Pink Eye In Babies: Signs, Symptoms, Causes And Treatment

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A pink eye in babies may result from an infection or allergy and is known as conjunctivitis. It may or may not be contagious. Often, conjunctivitis may resolve on its own, and medical treatment is usually not required.

The best way to prevent the condition from affecting your baby’s eyes is by avoiding the causative factors. Continue reading this post as we describe the causes of pink eye in infants, its symptoms, diagnosis, treatment, and preventive measures.

What Is A Pink Eye In Babies?

A pink eye is the generic name for an eye infection called conjunctivitis (1). It is one of the most common eye infections to affect people of all age groups including infants and toddlers. The affected part is the conjunctiva, which is a thin layer of tissue covering the white of the eyes and also the inside of the eyes. Hence the name conjunctivitis.

What Causes Pink Eye In Babies?

According to the US Center for Disease Control and Prevention, there are four types of pink eye: viral, bacterial, irritant, and allergen. All four causes display similar symptoms and each category has several agents/pathogens that can lead to a pink eye:

  1. Viruses: Viral conjunctivitis often co-exists with the common cold (2). Adenovirus is the most common viral pathogen since it causes both cold and conjunctivitis (3). Herpes simplex is another virus that can cause pink eye. Viral pink eye is less common among newborn babies, but older toddlers are susceptible to it (4).
  1. Bacteria: Numerous bacteria can lead to pink eye. The most common ones are Staphylococcus aureus (Staph infection bacterium), Streptococcus pneumoniae (Pneumonia bacterium), and Haemophilus influenzae (Influenza bacterium) (5). Bacterial conjunctivitis is more common among newborns who are a few days to weeks old.
  1. Irritants: Smoke, dust, and fumes of chemicals are common causes for irritant conjunctivitis.
  1. Allergens: Allergic conjunctivitis occurs due to the body’s reaction to an allergen, which is a substance that can cause allergy. Examples of allergens are pollen, dust mites, molds, pet dander, and some medicines. Allergic conjunctivitis is usually more common among infants with an existing allergic condition like eczema and asthma.

While several factors could lead to pink eyes in babies, finding out the exact cause of it in babies is important to provide the right treatment.

How Does A Baby Get Pink Eye?

Certain risk factors can increase an infant and toddler’s risk of acquiring the pink eye infection. They include:

  1. Catching the pathogen from someone: A family member with a pink eye or cold can pass the pathogen to the infant by holding them with contaminated hands.
  1. Touching eyes with dirty hands: Toddlers returning from outdoor play may rub their eyes with their dirt-laden hands and spread an irritant like pollen or a pathogen. Babies with cold may put hands in their mouth and then touch their eyes.
  1. Seasonal changes: There could be more pollen or dust in the air during certain seasons, which increases the likelihood of developing allergic conjunctivitis.
  1. Lifestyle: A baby could be allergic to the family pet, medicine, or to a plant in the surroundings – all of which can contribute to irritant and allergic conjunctivitis.
  1. Spending a lot of time at daycare: Infants and toddlers at daycares are always at a higher risk of getting several illnesses including pink eye. Transmission of a pathogen is faster in a crowded setting.

There are so many ways your little one can get conjunctivitis. It is thus essential to know how to spot the symptoms.

What Are The Symptoms Of Pink Eye In Babies?

A baby with conjunctivitis displays the following symptoms (6):

  1. Redness of the eye: Inflammation of the conjunctiva causes the blood vessels to become prominent and hence more visible across the white of the eye. The white of the eye has a pinkish-red tint and the blood vessels are noticeable. Viral conjunctivitis often begins with one eye and later spreads to the other one.
  1. Excessive tears: The eyes get watery due to surplus production of tears. Watery discharge from the eyes is more common in viral conjunctivitis.
  1. Irritation, burning, and feeling of a foreign body: The eyes feel irritated, sore, and have a constant burning sensation. Older toddlers may feel and complain about ‘something getting into their eyes’.
  1. Intense itching: The infant would rub their eyes frequently to ease the itching and irritation. Intense itching can be more common when the cause of pink eye is an allergy.
  1. Swelling of the conjunctiva: The eye appears swollen within the socket. It is due to the inflammation of the conjunctiva.
  1. Pus within eyelids: Pus is more common in bacterial conjunctivitis. Excess pus may ooze from the corner of the eyes.
  1. Crusty eyelashes: Eyelashes develop a layer of crust especially in the mornings. It can be more common when the baby also has pus, which dries overnight and forms crusts by morning.
  1. Trouble opening eyelids: If the baby has pus and crusting of eyelids, then they will also have trouble keeping their eyelids open. Eyelids will appear sticky with the pus discharge stretching out between the eyelids.

If fever is not resolving in two days, or the baby has swelling and pus discharge, or blurry vision, take the baby to a doctor. 

How Is A Pink Eye Diagnosed?

Doctors use the following steps for the diagnosis of conjunctivitis in infants:

  1. Eye examination: Your doctor will check the eye and look for symptoms like the redness of the eye and the inflammation of the conjunctiva. Other parameters such as the ability to open eyelids and clear vision are also checked.
  1. Associated symptoms: Viral conjunctivitis is often accompanied by a common cold, while an ear infection mostly accompanies pink eye due to bacteria. Checking for the other associated symptoms can give the doctor a lead and help in better diagnosis.
  1. Blood test: A laboratory blood test checks for virus, bacteria, and antibodies that tells the doctor about the precise nature of the underlying infection. But, generally, it is not required.

