Posted on October 08, 2017
My child has Pink Eye! What do I do?
By: Jeffrey Colburn, MD
It's one of the frustrations of parenting young kids, your child wakes up in the morning with an eye sealed shut with yellow goup. If your child is an infant, the eye itself is white looking, and this is an ongoing chronic issue then this may be just a blocked tear duct. But otherwise, they likely have conjunctivitis, commonly called "Pink Eye", which is an infection of the superficial covering of the eye (conjunctiva). Conjunctivitis can be caused by either a virus or bacteria.
Viral conjunctivitis tends to have mild to moderate eye redness, mild white discharge, and symptoms of eye irritation and burning (see photo below courtesy of eyerounds.org). It can involve one or both eyes and often happens along with or right after an upper respiratory infection. Like a common cold, the treatment is primarily for comfort. Antibiotic eye drops will not help as they do not fight viruses. The infection will improve on its own, usually in 1-2 days, but occasionally it might last up to 1-2 weeks. It is very contagious and care should be taken to avoid touching the eyes and to keep up with strict hand washing.
Bacterial conjunctivitis tends to have more severe symptoms with worse redness, more eye pain, and a greater amount of yellow or greenish discharge. Again, it is very contagious and hygiene measures are critically important. As opposed to viral conjunctivitis, a bacterial pink eye can be treated effectively with antibiotic eye drops to shorten the infection.
Sometimes it can be difficult to determine which type of conjunctivitis you are dealing with, even for primary doctors or eye doctors. If in doubt, have your child evaluated by your pediatrician, family doctor, or an urgent care. For persistent or worsening cases of conjunctivitis that are not responding to any treatment given, bring them in to see us for a pediatric ophthalmology evaluation.
The hardest question to answer is whether a child with conjunctivitis should be kept at home away from pre-school or school. Most eye doctors, including us, will recommend keeping the child at home until their eyes are no longer red and have no discharge due to the highly contagious nature of the infection. But this certainly has implications for the child's school attendance and the parents' work responsibilities. The American Academy of Pediatrics recommends handling viral pink eye like a common cold and not automatically excluding them from school. If the infection is bacterial, they will probably need to be at least on antibiotic drops and improving before returning. Check with your pre-school or school district regarding their rules and guidelines.