As all us lucky parents know only too well, young children get red eyes very frequently (and because it’s really contagious, us parents get it too). Having said this, there are a few bits of information that make managing this much much easier.
Firstly, we have to work out why the eye is red. The majority of cases are due to a condition we have all heard of but few of us understand – conjunctivitis. Conjunctivitis is an inflammation of the conjunctiva (the cling-film like structure that lies over the white of the eye). This inflammation can have a number of different causes for it. For example, it can be caused by allergy (hay fever), infection (viral, bacterial etc.) or even physical trauma to the eye (scratching an eye during sleep).
Red eyes can also be caused by a remarkable amount of other conditions too, namely inflammation of any of the other structures in or around the eye. This is rarer but occasionally can be very serious. This is why you need to have it checked out by a GP or optometrist. Equally, the management of different types of conjunctivitis is different and therefore it is difficult for a parent to make the call.
The biggest question in most parents heads will be, ‘Do I use an antibiotic or not?’ Generally, the antibiotics prescribed are very very safe but there are a few problems with them. Only one of these conditions responds in any way to the use of the most frequently prescribed antibiotic – bacterial conjunctivitis. This form is probably the most common cause of red eye that I would see in young children.
You can usually tell the bacterial form by rapid onset, bright red eye(s) and the thick green discharge (a shocking amount of green goo). The problem with parents diagnosing is that it you might be wrong and eyes are important – my advice would be to get it checked out. The good news is that bacterial conjunctivitis is not nearly as bad as it looks. It is not sight threatening and in the vast majority of cases gets better on its own.
If you do have to put in antibiotic eye drops, it is essential to finish the course even if symptoms have subsided. The frequency and dosage of the drops are important also. Instilling drops in a young child’s eyes can be difficult so if you need help, have a look at our article on ‘Getting the drops in.’ Often the child would also be feeling generally unwell too so resting, eating properly and plenty of fluids are vital.
As conjunctivitis is hugely contagious (viral form unbelievably so), it is very important for the patient or parent to be extremely vigilant about hand-washing (especially both before and after drops). Do not share towels or face-cloths. Alcohol hand-gel is often more workable when caring for young children. Believe it or not, it is possible for re-infection to occur so children can pass it back and forth between them. Whilst they are infectious, it is only fair to protect the rest of their peers by trying to keep the child out of close contact with others. The infectious period is very different for different types of red eye.
On a final note, in almost all forms of red eye there will be some form of discharge so cleaning the area systematically will make the child much more comfortable. They key to doing this is not to make the situation worse. Hand washing again is vital so as not to give yourself a red eye and make sure you don’t pass infection across to a previously healthy other eye. Equally, an eye with an infection is compromised and will be more easily infected by a second infection so let’s not make things worse! Use cool boiled water or saline, cotton wool pads and good lighting. Use each cotton wool pad only once, wet it, clean carefully around the eyelids and eyelashes and then throw it straight in the bin. You will probably need three or four for each eye and it will be as bad as ever again within a couple of hours.
My wife and I have found that applying Vaseline liberally to the eyelids and lashes after getting ready for bed really helps. If a child wakes up in the middle of the night and can’t open their eyes, you can imagine how distressing it is for them. The Vaseline means that the green goo doesn’t adhere to the eyelashes and when the child is asleep the eyelashes don’t get stuck together. It also help to stop the child from getting red inflamed skin around their eyes.
The most important thing is, if in doubt, get it checked out. If ever you are concerned about a child’s eyes, feel free to contact me (Andrew Petticrew) on 02890 323 341. We are always happy to do what we can to help. You are never troubling me unnecessarily.
Andrew Petticrew BSc(Hons) MCOptom