A proper diagnosis follows a course of treatment, which depends on the underlying cause.

How Is The Pink Eye In Infants Treated?

In most cases, conjunctivitis goes away on its own and treatment is rarely needed. Certain steps, however, help ease the symptoms and accelerate the rate of healing. Treatment options include (7) (8):

    1. Antibiotic eye drops: Antibiotic eye drops and ointments can only work in the case of bacterial conjunctivitis. Whether or not antibiotics are effective against bacterial conjunctivitis is not known, although small quantities of antibiotics help shorten the course of infection (9).

Always use the antibiotics in the prescribed quantity to prevent overdose and develop antibiotic resistance. Visit the doctor before using antibiotic eye drops. Most infants show an improvement in 2-6 days without antibiotic treatment for bacterial conjunctivitis.

  1. Antiviral eye drops: The body’s immune system clears away the virus causing viral conjunctivitis. However, if the infection is severe, then the doctor may prescribe antiviral eye drops. These drops usually work against potent viruses like herpes simplex. Viral conjunctivitis can take a week to two weeks to go away but may extend beyond two weeks if the pink eye infection is severe.
  1. Clearing the allergen/irritant off the eye: Wash your hands with soap, dry them, and use a sterile cotton ball to remove a visible allergen from the baby’s eyes gently. If the allergen is too small or lodged deep within the eye, then do not attempt removal and consult a doctor right away.

You can wash the allergen using water in the case of older toddlers. Make sure to keep your hands clean and use clean water, preferably clean drinking water. Pour the water gently over the eye to rinse the allergen away. If the child does not get relief, then consult the doctor.

Adults with conjunctivitis often use cold compresses and saline drops for eyes. However, such infection management techniques may not be safe for a baby. Some mothers may pour a small quantity of breast milk into the infected eye of the infant. But there is no scientific evidence that breast milk is an effective cure for conjunctivitis in babies (10).

It is best to avoid any home remedies for your baby’s pink eyes since we do not know how the infant’s eye would respond to a home remedy. If the eyes get too watery or sticky, then use a sterile cotton ball to clean them gently. The doctor can prescribe an antiseptic liquid to soak the cotton ball in before cleaning the eyelid. Always clean externally and never inside the eye.

Pink eye seldom causes any lasting problems. Complications can be pervasive among infants with immunosuppressive diseases like HIV/AIDS or cancer. Pink eye in babies is mostly a self-limiting infection and resolves without any complications (11). Nevertheless, prevention is always the best option.

How To Prevent Pink Eyes In Babies?

Preventing pink eye in babies is like avoiding any other illness. Here is what you must do to protect your child from conjunctivitis (12):

  1. Maintain hygiene: Keep your baby’s surroundings and personal items clean. Ask your toddler to wash their hands every time they come home from outdoors. Also, teach them never to rub their eyes with fingers.
  1. Avoid allergens and irritants: If your baby has allergies, then take adequate steps to prevent exposure to potential allergens. Keep the baby away from chemicals, automobile exhaust fumes, and other potential airborne irritants.
  1. Avoid contact with those infected: Keep baby away from family members who are unwell with infections like the common cold. If the mother has an infection, then she must wash her hands before handling the baby. Wear a face mask while breastfeeding the baby to prevent the transfer of pathogens.
  1. Vaccinate: Get the child vaccinated for some common viral infections such as influenza and pneumonia bacteria that can cause pink eyes.

Conjunctivitis or pink eye in babies can be caused by viruses, bacteria, or allergens and transmitted when in contact with an infected person. The symptoms of pink eye, such as red eyes and excessive tear production, usually resolve on their own. However, doctors usually prescribe eye drops and eyewashes to assist the recovery. It is advised to refrain from trying any home remedies to treat conjunctivitis in babies unless your doctor has approved them. Further, vaccinate your child and maintain proper hygiene to avoid exposing your child to such infections.

References:

MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.
1. Pink Eye: Usually Mild and Easy to Treat
2. M. Marshall, Most cases of pink eye (conjunctivitis) don’t require antibiotics; Harvard Medical School
3. Adenoviruses; US Centers for Disease Control and Prevention
4. T. Senaratne & C. Gilbert, Conjunctivitis; National Center for Biotechnology Information
5. Conjunctivitis (Pink Eye): Causes; US Centers for Disease Control and Prevention
6. Conjunctivitis (Pink Eye): Symptoms; US Centers for Disease Control and Prevention
7. Facts About Pink Eye; National Eye Institute
8. Conjunctivitis (Pink Eye): Treatment; US Centers for Disease Control and Prevention
9. Pinkeye (Conjunctivitis); American Academy of Pediatrics
10. Breastmilk as medicine?; La Leche League Canada
11. Conjunctivitis (Pink Eye); Cornell University
12. Conjunctivitis (Pink Eye): Prevention; US Centers for Disease Control and Prevention
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Dr. Shashidhar A

(MD)
Dr. Shashidhar is a qualified pediatrician and neonatologist currently practicing at St John's Medical College and Tiny Tots Clinic in Koramangala, Bangalore. He is a part of an accomplished team taking care of preterm and sick newborns until discharge and follow up. He is a teacher at various levels from undergraduate to post-doctoral medical students. Keenly interested in different aspects... more

Rohit Garoo

Rohit Garoo is a zoologist-botanist turned writer with over 8 years of experience in content writing, content marketing, and copywriting. He has also done an MBA in marketing and human resources and worked in the domains of market research and e-commerce. Rohit writes topics related to health, wellness and development of babies. His articles featured on several notable websites, including... more