Conjunctivitis

Conjunctivitis, also called 'pink eye', is the inflammation of conjunctiva. The conjunctiva is the clear membrane that covers the white part of your eye and the inside of your eyelids. It is a common condition caused by viral or bacterial infections or allergies.

If your newborn develops conjunctivitis 2 to 5 days after they are born, their infection is called neonatal conjunctivitis.

If your child has conjunctivitis, they may have these symptoms:

• redness in their eye or inside their eyelid
• eyelid swelling
• watering eyes
• not liking bright lights (photophobia)
• itchy eye and a feeling of dirt or sand in their eye
• a yellow or green sticky eye discharge — this dries into a crust while your child is asleep

If your child has bacterial conjunctivitis, it might start in one eye but usually both eyes will be affected. Their eyes will not be itchy. It usually takes 7 to 10 days for their infection to pass.

If your child has viral conjunctivitis, one or both eyes can be infected. It usually takes 2 to 3 weeks to pass.

If your child has allergic conjunctivitis, they will usually also have other allergy symptoms, such as an itchy or runny nose and sneezing. Their symptoms can range from mild to severe.

There are 2 types of conjunctivitis: infectious (including viral and bacterial) and non-infectious (allergic) conjunctivitis. The symptoms are similar. Sometimes it can be hard to tell which type your child has.

Infectious conjunctivitis

Infectious conjunctivitis can be caused by a virus or bacteria. Viral conjunctivitis is more common than bacterial conjunctivitis. It is very contagious.

Your child can become infected by having contact with:

• discharge from an infected person's eyes, nose or throat
• contaminated fingers, surfaces or towels
• contaminated water, for example, when swimming

Non-infectious or allergic conjunctivitis

This is caused by an allergic reaction, chemical or a toxin. This type of conjunctivitis is not contagious.

Your child can get allergic conjunctivitis if they are allergic to:

• pollen
• dust
• animal fur, hair or feathers
• medicines
• eye solutions

If your child's conjunctivitis is caused by a pollen allergy it may come and go, depending on the season and weather conditions.

Your doctor can diagnose conjunctivitis by:

• asking you questions about your child's medical history
• examining your child's eye
• taking a sample of discharge from your child's eye and sending it to the laboratory if they want to identify what is causing the infection

Your child's doctor will also rule out other dangerous conditions that could cause symptoms similar to conjunctivitis.

Other conditions with similar symptoms include:

• a small object stuck in your child's eye
• a corneal abrasion — a scratch on the surface of your child's eye
• dry eyes
• blepharitis — inflammation of the edges of your child's eyelids
• serious eye infections

Babies are often born with blocked tear ducts. This can cause a watery or sticky discharge in their eyes. It usually goes away without treatment. Occasionally it can lead to an infection that needs antibiotics. If your baby has a discharge from their eye, seek advice from your doctor, child health nurse or paediatrician.

You should take your child to their doctor if they have discharge from their eye or you suspect they have conjunctivitis.

You should take your child back to their doctor if:

• your child has viral conjunctivitis and symptoms have not improved within 2 to 3 weeks
• your child has bacterial conjunctivitis and their symptoms have not improved within a week

Some symptoms could indicate that your child might have a more serious eye condition.

You should take your child immediately to the doctor if:

• you suspect your newborn baby has conjunctivitis
• your child is in pain or has severe sensitivity to light
• your child has trouble seeing
• there is swelling, redness or pain that gets worse over their eyelids or around their eye
• there is a white spot in your child's eye
• your child wears contact lenses and has symptoms of conjunctivitis

Your child's treatment depends on what is causing their conjunctivitis. Treatment can include medicines and self-care at home to help reduce symptoms.

Self-care at home

Here are some tips to help relieve your child's symptoms:

• Gently clean your child's eyes. To remove discharge, wipe your child's eye with a cotton ball soaked in water. Wipe from the inside of their eye (near the nose), towards the outside. If you need to wipe again, use a new cotton ball. Use a separate cotton ball for each eye.
• Place a clean cool compress over your child's infected eye a few times a day.
• Use 'artificial tears' eye drops — ask your pharmacist to recommend drops that are suitable for your child's age.
• If your child wears contact lenses, throw them out. They should wait until they have recovered for one week before wearing new contact lenses.

Your local pharmacist can help you with self-care for conjunctivitis.

Treatment of bacterial conjunctivitis

If your child has bacterial conjunctivitis, their doctor will prescribe antibiotic eye drops or ointments for up to 7 days.

If your newborn's neonatal conjunctivitis is caused by chlamydia trachomatis, they will be given oral antibiotics. Your baby's health team may recommend they stay in hospital for monitoring until the infection clears.

Treatment of viral conjunctivitis

If your child has viral conjunctivitis, they will not need antibiotics. Often they will recover on their own within 2 to 3 weeks without treatment. In some cases, your child's doctor may prescribe a steroid ointment.

If your child's viral conjunctivitis is caused by herpes simplex virus (HSV), your child may need an antiviral ointment.

Treatment for allergic conjunctivitis

If your child's conjunctivitis is caused by an allergy, their treatment may include :

• avoiding anything that triggers the allergic reaction
• antihistamine eye drops or syrup — ask your doctor or pharmacist if your child can take antihistamines
• lubricating eye drops
• allergen immunotherapy for severe cases

If your newborn has neonatal conjunctivitis that is not treated, their vision can be affected. It can cause blindness. Usually, infectious and allergic conjunctivitis does not cause serious complications.

You can help prevent your child from catching infective conjunctivitis by following good hygiene practices and avoiding contact with people who have conjunctivitis.

If your child has infectious conjunctivitis, you'll need to keep them home until the discharge has gone. Here are some tips to stop them spreading it to others:

• Wash your hands with soap and warm water or alcohol-based hand sanitiser especially after touching their eyes or putting in eye drops.
• Throw away tissues or cotton balls that have touched your child's eyes.
• Change your child's pillowcase and towel every day.
• Clean surfaces that they've touched.
• Do not let your child share tissues, towels, facecloths, pillows, eye make-up or eye drops with others.

• Read more about conjunctivitis symptoms, treatment and prevention at South Australia Health.
• Learn more about allergic conjunctivitis at Allergy & Anaphylaxis Australia.
• The Sydney Children's Hospitals Network has a factsheet about eye problems in children.

Other languages

The Royal Children's Hospital Melbourne has translated their fact sheet about conjunctivitis in many community languages.

Information for Aboriginal and/or Torres Strait Islander peoples

The Fred Hollows Foundation has information about children and eye disease for Aboriginal and/or Torres Strait Islander people.