Conjunctivitis in children and infants causes symptoms and rapid treatment

Many infants and children suffer from a common yet very bothersome condition: conjunctivitis, also known as “pink eye.” This condition causes eye redness, continuous tearing, different types of discharge, and sometimes swollen eyelids, which often worries parents and makes them look for quick and effective treatment options.In this Dalili Medical article, we will uncover the main causes of conjunctivitis in infants and children, the most important symptoms to watch for, practical prevention tips, and the latest medical and surgical treatment methods. With this information, you as a parent or caregiver will be able to protect your child and reduce complications quickly and safely.

What is Conjunctivitis in Infants and Children?

Conjunctivitis, also known as “pink eye,” is redness or inflammation of the thin membrane that covers the eyes and eyelids.
It can be caused by:

Bacteria
Viruses
Allergies
External irritants

Is Conjunctivitis Contagious?

Yes: Bacterial and viral conjunctivitis are highly contagious.
No: Allergic and irritant conjunctivitis are usually not contagious.

How Can I Differentiate Between Types of Conjunctivitis?

Type	Distinctive Symptoms
Bacterial	Thick yellow or green discharge, eyelids sticking together after sleep
Viral	Watery discharge, continuous tearing, moderate redness
Allergic	Intense itching, excessive tearing, mild redness, no pus

Does Conjunctivitis Affect Vision?

Usually not, if treated promptly.
Severe or untreated cases may cause corneal ulcers, which can temporarily or permanently affect vision.

Can Conjunctivitis Recur?

Yes, especially in:

Allergic conjunctivitis
Blocked tear ducts in infants

Maintaining good hygiene and regular follow-ups help reduce recurrence.

Can Newborns Get Conjunctivitis at Birth?

Yes, this is called Neonatal Conjunctivitis.
It may be caused by:

Maternal infections (e.g., gonorrhea or chlamydia)
Irritation from preventive eye drops after birth

It requires immediate medical care to prevent complications.

Can Conjunctivitis Heal Without Medication?

Some viral or irritant cases may resolve on their own within a few days with supportive care.
Bacterial conjunctivitis or neonatal conjunctivitis require specific medical treatment.

Does Conjunctivitis Affect Sleep or Feeding?

Yes. Pain, itching, or heavy discharge can disturb infants, affecting both sleep and feeding.

Are Eye Drops Safe for Infants?

Not all drops are safe. Only prescribed drops or ointments suitable for the child’s age and condition should be used.

How Long Do Symptoms Last?

Type	Duration of Symptoms
Bacterial	5–7 days with antibiotic treatment
Viral	1–2 weeks
Allergic	Depends on exposure to allergens
Neonatal	Depends on how early treatment is started

Can a Child Go to School or Daycare with Conjunctivitis?

No: If it’s bacterial or viral (contagious), the child should stay home until discharge improves or as advised by a doctor.
Yes: If it’s allergic or irritant conjunctivitis, attendance is usually fine.

How to Clean a Child’s Eye Safely?

Use a clean cotton pad or sterile gauze.
Wipe from the inner corner to the outer corner gently.
Use a new pad for each wipe; do not reuse.

Can Conjunctivitis Become Recurrent?

Yes, especially in children with:

Chronic allergies
Blocked tear ducts
Poor hygiene or unclean environments

Good hygiene and prevention strategies reduce recurrence.

Difference Between Conjunctivitis and the Common Cold?

Conjunctivitis (bacterial/viral): Red eyes, discharge, tearing, eyelid swelling.
Cold/flu: Runny nose, sneezing, fever; conjunctivitis may sometimes occur as a secondary symptom.

Causes of Conjunctivitis in Infants and Children

1. Bacterial Causes

Caused by bacteria like Staphylococcus or Streptococcus pneumoniae.
Symptoms: intense redness, thick yellow/green discharge, eyelids stuck together after sleep.
Highly contagious, spreads easily among children.

