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The infection usually begins with one eye, but may spread easily to the other.
Both bacterial and viral infections are contagious and passed from person to person, but can also spread through contaminated objects or water.
The gritty and/or scratchy feeling is sometimes localized enough for patients to insist they must have a foreign body in the eye. Bacteria such as Chlamydia trachomatis or Moraxella can cause a non-exudative but persistent conjunctivitis without much redness.
Bacterial conjunctivitis may cause the production of membranes or pseudomembranes that cover the conjunctiva.
Classification can be either by cause or by extent of the inflamed area.
Blepharoconjunctivitis is the dual combination of conjunctivitis with blepharitis (inflammation of the eyelids).