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Having a red eye (pink eye) is a common symptom in children, in which the white part of the eye (sclera) and inside the eyelids may become red. But it is important to remember that it is just a symptom, and not in itself a disease. There are many causes of a red eye in children.
One of the most common causes is bacterial conjunctivitis, with redness and green/yellow drainage and this is what most people think of when they hear the words pink eye. But there are many other causes, including viral infections, allergies, trauma, etc., and with many causes similar symptoms, including redness, itching, and swelling.
In addition to the prescribed treatment for the cause of your child's pink eye, you can also often offer symptomatic treatment with warm compresses (or perhaps cool compresses for allergies), especially to wipe away any discharge or crust. Clean cotton balls are also good for doing this so that you can dispose of them and get new ones each time.
Over the counter eye drops for redness and itching can also often be used.
Avoid letting your child wear her contact lenses when she has a red eye.
To prevent your child from getting an infectious cause of pink eye, you should encourage them to wash their hands regularly and avoid rubbing or touching their eyes.
- Bacterial conjunctivitis is one of the most common causes of a red eye in children. Additional symptoms include a yellow-green purulent discharge and matting. Other symptoms might include burning, photophobia, and itching. The most common bacteria that cause pink eye include H. influenzae (which may cause an ear infection at the same time) and S. pneumoniae. Treatment of bacterial conjunctivitis is usually with topical antibiotic eye (ophthalmic) drops, which might include Polytrim, Tobramycin (Tobrex, TobraDex), Gentamycin (Garamycin, Gentacidin) and Sulfonamides (Bleph-10), although newer fluoroquinolone antibiotics are being used more often because they are thought to work better, with better coverage and less resistance than the other antibiotics. Examples of these newer medications include Ciloxan, Ocuflox and Quixin. Vigamox is an even newer, fourth generation, fluoroquinolone and can be used just three times a day for seven days.
If your child is on an oral antibiotic, you may not need to use antibiotic eye drops, unless your child is on amoxicillin or isn't getting better.
One of the big questions in kids with bacterial conjunctivitis is 'when can they return to school or daycare?' And the answer is usually about 24 hours after beginning treatment with an antibiotic.
- Viral conjunctivitis is another cause of pink eye in children. In addition to redness, symptoms may include itching and a clear or white discharge. Children may also have other viral symptoms, such as a runny nose, cough or sore throat. Many children with viral conjunctivitis also have an enlarged lymph node in front of their ear (preauricular adenopathy).
Adenovirus is a virus that can cause pink eye, which is usually accompanied by a sore throat.
HSV (herpes simplex virus) is a more serious viral infection of the eye and usually affects just one eye and may cause pain. Children will also often have vesicles on the skin around the eye.
- Allergic conjunctivitis. Allergies are another common cause of pink eye. Other symtoms usually include tearing and itching and there is often a personal or family history of allergies. Chemosis, swelling of the white part of the eye is also often found in kids with allergic conjunctivitis. There are many allergy eye drops that can help treat this kind of pink eye, including Alocril, Patanol and Zaditor.
- Trauma or a foreign body. A child's eye can also be red if it is hit with something (often causing a corneal abrasion) or has something stuck in it (like a piece of sand or eyelash). This should especially be considered if the redness only affects one eye.
- Newborns. New born babies often have red eyes or discharge and it is often caused by chemical irritation from the use of silver nitrate drops. More serious causes can include infections with Neisseria gonorrhoeae or Chlamydia tracheomatis, both of which are STDs and can be transmitted from an infected mother.
- Blocked tear duct. Infants who can repeated episodes of pink eye or simple tearing likely have a blocked tear duct (dacryostenosis).
- More serious causes of a red eye can include acute glaucoma and iritis. Be sure to seek medical attention (perhaps from a Pediatric Ophthalmologist?) if your child's pink eye isn't quickly getting better, or if he also has decreased vision and/or severe pain.
Applying Eye Medications
The other big problem when faced with a child that has pink eye, is how to you get your kids to sit still so that you can get the eye drops in?
The usual recommendation is to sit your child down, tilt his head back, gentely pull the lower eye lid down and place the eye drops or ointment into his eye.
Another method, especially if the above method isn't successful, involves tilting your child's head back, having him close his eyes and then placing the drops on the inner corner of his eyes and then have him open his eyes. The drops should get all over his eyes with this method.
An eye ointment can usually be used for newborns and infants. Older kids often don't like the blurry vision that can accompany using an eye ointment.
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