Red Eye in London: When Is It Urgent, and Do You Need Antibiotics?

A red eye after a long day can seem minor. Most cases settle, but the right question is not simply whether it looks like conjunctivitis. Pain, vision changes and contact lens use can point to a more serious problem. Check these signs before waiting for a routine appointment or trying antibiotic drops.

When is a red eye an emergency?

Go to A&E or call 999 if a red eye comes with any change in sight, pain when looking at light, a severe headache with nausea, a very dark red eye, a difference in pupil size, an eye injury, a chemical splash or something stuck in the eye. The NHS lists these as immediate-action signs. Do not drive yourself to A&E. A routine GP appointment is not the right first step in these circumstances.

What if I wear contact lenses?

A red eye in a contact lens wearer needs urgent assessment by a GP or optician, or advice from NHS 111, even if it initially resembles ordinary conjunctivitis. An eye infection can affect the cornea and needs prompt examination. Take out the lenses and do not wear them until a clinician says it is safe. Tell the assessor that you use lenses and whether there is pain, discharge or blurred vision.

Could it be conjunctivitis?

Conjunctivitis can make eyes feel gritty, itchy or watery, and may leave a sticky discharge. Infection and allergy are different causes; a red eye is not automatically conjunctivitis. The NHS says conjunctivitis often improves within a couple of weeks without treatment. If there is eye pain, light sensitivity, a change in sight or a very red eye, seek urgent GP or NHS 111 advice instead of treating it as uncomplicated conjunctivitis.

Do I need antibiotic eye drops?

Not necessarily. Antibiotics will not treat viral or allergic conjunctivitis. If a clinician thinks an infection is bacterial, they may prescribe them, but the decision depends on symptoms and examination. Do not use leftover eye drops or share them. A pharmacist can advise on symptom relief and when you should be assessed.

What can I do safely while waiting?

Do not rub the eye and avoid contact lenses. For likely conjunctivitis, the NHS suggests gently cleaning crusts from the eyelids with cooled boiled water and a fresh cotton wool pad for each eye. A cool flannel may help discomfort. Wash hands often and do not share towels or pillows if discharge suggests an infection. These steps do not replace urgent assessment when warning signs are present.

When does a routine assessment make sense?

Ask a GP or optician if you have sticky discharge, a child under two has a red eye, symptoms around the eyelids persist for more than a few days, or you are worried. A baby under 28 days with red eyes needs urgent assessment. If conjunctivitis symptoms have not cleared in seven days, seek GP advice. A clinician can check what is causing the redness and refer to an eye specialist when needed.

How can The Online GP help?

For a mild red eye without urgent signs, a same-day phone consultation is listed at £59; an in-person GP appointment in Marylebone is listed at £220. A phone call can help you describe symptoms and decide the next step, but an eye examination may be needed to identify the cause. Do not book routine private care instead of urgent eye services when vision, pain, contact lenses or injury raise concern.

Telephone GP: https://www.theonlinegp.com/services-store/p/same-day-telephone-gp

In-person GP: https://www.theonlinegp.com/services-store/p/same-day-urgent-in-person

Ask the team which appointment fits: https://www.theonlinegp.com/contact

Frequently asked questions

Can I wait until tomorrow with a red eye? Only if there are no urgent warning signs. Contact lens use, severe pain or worsening sight changes the urgency.

Does sticky discharge prove I need antibiotics? No. The cause and severity matter, and viral or allergic conjunctivitis will not respond to antibiotics.

Can I keep wearing my contacts? No. Leave them out until the eye is better and a clinician advises it is safe.

Sources: NHS red eye https://www.nhs.uk/symptoms/red-eye/ ; NHS conjunctivitis https://www.nhs.uk/conditions/conjunctivitis/

General information, not a personal diagnosis. Written and reviewed by the clinical team at The Wellness. Updated September 2026.