Commonly known as pinkeye, conjunctivitis is an inflammation of the conjunctiva, the clear membrane that covers the white part of the eye and lines the inner surface of the eyelids. It is a fairly common condition and usually causes no danger to the eye or your child's vision. It can be caused by bacteria, viruses, allergies such as hay fever, and irritants in the environment. With antibiotic treatment, it typically goes away without complications.
Causes of Conjunctivitis
Many different bacteria and viruses can cause pinkeye. The organisms that cause the sexually transmitted diseases (STDs) gonorrhea and chlamydia can also infect the eyes and cause conjunctivitis. This can occur in sexually active people and in newborns who acquire the infection at birth from their mothers.
Conjunctivitis also can be caused by some viral infections, such as adenovirus, and can occur in someone battling a cold or the flu. Allergic conjunctivitis occurs more frequently among kids with allergic conditions such as hay fever. It's typically seen only at certain times of the year, especially when caused by allergens such as grass or ragweed pollen. Other allergy-causing substances like animal dander or dust mites can cause year-round symptoms of conjunctivitis. Chemicals such as those in chlorine and soaps or air pollutants such as smoke and fumes also can lead to pinkeye.
Conjunctivitis in Newborns
Many babies are born with a narrow or blocked tear duct, which can lead to pinkeye, and redness and tearing in one or both eyes. This usually resolves on its own within a few months.
Newborns are also susceptible to infectious conjunctivitis, which can be serious. Sexually transmitted bacteria can pass from an infected mother's birth canal into her baby's eyes during delivery. These bacteria can cause symptoms of conjunctivitis in babies during the first month of life, and can lead to serious eye damage if left untreated.
Symptoms of Conjunctivitis
The different types of conjunctivitis can have different symptoms. In addition, symptoms may vary from child to child.
One of the most common symptoms is discomfort or pain in the eye, which may feel like the sensation of having sand in the eye. Many kids have redness of the eye and inner eyelid, swollen eyelids,sensitivity to bright light, and itchiness and tearing.
Conjunctivitis can cause discharge from the eyes, which may cause the eyelids to stick together when a child awakens in the morning.
Ear infections can occur in some kids who are diagnosed with bacterial conjunctivitis because similar bacteria can cause both infections.
All types of infectious conjunctivitis are contagious. A child can first become infected from direct contact with someone who has the infection or something that person has touched, such as a used tissue. It also spreads through coughing and sneezing. In addition, certain viruses spread in the summertime when kids swim in contaminated water or share contaminated towels.
Conjunctivitis caused by allergies, or irritants in the environment such as chemicals, are not contagious.
To prevent infectious conjunctivitis, teach kids to wash their hands often with warm water and soap. They also should not share eyedrops, tissues, eye makeup, washcloths, towels, or pillowcases with other people.
A child who already has conjunctivitis should wash his or her hands after touching the eyes, since conjunctivitis can easily spread from one eye to the other on contaminated hands or tissues. Be sure to wash your own hands thoroughly after touching your child's eyes, and throw away items like gauze or cotton balls after they've been used. Wash towels and other linens that your child has used in hot water separately from the rest of the family's laundry to avoid contamination.
If you know your child is prone to allergic conjunctivitis, keep windows and doors closed on days when the pollen is heavy, and dust and vacuum frequently to limit allergy triggers in the home. Irritant conjunctivitis can only be prevented by avoiding the irritating causes.
Many cases of neonatal conjunctivitis are prevented by screening and treating pregnant women for STDs. The mother-to-be may have bacteria in her birth canal even if she shows no symptoms, which is why prenatal screening is important. Other cases are prevented by treating newborns with antibiotic ointment or eyedrops in the delivery room. This practice in certain countries, including the United States, has significantly decreased the rate of conjunctivitis due to gonorrhea in newborns and the blindness it can cause. To prevent conjunctivitis from herpes virus, a cesarean section is recommended when the mother has active genital herpes lesions at the time of delivery.
Most cases of pinkeye are treated with prescription antibiotics or ointments for the eye.
Generally, this treatment is well tolerated by kids, although it can be a challenge to get drops into their eyes several times a day. If you're having this trouble, put the drops on the inner corner of the eye — when the child opens his or her eye, the medicine will flow into it. If you continue to have difficulty, ask your doctor about antibiotic ointment. It can be applied in a thin layer where the eyelids meet, and will melt and enter the eye.
If your child has allergic conjunctivitis, your doctor may prescribe anti-allergy medication in pill, liquid, or eyedrop form.
To make kids comfortable during a bout of conjunctivitis, offer cool or warm compresses and acetaminophen or ibuprofen, if necessary. You can clean the edges of the infected eye carefully with warm water and gauze or cotton balls. This technique also can remove the crusts of dried discharge that may cause the eyelids to stick together first thing in the morning.
When to Call the Doctor
If you think your child has conjunctivitis, it is important to contact your child's doctor to try to determine what is causing the conjunctivitis and the best form of treatment.
Other serious eye conditions can mimic infectious conjunctivitis, so if your child complains of severe pain, changes in eyesight, or sensitivity to light, your child should be reexamined. If the conjunctivitis does not improve after 2 to 3 days of treatment, or after a week when left untreated, call your child's doctor.
If you notice increasing swelling, redness, and tenderness in the eyelid and skin around the eye, especially if your child also has a fever, it may mean the infection has spread to the tissues around the eye. This will require antibiotic treatment and close follow-up.