Seeing Red? Your Child Might Have Pinkeye.

“Emily woke up this morning with red eyes, and her eyelashes were matted together with a greenish/yellow discharge. Last night when I wiped the discharge away, it kept coming back. Do you think she has pinkeye?”

It’s a common question for the nurses who work on the Answer Line at St. Louis Children’s Hospital.

Pinkeye, or conjunctivitis, occurs when the conjunctiva – a thin mucous membrane that covers the front portion of the eye and inner eyelids – becomes irritated or red. Bacterial conjunctivitis produces a yellow discharge from the eye(s), and is often a complication from a cold. There are many causes of conjunctivitis, and treatment can vary with the cause. The most common causes in children are bacteria, viruses and allergies.

Home care tips
Let’s say your pediatrician has decided that Emily has bacterial conjunctivitis that should be treated with antibiotic eye drops or eye ointment. What do you need to know?

• Bacterial conjunctivitis is very contagious, so Emily will be considered contagious until she has been on the antibiotic for 24 hours and the amount of discharge is minimal.
• In the home, give Emily her own towel, wash cloth and pillow cases, and wash them frequently until the infection subsides.
• Frequent, thorough hand washing by all family members will help keep the infection from spreading throughout the household.
• When applying the medication, take care not to contaminate the end of the dropper or share eye drops with anyone else in the family.
• Comfort measures include gently cleansing the discharge from the eyes with a warm, damp cotton ball. Dispose of the cotton ball carefully as there is infective matter on it. Wash your hands well.

Using the medicine
Here are some suggestions for giving the eye drops or eye ointment:

• Cleanse the eye before applying the medication. If your child wears contact lens, she should switch to glasses temporarily.
• When giving eye drops to an infant, cradle her in your arms or have her lie on her back. When the eye is closed, place the drops in the inner corner of the eye. When the baby opens her eye, the medication will roll in.
• If you have a toddler, have her lie on her back, then gently pull the lower lid down and place the eye drops or ointment in the little pocket. Older children can stand and look up while you place the medication in the same manner.
• If your child balks at having medication placed in her eye, take a tip from a nurse: Instead of asking, “Emily, do you want your eye drops now?” try saying, with great confidence, “Emily, it’s time for your eye medicine now.” (Trust me, this approach works best!)

While the child doesn’t have a choice about whether or not to get the medication, she can have a choice about other things, such as what room she will be in when the medication is given. You can also give her a pleasant choice of things to do after the medication is in – for example: “Do you want to go out and play, or do you want me to read to you?”

Recovery
In general, the affected eye starts to feel better in about 24 hours. If your child still has drainage after three days or the eye isn’t improving, give your pediatrician a call. Sometimes there is a resistant strain of bacteria and your child may need a different medication.

If the eye becomes very itchy, especially right after instilling the medication, stop the medicine and call your doctor. Your child could be allergic to the medication. While bacterial conjunctivitis usually resolves without a problem, there are some reasons to contact your doctor right away:

• If the eyelid or area around the eye looks very red or swollen, especially if your child has fever. This could indicate an infection of the tissue around the eye and requires immediate treatment.
• If your child seems very sick.
• If your child has marked discomfort or decreased vision. 
  If the cornea (clear part of the eye) has a cloudy spot.

This article was written by Judy Ward, RN, a pediatric nurse at the St. Louis Children's Hospital Answer Line. For more information, please call the St. Louis Children’s Answer Line at 314.454.KIDS or 800.678.KIDS.