Pink Eye (Conjunctivitis)

Overview

  • Conjunctivitis, commonly known as “pink eye,” is inflammation of the thin tissue covering the white part of the eye and the inside of the eyelids. 
  • Conjunctivitis can be caused by viruses, bacteria, allergies, irritation, or foreign bodies. 

Viral Conjunctivitis

Cause

  • Viral conjunctivitis is typically caused by viruses that can also cause the common cold. 
    • There are many viruses that cause viral conjunctivitis. 
  • Children with viral conjunctivitis most often exhibit other common cold symptoms such as runny nose, congestion, sneezing, cough, sore throat, or even fever. 
  • Viral conjunctivitis is the most common type of conjunctivitis!

Symptoms

  • Redness, watery or mucus discharge
  • One or both eyes may be affected 
  • A burning or gritty sensation may be present in one or both eyes
  • As mentioned above, most children with viral pink eye also have signs and symptoms of a common cold. 

Treatment 

  • There is no medication to treat viral pink eye, as viruses resolve on their own and do not respond to antibiotics.
  • Symptoms may get worse for the first 3 to 5 days, and then gradually tend to improve.
    • However, symptoms may come and go for 2-3 weeks, just as symptoms of a cold do the same. 
  • If your child seems bothered by their viral pink eye symptoms, we recommend applying cool compresses as needed.
  • You may also apply over-the-counter artificial tears (unmedicated) as needed to provide some relief.


Bacterial Conjunctivitis 

Cause

  • Bacterial pink eye may be caused by multiple strains of bacteria.

Symptoms

  • Redness to the white of the eye
  • Thick copious yellow, white, or green discharge from the eye
    • The discharge promptly returns when wiped away.
  • Upon waking, the discharge may cause the eye to be “stuck shut."
  • Bacterial pink eye can affect one or both eyes.

Treatment

  • Bacterial pink eye is treated with antibiotic eye drops or ointment.
    • These are not sold over-the-counter and require a prescription.
  • Cool compresses may also provide some relief and can be used as needed.
  • The redness and eye discharge tend to decrease after using the antibiotic eye medication for 48-72 hours.


How is Conjunctivitis Spread?

  • Viral and bacterial conjunctivitis are both highly contagious.
  • Spread by direct contact either from objects which have come into contact with the infected person's eye secretions.
    • As examples, the virus can be transmitted when an infected person touches their eye and then touches another surface (i.e., door handle) or shares an object that has touched their eye (i.e., a towel or pillow case).
    • Hands become contaminated by direct contact with discharge from an infected eye, or by touching other surfaces that have been contaminated by respiratory tract secretions, and gets into the child’s eyes.

Prevention

Encourage good hand hygiene and avoidance of touching the eyes/face in children able to understand. 


School Exclusion

Viral Conjunctivitis 

  • As long as your child is currently fever-free and has been fever-free for 24 hours, there is no need for school exclusion.
  • Again, encourage your child to wash their hands often and not touch their eyes.

Bacterial Conjunctivitis 

  • Your child may return to school 24 hours after starting prescription antibiotic eye drops/ointment. 

Allergic Conjunctivitis 

  • No school exclusion is necessary.


Tips for Administering Eye Ointment and Eye Drops

Applying eye drops and eye ointment is often very stressful for both the parent and the child.

General Tips

  • Avoid touching the tip of the applicator directly to the eyes or surrounding skin. 
  • Wash hands well afterward!

Eye Ointment Instillation

  • Have your child lay flat on their back.
    • Gently pull down on the lower eyelid and attempt to apply the ointment inside the eyelid. 
    • However, even if the ointment is not perfectly placed in the lower eyelid, it should still be effective because it sticks to the lid and is spread with blinking. 

Eye Drop Instillation

  • Have your child lay flat on their back.
  • Allow your child to keep their eyes closed.
  • Instill the eye drops in the inner corner of each closed eye.
    • The eye drops will pool in the corners and your child will eventually open their eyes, allowing most of the drops to flow in.
  • Gently wipe off any excess with a soft cloth.