Pink Eye In Toddlers: Causes, Symptoms And Treatment

Treatment may depend on the cause or symptoms, and some types may be contagious.

Medically reviewed by Dr. Elna Gibson, MBChB, MMed Dr. Elna Gibson Dr. Elna GibsonMBChB, MMed facebook_icon Specialty: PediatricsExperience: 25 years
Written by Dr Bisny T. Joseph Dr Bisny T. Joseph
Last Updated on
Pink eye in toddlers

Image: Shutterstock

Conjunctivitis or pink eye in toddlers is the inflammation of the conjunctiva, the eye membrane covering the eyeball. The eyes may appear reddish or pinkish due to inflammation of tiny blood vessels in the conjunctiva.

The toddler may also get red or pink eyes due to other eye conditions that may affect vision. You may consult a pediatrician if the symptoms do not improve within 12 to 24 hours of home care.

Read this post to know more about the causes, symptoms, and treatment of pink eyes in toddlers.

Causes Of Pink Eyes

Any of the following reasons can cause pink eye or conjunctivitis in toddlers (1).

  • Bacteria, including Staphylococcus aureus, Streptococcus pneumoniae, Neisseria gonorrhoeae, Haemophilus influenzae, and Chlamydia trachomatis, are common causes of conjunctivitis.
  • Viruses, such as adenovirus and herpes virus, are common causes of viral conjunctivitis. Rubeola (measles) virus may also cause pink eyes in toddlers.
  • Allergens, such as pollen, tree weed, and animal dander, could cause conjunctivitis.
  • Chemicals, such as those found in eye drops or certain baby products, could cause conjunctivitis if they come in contact with the eyes.
  • Irritant pink eyes can be due to exposure to irritants, such as smoke or chlorine in the swimming pool.
  • A foreign object or toxic chemical splash in the eyes could cause pink eyes. This condition should be treated immediately to avoid eye damages.

Toddlers with upper respiratory tract infections may have an increased risk of developing viral or bacterial conjunctivitis.

Is Pink Eye Contagious?

Infectious (bacterial or viral) pink eyes in toddlers can be contagious. Viral conjunctivitis is more contagious than other types of infectious conjunctivitis. Toddlers in contact with an infected person or those who touch the eyes with unwashed hands have a higher risk of developing pink eyes. A toddler with conjunctivitis can be contagious until the symptoms resolve (2).

Bacterial pink eyes can be contagious for 24 to 48 hours after starting antibiotic treatment. It may take a few weeks to resolve viral pink eyes in toddlers, and the watery discharge from eyes can continue to be contagious until the infection resolves.

Allergic, irritant, and chemical conjunctivitis are not contagious. They occur in toddlers exposed to irritants, allergens, or chemicals.

Symptoms And Signs Of Pink Eyes

Toddlers may have any of the following signs and symptoms during conjunctivitis (1).

  • Red or pink eyes
  • Swollen eyelids
  • Itching or burning sensation in the eyes
  • Pain while looking at the light (photosensitivity)
  • Watery eyes (clear fluid discharge) in viral or allergic conjunctivitis
  • Thick green or yellow discharge in bacterial infection
  • Eyelids may stick after waking from sleep
  • Crusty appearance with lesions on eyelid often seen in herpes virus infection
  • Runny nose, stringy eye discharge, and sneezing are seen in allergies
  • Signs of ear infections are also seen in some cases of bacterial conjunctivitis

Mild fever can be seen in some toddlers due to infections and often resolves when the pink eye is treated. Toddlers with high fever may have pink eyes due to severe infections and often require fever medications along with the pink eye treatment. It is often associated with upper respiratory tract infection and middle ear infection.

Some of these symptoms and signs are also seen in other diseases or eye conditions. You may consult a pediatrician for exact diagnosis and treatment.

Diagnosis Of Pink Eyes

Pediatricians may ask about the signs, symptoms, and health history of the toddler. Physical examination of the eye is enough to diagnose conjunctivitis in toddlers. In some cases, samples of the discharged fluid are collected for laboratory analysis.

Laboratory examination of the eye discharge is usually done for toddlers with recurrent and severe conjunctivitis. Identifying the exact cause could help the doctor prescribe specific treatment, especially for bacterial conjunctivitis.

Treatment For Conjunctivitis In Toddlers

The treatment options may vary depending on the cause, symptoms, and health status of the toddler (3). 

  • Bacterial pink eyes are treated with antibiotic eye drops. Some of the commonly prescribed eye drops include fluoroquinolone (levofloxacin, ciprofloxacin), aminoglycoside (gentamicin), and macrolide (azithromycin). Some toddlers may receive antibiotic eye ointments, such as bacitracin, neomycin, or erythromycin. Chlamydial and gonorrheal conjunctivitis require systemic antibiotics along with topical eye drops or ointments. If there is associated infection of ears and nose an oral antiobiotic might be needed as well.
  • Viral pink eyes do not require treatment in many cases. Some toddlers may receive artificial teardrops to reduce eye irritation. In rare cases, antibiotic eye drops are prescribed if there is a risk of secondary bacterial infection. Herpes infection may require oral antivirals along with eye drops. Doctors may recommend a cold compress for viral conjunctivitis.
  • Allergic pink eyes require oral antihistamines, such as cetirizine or loratadine, to relieve symptoms. Antihistamine eye drops with antihistamines, such as ketotifen, could also be prescribed to reduce symptoms.
  • Chemical pink eyes may require steroid eye drops after flushing (washing) the chemical out of the eye with saline.

