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.

Conjunctivitis is more common in toddlers and young children. They may rub their eyes and transmit the infection to other children at preschool, day care, or on the playground.

This article discusses the symptoms, causes, and treatments of conjunctivitis in toddlers.

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Symptoms of conjunctivitis include:

In mild cases, conjunctivitis symptoms typically clear up by themselves.

Toddlers cannot always express their symptoms clearly, so parents and caregivers 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
  • squinting

There are three common causes of conjunctivitis:

  • Viral conjunctivitis: This is the most common cause of conjunctivitis. It occurs due to a viral infection of the eye or surrounding tissues. Adenoviruses most often cause viral conjunctivitis.
  • Bacterial conjunctivitis: This is another type of infectious conjunctivitis. It occurs due to bacterial infections.
  • Allergic conjunctivitis: Allergens and irritants can cause conjunctivitis when coming into contact with the eye.

Less common causes

  • Systemic conditions: Underlying health conditions such as reactive arthritis and rosacea can cause conjunctivitis.
  • Toxic conjunctivitis: Long-term use of eye medication can dry out or scar the eye and surrounding tissues. This can lead to inflammation.
  • Meibomitis: This is inflammation of the meibomian glands, which line the eyelid behind the eyelashes. It occurs when natural oils solidify in the glands. This is uncommon in toddlers.
  • Blepharitis: Blepharitis is another condition that causes chronic eyelid inflammation and irritation. It occurs when debris clogs glands at the base of the eyelashes.

Recurrent conjunctivitis

Some toddlers get conjunctivitis repeatedly. This is not unusual, as children in school, day care, and other community settings are more prone to repeat infections or allergens.

However, repeat conjunctivitis can signal underlying health conditions, such as Stevens-Johnson syndrome or an undiagnosed allergy.

Conjunctivitis is contagious when a bacterial or viral infection causes symptoms.

Parents and caregivers of toddlers with conjunctivitis should assume the condition is contagious and keep the child home from day care or school, particularly if they have a fever or are not feeling well. Some doctors recommend that children stay home until their symptoms resolve.

In most cases, pink eye due to infection remains contagious for as long as a person still has symptoms.

Bacterial conjunctivitis usually lasts about 5–10 days and often clears up faster with antibiotics. Viral conjunctivitis can last as long as 14 days, though it usually resolves sooner. Viral pink eye will not respond to antibiotics.

It is possible, though not common, for viral, allergic, and irritant-related conjunctivitis to lead to a bacterial infection. This happens when a toddler rubs their eyes with dirty hands, transferring bacteria to the eye.

Read more about signs of contagious conjunctivitis here.

A doctor can typically diagnose conjunctivitis based on a child’s symptoms, though they may not be able to pinpoint the exact cause. The doctor may ask questions about the child’s recent health history, whether the child wears glasses, and whether anyone else in the family or school has the condition.

Conjunctivitis may look different depending on its cause.

If a child has frequent conjunctivitis infections or their condition does not respond to treatment, a doctor may take a sample from the child’s eye for analysis. This can provide information about whether a virus, bacteria, or allergen caused the pink eye and how best to treat it.

Different types of conjunctivitis have different treatments.

  • Viral conjunctivitis: This form of conjunctivitis typically resolves independently within 2 weeks.
  • Bacterial conjunctivitis: In mild cases, bacterial conjunctivitis may disappear within 2 weeks without treatment. However, doctors may prescribe antibiotics in more severe cases. These may help to speed up healing in mild cases.
  • Irritant conjunctivitis: When an allergen or irritant causes conjunctivitis, avoiding the irritant can help. A doctor may also recommend special eye drops to soothe irritation.

No matter what type of conjunctivitis a toddler has, home treatment can help ease the pain. Parents and caregivers can try the following steps:

  • Ask a doctor about using over-the-counter pain relievers.
  • Use artificial tears or other eye drops to ease pain after consulting a doctor about the appropriate 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.

Read more about treating pink eye at home here.

Conjunctivitis can spread through an entire day care center or preschool. In some cases, a toddler may spread the infection to friends, who transmit it back to the toddler.

Simple prevention strategies can reduce the spread of the infection and lower the risk of recurrent conjunctivitis:

  • 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
  • practice frequent hand washing
  • encourage children not to touch their friends’ faces

Conjunctivitis is typically a temporary condition and not a sign of a serious eye health issue. Many children develop conjunctivitis, and most recover within 1–2 weeks.

When symptoms are severe or do not go away by themselves, parents or caregivers should contact a doctor. Prompt treatment can cure or help prevent serious eye health issues.