So your kiddo just woke up with eyes glued shut with crust, now what?
As pediatricians, we hear this story all the time! In fact, it may have even happened at my house recently.
So, what are we going to do with the red, goopy, watery eye?
Pink eye, or conjunctivitis, is caused by inflammation of the thin membrane that lines the inner side of our eyelids and white part of our eyes. This can arise due to 3 common causes:
– Allergic conjunctivitis
– Viral conjunctivitis
– Bacterial conjunctivitis
Being able to differentiate helps us know what treatment is right for your child.
Allergic conjunctivitis is caused by allergies. It typically causes redness and itching. There is often little discharge, and the discharge that is present tends to be watery rather than thick. Sometimes other allergy symptoms will also be present. Allergic conjunctivitis is treated with antihistamines most often. They can be applied directly to the eye in the form of an antihistamine eye drop or given orally, like the oral antihistamines, loratadine or cetirizine.
Viral conjunctivitis is by far the most common type of infectious pink eye we see in pediatrics. It typically affects both eyes, though often one after the other. It can also cause irritation or itching, and discharge which is seen primarily as yellow crust. As with most viral infections, treatment is supportive and we rely on the body to fight the infection. Getting a washcloth wet prior to cleaning the eyes in the morning is helpful. If eyes have drainage through the day, gently wipe with a tissue and then wash hands as this passes easily from person to person.
Bacterial conjunctivitis is also seen in kids. It can occur in one or both eyes, is characterized by redness, and usually LOTS of discharge from the eyes. Sometimes in younger children, there will be an ear infection at the same time. This is why we always check the ears! This is properly treated by antibiotics – if it is just the eyes, we use drops, but we use oral antibiotics if both eyes and ears are infected.
Now, when can my kid go back to school? The short answer is when their eyes are improving and no longer having discharge. However with allergic conjunctivitis, you aren’t contagious and there is no need for exclusion. When it is considered to be infectious, we generally advise that you wait until discharge resolves as young children are so good at sharing everything with their friends at school!
We are seeing a lot of viral conjunctivitis in the office these days, so wash those hands in hopes it doesn’t spread its way through your house!
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