Infant eyelid redness

Pink Eye (Conjunctivitis) in Newborns

Newborns with symptoms of conjunctivitis (pink eye) should see a doctor right away.

Neonatal conjunctivitis is a red eye in a newborn caused by infection, irritation, or a blocked tear duct. When caused by an infection, neonatal conjunctivitis can be very serious.

Symptoms and Causes of Conjunctivitis in Newborns

Newborns with conjunctivitis develop drainage from the eyes within a few days to several weeks after birth. Their eyelids become puffy, red, and tender. The cause of neonatal conjunctivitis is often difficult to determine because, in many instances, the symptoms don’t vary by cause.

Conjunctivitis in a newborn may be caused by a blocked tear duct, irritation produced by the topical antimicrobials given at birth, or infection with a virus or bacterium passed from the mother to her baby during childbirth. Even mothers without symptoms (asymptomatic) at the time of delivery can carry and pass bacteria or viruses to babies during birth.

The most common types of neonatal conjunctivitis include the following:

Inclusion (chlamydial) conjunctivitis
Chlamydia trachomatis can cause inclusion conjunctivitis and genital infections (chlamydia). A woman with untreated chlamydia can pass the bacteria to her baby during childbirth. Symptoms of inclusion conjunctivitis include redness of the eye(s), swelling of the eyelids, and discharge of pus. Symptoms are likely to appear 5 to 12 days after birth. Symptoms can develop earlier if the amniotic sac is ruptured during delivery. Some newborns with chlamydial conjunctivitis can have the infection in other parts of their bodies. The bacteria can infect the lungs and nasopharynx (where the back of the nose connects to the mouth).
Gonococcal conjunctivitis
Neisseria gonorrhoeae can cause gonococcal conjunctivitis, as well as the sexually transmitted infection called gonorrhea. A woman with untreated gonorrhea can pass the bacteria to her baby during childbirth. Symptoms usually include red eyes, thick pus in the eyes, and swelling of the eyelids. This type of conjunctivitis usually begins in the first 2-5 days of life. It can also progress to serious infections of the bloodstream (bacteremia) and lining of the brain and spinal cord (meningitis) in newborns.
Chemical conjunctivitis
When eye drops are given to newborns to help prevent a bacterial infection, the newborn’s eye(s) may become irritated. This may be diagnosed as chemical conjunctivitis. Symptoms of chemical conjunctivitis usually include mildly red eye(s) and some swelling of the eyelids. Symptoms are likely to last for only 24 to 36 hours.
Other neonatal conjunctivitis
Viruses and bacteria other than Chlamydia trachomatis and Neisseria gonorrhoeae can cause conjunctivitis. For example, bacteria that normally live in a woman’s vagina and are not sexually transmitted can cause conjunctivitis. Additionally, the viruses that cause genital and oral herpes can cause neonatal conjunctivitis and severe eye damage. The mother may pass such viruses to her baby during childbirth. However, herpes conjunctivitis is less common than conjunctivitis caused by gonorrhea and chlamydia. Symptoms usually include red eye(s) and swollen eyelids with some pus.

Prevention and Treatment of Conjunctivitis in Newborns

To prevent neonatal conjunctivitis, most states have laws requiring providers to put drops or ointment in a newborn’s eyes, typically within 2-3 hours of birth. In the past, hospitals used silver nitrate; now hospitals mostly use antibiotic eye drops, typically erythromycin. During pregnancy and prior to giving birth, women with genital herpes should consult with their physician about ways to minimize the chances of spread to their newborn baby.

Doctors may treat neonatal conjunctivitis caused by a bacterial infection with antibiotics. It will depend on the severity of the infection and the bacteria that caused it. Some antibiotics are applied as an eye drop or ointment in the eye (topical). Other antibiotics are given by mouth (orally), through a vein (intravenous), or as a shot (intramuscular). Doctors may treat a newborn’s conjunctivitis with a combination of topical, and either oral, intravenous, or intramuscular antibiotics. Rinsing the newborn’s infected eye with a saline solution will remove any debris that may develop in response to the infection.

