward conversation and it is the right one: your mask needs proper disinfection, and continuing a course with a discharging eye spreads it to everyone on the boat.
If you wear contact lenses, switch to glasses for the duration and start with a fresh pair afterwards. Continuing to wear lenses through conjunctivitis is how a nuisance becomes a corneal problem.
What actually helps
For viral conjunctivitis, comfort measures rather than drops: cool compresses, artificial tears, and cleaning the lids gently with cooled boiled water on clean cotton wool. Antibiotic drops do nothing for a virus and are prescribed for it far too often.
For bacterial conjunctivitis, antibiotic drops for about five to seven days, with the eyelids cleaned before each dose so the medication reaches the eye rather than the crust.
For allergic conjunctivitis, antihistamine drops and oral antihistamines, plus identifying the trigger — which in a fan-cooled room is often dust or mould rather than anything outdoors.
Sunlight, salt water and things people put in their eyes
An inflamed eye is more sensitive to bright light, and the glare off water here is punishing. Sunglasses are genuinely therapeutic rather than cosmetic, and wraparound ones help most.
Salt water is not a treatment. People assume the sea will clean an infected eye and it does the opposite — it irritates an already inflamed surface and introduces whatever else is in the water that week.
Do not put breast milk, urine, lemon juice or any of the other things suggested in beach bars into your eye. Cooled boiled water and artificial tears are the correct fluids.
Chlorinated pool water is not a treatment either, despite a persistent belief that it disinfects things. It irritates an inflamed conjunctiva considerably, and on an under-chlorinated pool it introduces more than it removes. If your eye is red, the water is the one thing to stay away from entirely for a few days.
How long you are contagious, and diving
Viral conjunctivitis is contagious while the eye is red and watering, typically one to two weeks. Bacterial is generally no longer contagious after about twenty-four hours of antibiotic drops.
Do not dive with conjunctivitis. A mask seals contaminated water against the eye for the whole dive, the pressure change does the rest, and you will hand it to the next person who rents that mask.
Airlines occasionally refuse boarding for an obviously infected eye. If you are travelling within a day or two and it looks dramatic, get it seen and get a note — see medical certificates. And if you are in a group, assume it will go round: separate towels from the day the first person notices, hand gel in the room, and nobody sharing a pillow.
Frequently asked questions
Do I need antibiotic drops?
Only if it is bacterial. Viral conjunctivitis is commoner, and drops do nothing for it.
How long does pink eye last?
Viral, one to two weeks. Bacterial usually improves within a couple of days of starting drops.
Can I dive?
No. A mask holds contaminated water against the eye for the whole dive, and you will pass it to whoever rents that mask next.
Can I wear my contact lenses?
No. Switch to glasses until it has fully cleared, then start a fresh pair. Lenses through conjunctivitis risk a corneal ulcer.
When is a red eye an emergency?
Real pain, blurred vision, strong light sensitivity, or redness ringing the coloured part of the eye. Those are not conjunctivitis.
Should I tell my dive school?
Yes. Your mask needs proper disinfection, and continuing a course with a discharging eye spreads it around the boat.
Can a doctor come to my room?
Yes — a doctor hotel visit works well for this, and it keeps you from spreading it around a waiting area.
Who treats you, and at what hour
English-speaking doctors on site, 24 hours a day. That is the part worth dwelling on, because Koh Phi Phi has no hospital and no road off it. The nearest emergency department is a ferry away on the mainland, and the ferries stop at night — so between roughly sunset and morning, a clinic that is actually open is the only medical care on the island. We are part of the Takecare Clinic group operating across Krabi and Phuket, which is what makes onward referral and continuing treatment on the mainland straightforward rather than something you arrange yourself from a hotel room.
Getting seen
Doctor Phi Phi Takecare Clinic is 24 hours, every day — genuinely, not as a phone line. No appointment is needed at any point and there is no wrong time to turn up. Walk in, or reach us on +66 82 140 3858 or WhatsApp. If you would rather not move, ask for a doctor hotel visit and we will come to you. And if this turns out to be beyond what the island can handle, that same call is how the ferry and the hospital transfer start being arranged — which on Phi Phi is a process worth starting early rather than late.