EYE, RED (WITHOUT PUS)
Symptom Definition
- Redness or pinkness of the white of the eye and inner eyelids.
- May have increased tearing (watery eye).
- Eyelid may be puffy or mildly swollen
- No pus or other discharge.
Causes
- Viral conjunctivitis (part of a cold) is the main cause. Almost always involves both eyes.
- Allergic conjunctivitis from pollens.
- Mild chemical conjunctivitis from irritants (e.g., sunscreen, soap, chlorinated pool water, smoke, or smog).
- Irritants transferred by touching the eye may just involve one eye (e.g., food or plant resins on the fingers).
Return to School
- Pink eye with a watery discharge is harmless and mildly contagious. Children with colds in the eye do not need to miss any day care or school.
See More Appropriate Topic (instead of this one) If
- Feels like something got in eye, see EYE, FOREIGN BODY IN.
- Yellow or green pus in eye, see EYE, PUS OR DRAINAGE.
- Main symptom is itchy eyes, see EYE, ALLERGY.
WHEN TO CALL YOUR DOCTOR
Call your doctor now (night or day) if:
- Your child looks or acts very sick
- Eyelid is very red or very swollen
- Constant tearing or blinking
- Eye pain or blurred vision
- Cloudy spot on the cornea (clear part of the eye)
- Turns away from any light
- Age less than 12 weeks with fever above 100.4°F (38°C) rectally. (Caution: Do NOT give your baby any fever medicine before being seen.)
Call your doctor within 24 hours (between 9am and 4pm) if:
- You think your child needs to be seen
- Only 1 eye is red and present for more than 24 hours
Call your doctor during weekday office hours if:
- You have other questions or concerns
- Age less than 1 month old
- Redness lasts over 7 days
Parent care at home if:
- Red eye as part of a cold and you don't think your child needs to be seen.
- Red eye caused by mild irritant (e.g. soap, sunscreen, food) and you don't think your child needs to be seen.
Treatment For Viral Eye Infections
- Reassurance: Some viruses cause watery eyes (viral conjunctivitis). It may be the first symptom of a cold. It isn't serious and we can treat that at home. Colds can also cause a small amount of mucus to collect in the inner corner of the eye.
- Eye Cleansing: Cleanse eyelids with warm water and a clean cotton ball at least every 2 hours while your child is awake and at home. This usually will keep a bacterial infection from occurring.
- Artificial tears:
- Artificial tears often make red eyes feel better.
- Use 1 drop per eye three times a day. Use them after cleansing the eyelids.
- Antibiotic and vasoconstrictor eyedrops do not help viral eye infections.
- Contacts: Children with contact lenses need to switch to glasses temporarily (reason: to prevent damage to the cornea).
- Contagiousness: Pink eye with a watery discharge is harmless and mildly contagious. Children with colds in the eye do not need to miss any day care or school. If asked, tell the school your child is on eyedrops (artificial tears).
- Expected Course: Pink eye with a cold usually lasts about 7 days.
- Call Your Doctor If:
- Yellow or green discharge develops
- Redness lasts for more than 1 week
- Your child becomes worse
Treatment For Mild Eye Irritants
- Reassurance: Most eye irritants cause transient redness of the eyes. We can treat that at home.
- Face Cleansing: Wash the face with mild soap and water. Wash off eyelids with water. This will remove any irritants.
- Eye Irrigation: Irrigate the eye with warm water for 5 minutes.
- Eye Drops:
- Red eyes from irritants usually feel much better after the irritant has been washed out.
- If they remain uncomfortable and bloodshot, instill artificial tears or a long-acting vasoconstrictor eye drops (no prescription needed).
- You can ask your pharmacist to recommend a brand.
- Use 1 drop every 8 to 12 hours as necessary.
- Expected Course: After removal of the irritant, the eyes usually return to normal color in 1 to 2 hours.
- Prevention: Try to avoid future exposure to the irritant.
- Call Your Doctor If:
- Develops yellow or green pus in the eye
- Redness lasts over 7 days
- Your child becomes worse
And remember, contact your doctor if your child becomes worse or develops any of the "Call Your Doctor" symptoms.
REFERENCES
- Fisher MC. Conjunctivitis in children. Pediatr Clin North Am. 1987;34:1447-1456.
- Gigliotti F. Acute conjunctivitis. Pediatr Rev. 1995;16:203-208.
- Greenburg MF, Pollard ZF. The red eye in childhood. Pediatr Clin North Am. 2003;50:105-24.
- Nakanishi AK and Soltau JB. Common viral infections of the eye. Pediatr Ann. 1996;25:542-554.
- Soparkar CN, Wilhelmus KR, Koch DD, Wallace GW, Jones DB. Acute and chronic conjunctivitis due to over-the-counter ophthalmic decongestants. Arch Ophthalmol. 1997;115:34-38.
Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.
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