If a blocked tear duct causes conjunctivitis, a gentle, warm massage between the eye and nasal area may help. If the blocked tear duct does not clear by 1 year of age, the newborn may require surgery.

Treatments for the common causes of neonatal conjunctivitis are as follows:

Inclusion (chlamydial) conjunctivitis
Doctors usually use oral antibiotics to treat inclusion conjunctivitis.
Gonococcal conjunctivitis
Doctors give intravenous (IV) or intramuscular (IM) antibiotics to treat gonococcal conjunctivitis. If untreated, the newborn could develop corneal ulcerations (open sores in the cornea) and blindness.
Chemical conjunctivitis
Since this type of conjunctivitis is caused by chemical irritation, treatment is usually not required. The newborn will usually get better in 24 to 36 hours.
Other bacterial and viral conjunctivitis
Doctors usually give antibiotic drops or ointments to treat conjunctivitis caused by other bacteria For both bacterial and viral conjunctivitis, a warm compress to the eye may relieve swelling and irritation. Be sure to wash hands before and after touching the infected eyes.

Baby Red Around Eyes: Causes and Treatments

If your sweet baby has redness around their eyes but they haven’t been crying, you’re probably wondering what’s causing it — and how much you should worry.

Let’s look at what could be going on.

Rubbing

Skin around the eyes is probably the most delicate skin of the body. (Yes, this is the first place we’ll notice fine wrinkles later in life for that very reason. ) If your child has been rubbing their eyes, the area will easily turn red.

Rubbing — in and of itself — isn’t really cause for concern, unless what’s making your baby rub is more serious. (Do keep in mind that fingers + eyes = recipe for infections.)

But if it’s just a sleepy behavior your newborn’s picked up, you can try hand covers to prevent it, or wait for it to resolve on its own.

Irritants

Irritants are substances that injure the eyes, skin, or airways in some way. You can divide irritants into indoor and outdoor. Indoor irritants include:

cigarette smoke
perfumes
sunscreen
soaps

Outdoor irritants include:

smoke
fumes
chemical vapors
chlorine in pool water
smog

Irritants usually cause localized redness that resolves once your baby is removed from the area where the irritant exists, or the irritant is removed from your home.

Allergies

Allergies happen when our eyes (or another part of our body) react to an allergen. An allergen is usually a harmless substance that triggers an immune response in people who are sensitive to the allergen.

Common allergens include:

dust mites
mold
perfume in cosmetics and lotions
medications
foods
dander from pets
pollen from trees, plants, grasses, and weeds
insect venom

If your child has a sensitivity and encounters an allergen, their eyes may produce histamine to fight the allergen. As a result, their eyelids and conjunctiva (the tissue that covers the white part of your eye and the inside of the eyelids) becomes red, swollen, and itchy.

You’ll probably also notice that your child’s eyes are watery with excess tears. A vicious cycle can set in: They rub their eyes to relieve the itching and burning, but the rubbing action irritates their eyes further and the redness increases.

While some of these allergens (like dust mites and pet dander) are around all year long, others are seasonal. If your child is allergic to pollen, you’ll notice their red eyes when pollen counts are high.

Children with eye allergies often have nasal allergies as well. Yes, it’s double the trouble. If you suspect that the redness around your child’s eyes is an allergic reaction, check if they’re sneezing excessively or have a stuffy nose.

Sometimes, if an allergic reaction happens often enough, your child’s mast cells can become oversensitive.

Think of mast cells as your body’s first line of defense against invaders. When mast cells in the eye become oversensitive, they release histamine even if the allergen doesn’t come into direct contact with the eye.

Eye allergies are also called allergic conjunctivitis.

Infections

An eye infection happens when viruses or bacteria enter the eye area. It’s important to know the difference, because bacterial conjunctivitis needs antibiotic treatment.

