Pink Eye or Conjunctivitis is a very bothersome condition that is very contagious but often looks worse than it is. We are talking about the eyes, however, and want to make sure you know what pink eye is, how to treat it, how to prevent it, and when to worry.
There are three main reasons children get a pink eye.
1. Infection (either viral or bacterial)
3. Injury, irritant or foreign body
When pink eye is caused by infection, the culprit is usually a virus, and it is quite contagious. Children will complain about discomfort, and possibly light sensitivity. The eye is, of course, pink or red, and it can affect one or both eyes. A sticky discharge is present, which may be thick or clear. If both eyes are affected with a clear discharge, and your child has a cough and cold, they likely have a viral cause. If one eye is affected with a thick yellow discharge without cold symptoms, they probably have a bacterial pink eye. Distinguishing a viral cause from a bacterial cause based on examination alone is more art than science, and culturing the discharge is rarely done. We tend to err on the side of caution and treat most cases of suspected infectious pink eye with antibiotoc drops or ointment.
Allergy can also cause pink eye. Here the discharge is far more watery, affects both eyes, and is accompanied by itchiness and other common allergy symptoms (sneezing and runny nose). It also helps to know if you have a history of previous allergy symptoms.
Injury or foreign body should be apparent from the child's story of getting hit on or near the eye, with a sudden appearance of pain and redness. There may also be exposure to irritation substance like smoke, sand or chemicals.
Injury and allergy related pink eye is not contagious, but because it is sometimes hard to distinguish,it is best to treat all pink or red eyes as contagious. If a sudden appearance of pain or redness occurs, you should immediately call or go to the emergency room if the pain is severe. If your child develops a pink or red eye, but is otherwise feeling well and does not have a fever or swollen eyelid, you may treat this initially at home with a cool or warm compress (whichever your child will tolerate), keeping the area clean, using acetaminophen or iburofen and contacting us for an office visit. Make sure to wash your hands and keep the child's hands clean to keep it from spreading. If you call we may choose to order antibiotic drops at your pharmacy or we may prefer to see you child in the office before prescribing. It depends on the particular situation and the age of the child.
If we feel your child has pink eye caused by allergies, medication other than antibiotics will be used. These can be eye drops or even a nasal spray. If other allergy symptoms are present, these too will be treated, to maximize the comfort for your child. Some eye injuries can be managed in our office but many cannot. We only have limited equipment and facilites to proprely diagnose and treat injuries and foreign bodies of the eye. Because of this you may be asked to go to the emergency room for evaluation.
Using eye drops can be a challenge, but it is usually a two-person job. If the child will absolutely not cooperate you may consider laying (or holding) the child down and putting the proper number of drops in the inner corner of the closed eye. When the child opens the eye, the drops will flow in. This is not the ideal way to deliver the drops, but it is certainly better than no drops or especially better than trying to hold open the eyelids.
If there is no improvement with treatment after 2 days, or if a fever, eyelid swelling or redness occur please call our office. Children will be restricted from school or day care for at least 24 hours after treatment starts so it's always good to plan ahead.
Helpful links for this topic:
Keep Kids Healthy