You should follow the doctor’s prescription for the exact type of treatment and medicine dosage.

Chemical exposure may require immediate medical care since some chemicals may cause severe eye damage. It is recommended to wash eyes with clean water to flush out chemicals before emergency services are available.

Home Remedies For Pink Eyes

Cold compresses and artificial teardrops are recommended home remedies that could be tried after doctor consultation. You can use a clean damp cloth to do a cold compress. You may wash the cloth with soap and water after each use or use a new one. Do not use the same cloth on both eyes to prevent accidental spread of infection from one eye to another (4).

If the doctor recommends a warm compress, you may soak a cloth in lukewarm water and leave it over the eyes for a few minutes. Warm or cold compresses can help relieve sticky eyes in the morning.

Toddlers tend to remove the cloth or contaminate it, so keep an eye on them. You may do it a few times a day, depending on your and your toddler’s comfort.

Although many believe that breast milk application may reduce pink eyes, this lacks scientific evidence. 

Possible Complications Of Conjunctivitis 

The complications may depend on the cause and severity of conjunctivitis. Pink eye due to herpes infection is one of the reasons for severe complications. Photosensitivity and high fever, along with pink eyes, usually indicate serious eye problems resulting in complications.

If left untreated, severe pink eye can result in the following complications (5).

  • Scarring
  • Corneal or retinal damage
  • Optic nerve damage
  • Partial or complete vision loss
  • Meningitis
  • Cellulitis
  • Otitis media (middle ear infection)
  • Sepsis

Unvaccinated toddlers may have a higher risk of developing pink eyes due to measles. Pink eyes before or with skin rashes are commonly seen in measles. Pink eyes due to measles are often associated with severe eye damage and vision loss.

How Long Does Pink Eye Last In Toddlers? 

The duration of the infection may depend on its severity and the health status of the toddler. Bacterial conjunctivitis usually resolves within a few days after the commencement of antibiotic treatment. Mild conjunctivitis may last up to seven to 14 days without treatment. In contrast, viral infections may last up to three weeks (6)

Allergic or chemical conjunctivitis usually resolves quickly after the causative agent is removed from the eyes.

Frequently Asked Questions

1. When is it safe to return to school after pink eye?

The right time depends on your child’s symptoms. If they have pink eyes with typical symptoms such as fever, it may be better to keep them at home for a longer period till they are better. Hence, besides waiting for the general lasting period of bacterial and viral conjunctivitis, i.e., 10 and 14 days, respectively, it is better to wait until the redness, discharge, and tearing of the eyes clears up (7) (8).

2. How can I prevent the spread of pinkeye?

To prevent the spread of pink eye, you must (9):

  • Wash your hands before and after touching your eyes, or avoid touching the eyes completely.
  • Ensure to not use the same eye drop bottle for both infected and non-infected eyes.
  • Not share your personal belongings.
  • Avoid swimming in the pool.

Pink eye in toddlers is generally a harmless condition when treated on time. The pinkish tinge in their eyes is easy to recognize and is often followed by other symptoms such as watery eyes, itchiness, and swollen eyelids. Consult a doctor for appropriate treatment if you notice these signs. Further, teach your children to be careful around their eyes and not touch them with dirty hands to avoid contracting infections. Since it is contagious, keep your child isolated and away from others until the symptoms subside while taking the necessary home measures to ease their discomfort.

Key Pointers

  • Conjunctivitis is an inflammation of the conjunctiva caused by bacterial or viral infections, allergens, or irritants.
  • It may cause red or pink eyes, swollen eyelids, itching, fluid discharge, and other symptoms.
  • Pink eyes due to bacterial or viral infections are usually contagious.
  • Depending on the causal factor, the condition may be treated with antibiotic or steroid eye drops, oral antihistamines, and other medications.
  • Warm or cold compress and artificial tears may be used as home remedies.

References

1. Conjunctivitis in Children; University of Rochester Medical Center
2. Conjunctivitis (Pink Eye); Centers for Disease Control and Prevention
3. Pink Eye (Conjunctivitis); St. Clair Hospital
4. Quick Home Remedies for Pink Eye; American Academy of Ophthalmology
5. Complications of Conjunctivitis; National Health Service
6. Treatment; Conjunctivitis (Pink Eye); Centers for Disease Control and Prevention
7. Do I need to keep my son home if he has pinkeye? Healthy Children
8. My daughter has pink eye. How long is pink eye contagious and when can I send her back to school? American Academy of Ophthalmology
9. Preventing the Spread of Conjunctivitis; Centers for Disease Control and Prevention
Was this article helpful?
thumbsupthumbsdown

Community Experiences

Join the conversation and become a part of our vibrant community! Share your stories, experiences, and insights to connect with like-minded individuals.

Dr. Elna Gibson
Dr. Elna GibsonMBChB, MMed, Paeds
Dr. Elna Gibson is a general pediatrician. She did her MBChB and specialization as a pediatrician in South Africa at the University of Pretoria. She obtained MMed Pediatrics (masters) with distinction in 1993.As a young specialist, Dr.

Read full bio of Dr. Elna Gibson
Latest Articles