2. Viral Causes

More common in older children, often linked to cold or flu viruses.
Symptoms: red eyes, watery discharge, light sensitivity, persistent tearing.
Very contagious, lasting several days to 2 weeks.

3. Allergic Conjunctivitis

Triggered by dust, animal dander, or certain eye products.
Symptoms: redness, itching, tearing, mild eyelid swelling, no pus.
Often seasonal or related to specific allergens.

4. Neonatal Conjunctivitis (Newborn Conjunctivitis)

Appears within the first 28 days after birth.
Causes: maternal infections (e.g., gonorrhea, chlamydia) or chemical irritation from eye drops.
Symptoms: severe redness, mucous or pus-like discharge, swollen eyelids, sometimes difficulty opening eyes.
Requires urgent medical attention.

Symptoms of Conjunctivitis in Infants and Children

1. General Symptoms (all types)

Eye redness (most common sign)
Excessive tearing
Swollen eyelids (especially in infants)
Itching or irritation (in older children)
Eye discharge (type depends on cause)

2. Bacterial Conjunctivitis

Thick yellow/green discharge
Eyelids stuck after sleep
Intense redness
Mild swelling around the eye
May affect one or both eyes

3. Viral Conjunctivitis

Moderate redness
Watery discharge
Continuous tearing
Light sensitivity in some cases
Usually affects both eyes

4. Allergic Conjunctivitis

Mild to moderate redness
Intense itching
Excessive tearing
Mild swelling
Both eyes affected
No pus discharge

5. Neonatal Conjunctivitis

Appears within the first 28 days after birth
Severe redness
Mucous or pus-like discharge
Swollen eyelids
Difficulty opening the eyes
Needs urgent medical treatment

Types of Conjunctivitis in Infants and Children

1. Bacterial Conjunctivitis

Cause: Bacteria such as staphylococcus or pneumococcus.
Age group: From newborns to older children.
Symptoms: Intense redness, thick yellow or green discharge, eyelids sticking together after sleep. Usually starts in one eye and may spread to the other.

2. Viral Conjunctivitis

Cause: Cold or flu viruses.
Age group: More common in older children, rare in newborns except during delivery exposure.
Symptoms: Moderate redness, watery discharge, continuous tearing, light sensitivity. Often affects both eyes.

3. Allergic Conjunctivitis

Cause: Allergens such as dust, pet dander, or certain eye products.
Age group: Usually in older children, rarely in infants unless exposed to strong irritants.
Symptoms: Severe itching, watery eyes, mild-to-moderate redness, mild eyelid swelling, no pus. Usually appears in both eyes.

4. Neonatal Conjunctivitis

Cause: Infections during delivery (e.g., gonorrhea, chlamydia) or irritation from chemicals used after birth.
Age group: First 28 days after birth.
Symptoms: Severe redness, mucous or pus-like discharge, swollen eyelids, difficulty opening the eye.
Note: Requires urgent medical care to avoid complications.

5. Irritant Conjunctivitis

Cause: Foreign particles, harsh soaps, or irritating eye solutions.
Age group: Any age.
Symptoms: Mild redness, watery eyes, irritation or burning, no pus. Usually improves once the irritant is removed.

Stages of Conjunctivitis in Children and Infants

Early Stage (Irritation)
- Mild redness, watery eyes, mild itching.
- No pus present.
- Could be caused by bacteria, viruses, or external irritants.
Inflammatory Stage (Discharge)
- Bacterial: Thick yellow/green pus, sticky eyelids.
- Viral: Watery discharge, continuous tearing, moderate redness.
- Allergic: Watery eyes, severe itching, redness, no pus.
- Mild eyelid swelling may occur.
Severe Stage (Complications Risk)
- Severe redness, noticeable eyelid swelling.
- Heavy discharge causing complete eyelid sticking.
- Light sensitivity, pain, difficulty opening the eye.
- More common in untreated bacterial infections or neonatal conjunctivitis.
Recovery Stage
- Symptoms gradually improve after proper treatment.
- Redness reduces, discharge clears, eyelid swelling subsides.
- Older children may need lubricating or anti-allergy eye drops.

