Pink eye, which doctors call conjunctivitis, is inflammation and redness in the conjunctiva of the eye. The conjunctiva is the transparent membrane that lines the front of the eye and eyelids.
Pink eye is more common among toddlers and young children, who may rub their eyes and transmit infections to other children at preschool, daycare, or on the playground.
Infections, allergies, and irritants, such as sand or chemicals, can cause pink eye. However, viral and bacterial infections are the culprits in most cases.
Pink eye usually clears up by itself, but some people require treatment. Other conditions may mimic symptoms of pink eye, so anyone experiencing persistent or bothersome eye irritation should consider seeing a doctor for advice and diagnosis.
Symptoms of pink eye include:
- dry, itchy, red eyes
- watery eyes
- frequent blinking
- a feeling of something stuck in the eye
- light sensitivity
- puffy eyelids
- discharge from red, irritated-looking eyes
In some cases, pink eye can be painful.
Sometimes, toddlers cannot express their symptoms clearly, so parents and carers should check whether the child is:
- avoiding bright lights
- frequently covering their eyes
- rubbing their eyes
- crying often or having more tantrums
- having trouble concentrating
Pink eye is contagious when a bacterial or viral infection causes symptoms. However, infections do not cause all forms of pink eye. Sometimes, allergies or eye irritation can cause pink eye.
Parents and carers of toddlers with pink eye should assume the child is contagious and keep them home from daycare or school, particularly if they have a fever or are not feeling well. Some doctors, as well as some schools and daycares, recommend that children stay home until their pink eye symptoms have resolved.
In most cases, pink eye due to infection remains contagious for as long as a person still has symptoms. According to the American Academy of Ophthalmology (AAO), bacterial pink eye usually lasts about 5 to 10 days and often clears up faster with antibiotics. Viral pink eye can last as long as 14 days, though it usually improves much sooner. Viral pink eye will not respond to antibiotics.
It is possible, though not common, for viral, allergic, and irritant-related pink eye to give rise to a bacterial infection. This happens when a toddler rubs their eyes with dirty hands, transferring bacteria to the eye.
A doctor can usually diagnose pink eye based on a child’s symptoms but may not be able to pinpoint the exact cause. The doctor may ask questions about the toddler’s recent health history, whether the child wears glasses, and whether anyone else in the family or at school has pink eye.
Pink eye may look different depending on its cause. According to the AAO, allergic conjunctivitis usually causes very red, watery eyes and swollen eyelids. Bacterial pink eye may cause a sticky white or yellow discharge from the eye. Viral pink eye causes very red eyes and a watery discharge.
If a person has frequent pink eye infections or does not respond to treatment, a doctor may take a sample from the eye to send to a lab for analysis. This provides information about whether a virus, bacteria, or allergen caused pink eye and how best to treat it.
According to the Centers for Disease Control and Prevention (CDC), viral pink eye usually goes away on its own. Bacterial pink eye usually clears up within a week or two or less, but antibiotic drops may speed up the process. When an allergen or irritant causes pink eye, avoiding the irritant can help. A doctor may also recommend special eye drops.
No matter what type of pink eye a toddler has, home treatment can help ease the pain. People can try the following steps:
- Ask a doctor about using over-the-counter (OTC) pain relievers.
- Use artificial tears or other eye drops to ease pain, but consult a doctor about the right type of drops.
- Apply a cool compress to the eye. If cold compresses do not help, try warm compresses instead.
- Encourage the toddler to rub their eye only with a cool, clean washcloth, not with their hands.
Some toddlers get pink eye repeatedly. This is not unusual, as children in school, daycare, and other community settings are more vulnerable to repeat infections.
Some pink eye bacteria may be resistant to treatment. A doctor may need to take a culture to see which type of germ is causing the infection.
In some cases, repeat infections signal an underlying problem.
Other causes of pink eye
Meibomitis is inflammation of the meibomian glands, which line the eyelid behind the eyelashes. When these glands become irritated, this can cause eyelid irritation that increases the risk of pink eye. This is uncommon in toddlers.
Blepharitis is another condition that causes chronic eyelid inflammation and irritation. The AOO note that the eyelids may look flaky, dry, or swollen. People with blepharitis may struggle with frequent pink eye. Treating the blepharitis may help.
The trachoma infection, which is a type of chlamydia, may also cause chronic eye irritation and pink eye. Babies may contract this infection when they pass through the birth canal, and symptoms may appear in toddlerhood.
Trachoma is treatable but is also one of the world’s leading causes of blindness. Though widespread throughout some parts of the world, trachoma is now rare in the United States.
Carers should not assume that chronic eye redness is viral pink eye. It is best to see your child’s pediatrician and, if necessary, a pediatric ophthalmologist to get a comprehensive evaluation and accurate diagnosis.
Pink eye can spread through an entire daycare center or preschool. In some cases, a toddler may spread the infection to friends, who then transmit it back to the toddler.
Simple prevention strategies can reduce the spread of the infection and lower the risk of recurrent pink eye:
- Encourage toddlers to avoid touching or rubbing their eyes.
- Keep children with fever or thick eye discharge home from school.
- Do not share eye care products such as contacts, glasses, or eye makeup. Encourage children not to share these products.
- Practice frequent hand washing.
- Encourage children not to touch their friends’ faces.
Pink eye is usually a temporary condition and not a sign of a serious eye health issue. Many children develop pink eye, and most recover within a week or two.
When symptoms are severe or pink eye does not go away by itself, see a doctor. Prompt treatment can cure or prevent serious eye health issues.