Viral conjunctivitis

This is also called pink eye, although pink eye can be viral or bacterial. Children with colds commonly develop viral eye infections. Symptoms include:

red, puffy eyelids
red in the white part of the eye
watery eyes

Bacterial conjunctivitis

This is more serious than viral conjunctivitis. You’ll notice the same symptoms as those that you notice in a viral eye infection. Symptoms also include:

a sticky, yellow discharge from the eye
eyelashes and eyelids that may get stuck together from the discharge

Newborn conjunctivitis

Redness in the eye area of a newborn can be caused by a blocked tear duct, irritation, or infection. Newborn conjunctivitis can be serious, so talk with your pediatrician right away.

Stye

A stye (also called a hordeolum) is a painful, red bump on the eyelid. A stye happens when a hair follicle, oil gland, or sweat gland becomes infected. Symptoms include:

painful, red bump on the eyelid
redness on the eyelid
tenderness and swelling around the eye

Periorbital cellulitis

If the area around your child’s eye is injured or if your child has a sinus infection, they may develop periorbital cellulitis. This is a bacterial infection of the eyelids and skin around them. You’ll notice that your child’s eyelids are very red and swollen.

This is a serious condition and needs immediate treatment.

If your child has redness around their eyes, you can start treatment at home. However, if your child is a newborn or you suspect cellulitis, get immediate medical treatment.

Irritants

If you can, pin down which irritant is affecting your child. Try a different brand of soap, shampoo, and laundry detergent.

Allergies

Eye allergies usually come with a wider range of symptoms that also affect the nasal and airway passages. Keep a journal to track what could be causing the allergic reaction.

Here are some areas to examine:

What’s on your baby’s daily menu?
Is the allergic reaction related to the season?
Does it happen at day care? Or every time you visit a specific family member or friend?
Is the allergy related to animals?
Do food allergies, like those to milk, wheat, or eggs, run in your family?

Eye infections

Viral conjunctivitis

Take care of viral conjunctivitis by rinsing the eyes often with warm water. Use a clean cotton ball for each eye. Wash your hands before and after each cleaning.

If you’re nursing, you can try dripping some of your milk into the corner of the eye. Human milk contains many healing properties.

Antibiotics won’t help a viral eye infection. Expect the redness to last between 4 and 7 days.

Bacterial conjunctivitis

A sticky, yellow discharge indicates a bacterial infection. You can use warm water and your milk to keep the area clean and to provide some relief, but you’ll need to talk with a doctor about antibiotic eye drops or eye cream to fight the infection.

Newborn conjunctivitis

Newborns with redness in or around the eye need immediate medical attention.

If the redness is from a blocked tear duct, you can gently massage the opening of the duct and below the lower eyelid to help it open up.

Sometimes, the antimicrobial eye drops that your baby is given right after birth can irritate the eyes. This mild redness should clear up within 24 to 36 hours.

Infection can happen when viruses or bacteria in the birth canal pass from the mother to the baby.

Stye

Use a warm compress three to four times a day to ease discomfort and reduce redness. If you’re nursing, use a few drops of your milk, too.

Take your baby to a pediatrician if you don’t see any improvement despite the home treatments. Take your journal with you so that the doctor can help track any possible causes.

Remember to tell your pediatrician about any milk, egg, or gluten allergies that run in your family.

If your newborn has a bacterial infection, depending on the severity, your pediatrician will prescribe:

topical treatment, such as eye drops or ointment (most often)
oral antibiotics (less commonly)
intravenous antibiotics (very rarely)

If your baby’s tear duct is blocked, your pediatrician can show you how to massage the duct area to help it open.

Tear ducts usually open by themselves. However, if the duct doesn’t open by the time your child reaches age 1, they may need simple surgery.

If your toddler has bacterial conjunctivitis, your pediatrician will prescribe antibiotics.

Any time your little one has something going on, you may worry. But while redness around the eyes may bother you and your baby, it’s usually a simple thing to deal with.

Just be sure to call the doctor if there’s discharge, or if the issue hasn’t gotten better after a few days.

Redness of the eyes in children

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Conjunctivitis in children: diagnosis and treatment
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