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Conjunctivitis in Children

What is conjunctivitis?

Conjunctivitis is an inflammation of the conjunctiva of the eye. The conjunctiva is the membrane that lines the inside of the eyelids and covers the eyeball. Conjunctivitis is also known as “pink eye.”

In children, the condition is often grouped into either newborn conjunctivitis or childhood conjunctivitis. There are different causes and treatments for each group.

Types of newborn conjunctivitis include:

  • Chemical conjunctivitis. This is a rare condition caused by irritation from eye drops that are given to newborn babies to help prevent a bacterial infection. The eyes are usually red and inflamed, starting a few hours after the drops have been put in the eye. The symptoms last for 24 to 36 hours. This type of conjunctivitis usually doesn’t need treatment.
  • Gonococcal conjunctivitis. This is caused by bacteria called N. gonorrhea. A newborn baby can pick up this type of bacteria during vaginal birth from an infected mother. This type of conjunctivitis may be prevented with the use of eye drops in newborns at birth. The condition causes eyes that are very red, with swelling and thick fluid leaking from the eyelids. Symptoms usually start about 2 to 4 days after birth. Treatment often includes antibiotics through an intravenous (IV) catheter.
  • Inclusion conjunctivitis. This is caused by an infection with Chlamydia trachomatis. The symptoms include red eyes, swollen eyelids, and fluid leaking from the eyelids. Symptoms usually start 5 to 12 days after birth. Treatment often includes oral antibiotics.
  • Infection from other bacteria. After the first week of life, other bacteria may be the cause of conjunctivitis in the newborn. The eyes may be red and swollen with some drainage. Treatment depends on the type of bacteria that have caused the infection. Treatment usually will include antibiotic drops or ointments to the eye, warm compresses to the eye, and proper hygiene when touching the infected eyes.

Childhood conjunctivitis is a swelling of the conjunctiva and may also include an infection. It is a very common problem in children. Large outbreaks of conjunctivitis are often seen in daycare settings or schools. The most common causes of childhood conjunctivitis are:

  • Bacteria
  • Viruses, including the herpes virus
  • Allergies

If the condition is caused by an infection, it’s important to know that the infection can spread from one eye to the other by touching the affected eye or fluid from the eye. The infection can also spread to other people. Fluid from the eye is still contagious for 24 to 48 hours after starting treatment.

What causes conjunctivitis?

There are many different causes of conjunctivitis. The most common causes are:

  • Bacteria such as:
    • Staphylococcus aureus
    • Haemophilus influenza
    • Streptococcus pneumoniae
    • Neisseria gonorrhea
    • Chlamydia trachomatis
  • Viruses such as:
    • Adenoviruses
    • Herpes virus
  • Chemicals in newborn eye drops
  • Allergies

Who is at risk for conjunctivitis?

A child who has had contact with any of the below are at risk for the condition:

  • Staphylococcus aureus
  • Haemophilus influenza
  • Streptococcus pneumoniae
  • Neisseria gonorrhea
  • Chlamydia trachomatis
  • Adenoviruses
  • Herpes virus
  • Chemicals in newborn eye drops

What are the symptoms of conjunctivitis?

Symptoms can occur a bit differently in each child. They can include:

  • Itchy, irritated eyes
  • Swelling of the eyelids
  • Redness of the conjunctiva
  • Discomfort when the child looks at a light
  • Burning in the eyes
  • Eyelids that are stuck together in the morning
  • Clear, thin fluid leaking from the eyes, most often from a virus or allergies
  • Sneezing and runny nose, most often from allergies
  • Stringy discharge from the eyes, most often from allergies
  • Thick, green drainage, most often from a bacterial infection
  • Ear infection, most often from a bacterial infection
  • Lesion on eyelids with a crusty appearance, most often from a herpes infection

The symptoms of conjunctivitis can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

How is conjunctivitis diagnosed?

The healthcare provider will ask about your child’s symptoms and health history. He or she may also ask about your family’s health history. He or she will give your child a physical exam. In some cases, a sample of the fluid leaking from the eye may be tested to help confirm the cause of the infection.

How is conjunctivitis treated?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on the cause of the condition, for example:

  • Bacterial infection. This may be treated with antibiotic eye drops.
  • Viral infection. Viral conjunctivitis usually doesn’t need treatment. In some cases, antibiotic eye drops may be used to help prevent a secondary infection.
  • Allergic reaction. The allergies may be treated oral medicines or eye drops.
  • Herpes infection. Your child may need to see an eye doctor (ophthalmologist). Your child may be treated with both oral medicine and eye drops. 

If the condition is caused by an infection, it’s important to know that the infection can spread from one eye to the other by touching the affected eye or fluid from the eye. The infection can also spread to other people. Fluid from the eye is still contagious for 24 to 48 hours after starting treatment.

To help prevent spread of the infection, wash your hands often when caring for your child. Make sure your child doesn’t touch his or her eyes. Have your child wash his or her hands often. 

What are possible complications of conjunctivitis?

Conjunctivitis caused by herpes is a more serious infection. If untreated, it may lead to scarring of the eye and loss of vision.

Key points about conjunctivitis

  • Conjunctivitis is an inflammation of the conjunctiva of the eye. The conjunctiva is the membrane that lines the inside of the eyelids and covers the eyeball.
  • In children, the condition is often grouped into either newborn conjunctivitis or childhood conjunctivitis. There are different causes and treatments for each group.
  • Symptoms can include red, swollen, burning, irritated eyes
  • Treatment will depend on the cause of the condition and may include oral medicine and eye drops.
  • If the condition is caused by an infection, it’s important to know that the infection can spread from one eye to the other by touching the affected eye or fluid from the eye. The infection can also spread to other people. Fluid from the eye is still contagious for 24 to 48 hours after starting treatment.
  • To help prevent spread of the infection, wash your hands often when caring for your child. Make sure your child doesn’t touch his or her eyes. Have your child wash his or her hands often. 

Next steps

Tips to help you get the most from a visit to your child’s health care provider:
  • Before your visit, write down questions you want answered.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you for your child.
  • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.
Conjunctivitis in Children - WellSpan Health

Online Medical Reviewer: Berry, Judith, PhD, APRN
Last Review Date: 2015-11-06T00:00:00
Last Modified Date: 2015-12-26T00:00:00
Published Date: 2015-12-26T00:00:00
Last Review Date: 2007-03-30T00:00:00
© 2016 WellSpan Health. All Rights Reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.

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