Diagnosis of Conjunctivitis

Clinical Examination
- Direct eye exam by an eye specialist.
- Observing redness, discharge type, eyelid swelling, and sensitivity to light.
Medical History
- Duration of symptoms.
- Recent infections (cold, flu).
- Allergy history.
- Birth details for newborns to rule out neonatal infections.
Additional Tests (if needed)
- Swab of eye discharge for bacterial/viral identification.
- Allergy testing in chronic or recurrent cases.
- Special tests for newborns within the first month of life.
Differential Diagnosis
- Ruling out blocked tear duct, keratitis, or other irritations.

Possible Complications

Eye-related Complications
- Corneal damage (especially untreated bacterial cases).
- Severe eyelid swelling making it hard to open the eye.
- Persistent discharge or sticky eyelids.
- Chronic redness or recurrent irritation.
General Health Issues
- Infection spreading to the other eye or body.
- Secondary infections in infants with weak immunity.
- Disrupted sleep or feeding due to discomfort.
Long-term Risks
- Temporary or rare permanent vision problems.
- Recurrent or chronic conjunctivitis (common in allergies or blocked tear ducts).
- Emotional distress from constant discomfort.

Treatment of Conjunctivitis in Infants and Children

1. Bacterial Conjunctivitis

Treatment: Antibiotic eye drops or ointments (e.g., Tobramycin, Fortifloxacin, Erythromycin).
Duration: 5–7 days as prescribed.
Tips: Clean discharge before applying, continue treatment even if symptoms improve.

2. Viral Conjunctivitis

Usually clears in 1–2 weeks.
Supportive care:
- Artificial tears.
- Cold compresses.
- Pain relief if needed.
Note: Antibiotics are not effective unless a bacterial infection develops.

3. Allergic Conjunctivitis

Treatment:
- Anti-allergy eye drops.
- Artificial tears.
- Avoid triggers (dust, pets, cosmetics).
- Severe cases: short-term steroid drops under medical supervision.

4. Neonatal Conjunctivitis

Requires urgent treatment depending on the infection:
- Gonorrhea: Ceftriaxone injections or antibiotic ointments.
- Chlamydia: Oral antibiotics or medicated drops.
Note: Quick intervention prevents corneal damage or severe complications.

5. Irritant Conjunctivitis

Remove the irritant immediately.
Rinse eye with sterile saline or clean water.
Artificial tears for comfort.
Antibiotics only if a secondary infection develops.

Surgical or Medical Procedures (Rare Cases)

Neonatal severe conjunctivitis: May need continuous rinsing or tear duct procedures.
Blocked tear ducts: Probing or stent placement in chronic cases.
Corneal complications: Specialized treatment or surgical repair in very rare cases.

Home Care and Prevention Tips for Parents

Hygiene
- Wash hands before/after touching eyes.
- Clean discharge gently with sterile cotton.
Eye Care
- Use sterile saline if needed.
- Avoid rubbing eyes.
- Cold compresses for relief in older children.
Preventing Spread
- Do not share towels, pillows, or toys.
- Wash bedding and clothing in hot water.
- Isolate child if infection is contagious.
Medication Compliance
- Use drops/ointments exactly as prescribed.
- Complete full treatment course.
Special Care for Newborns
- Seek medical attention immediately for eye discharge or swelling.
- Avoid over-the-counter drops without prescription.
Monitoring
- Track symptoms daily.
- Urgent medical care if severe swelling, thick pus, light sensitivity, or vision problems appear.
Long-term Prevention
- Teach older kids proper handwashing.
- Reduce allergen exposure.
- Maintain a clean environment.