Red eyes in children are most often a symptom of conjunctivitis, which can be easily treated either through home observation (if the discharge is watery) or with topical antibiotics (if the discharge is purulent).
The majority of causes of red eyes in children are benign. However, a pediatric ophthalmological examination is mandatory in order to diagnose the problem and receive the necessary ocular treatment.
Why do the eyes become red?
Red eyes can occur frequently in both adults and children.
The eyes become red when the blood vessels on the surface of the eye dilate due to irritation or infection.
The eyes can become red gradually or suddenly, depending on the cause. A patient can have red eyes without any other symptoms or the problem can be accompanied by other symptoms. The most common ones are red and swollen eyes in children, red eyes in children with colds, fever and red eyes in children, red eyes and discharges in children, red eyes and itching in children. Certain changes in vision can also occur. It is also common for a red eye to look worse than it actually feels.
Possible causes for redness of the eyes in children
There are several underlying causes for red eyes in children. Even though many of them are not a real cause for concern, it is necessary for an ophthalmologist to evaluate any problem.
The most common causes of red eyes in children are:
1. Viral conjunctivitis
Viral conjunctivitis, also known as “red eyes”, is most commonly the result of a cold. This form of conjunctivitis is contagious and can occur after the child has had an upper respiratory tract infection.
Symptoms usually start in one eye and then spread to the other. Signs of conjunctivitis include:
- Red eyes
- Burning or itching sensation in the eyes
- Swollen eyelids
- Photosensitivity (sensitivity to light)
- Excessive tearing
- Yellow, watery or viscous discharge
2. Bacterial conjunctivitis
Bacterial strains of conjunctivitis occur as a result of direct contact with a bacterium. The child can develop bacterial conjunctivitis by touching the face with dirty hands or by applying contaminated makeup or facial lotions.
The symptoms of bacterial conjunctivitis are similar to those of the viral strain, except that it usually involves a much yellower discharge.
Bacterial conjunctivitis is contagious and requires treatment.
3. Allergic conjunctivitis
This disorder occurs when allergens enter the eyes and trigger an allergic reaction. Allergic conjunctivitis is accompanied by red eyes, itching, tearing, and a burning sensation.
The common causes of allergic conjunctivitis are:
- Dust
- Pollen
- Mold spores
- Animal dander
- Detergents or perfumes
The child may experience this allergic reaction for a short or prolonged period, depending on the trigger of the allergy.
4. Corneal abrasion
Corneal abrasion refers to a scratch on the cornea (the transparent part that protects the eye). Many small particles can cause scratches on the cornea, such as dust, dirt, sand, contact lenses, or even a piece of paper.
Signs indicating a possible corneal abrasion in your child:
- Eye pain
- A gritty sensation in the eyes
- Tearing
- Red eyes
- Sensitivity to light
- Headaches
5. Blepharitis
Blepharitis is an inflammation of the eyelids. This problem can occur due to small glands near the base of the eyelids becoming blocked, causing irritation and inflammation. Sometimes, blepharitis can lead to the development of the chalazion.
Although uncomfortable, blepharitis is not contagious and does not cause permanent eye damage.
Some symptoms of blepharitis include:
- Tearing
- Red eyes
- Itching at the level of the eyelids
- Burning or stinging sensation in the eyes
- Skin peeling around the eyes
Diagnosing red eyes
First, the doctor wants to know how long the redness has been present and whether it involves one or both eyes. They will also look for information regarding associated symptoms: blurred vision, photophobia, vision loss, eye discharge, discomfort, or itching.
It is important to gather information about a recent history of trauma. This could be physical impact, a foreign object, or exposure to chemicals.
The ocular history is extremely important, as “sudden loss of vision” can occur due to amblyopia or chronic eye problems. The medical history should include recent illness, systemic abnormalities, medications, allergies, and prenatal and birth history. A family history of eye problems and any relevant medical conditions can be helpful.
Next, the vision is evaluated.
- In infants and young children, the procedure involves testing their ability to fix and follow. For children over three years old, the use of an eye chart is recommended, and the exact type of chart (e.g. Lea, HOTV, Snellen) depends on their level of literacy.
- The uvea and the surface of the patient’s eye should be examined with a magnifying glass for the head and proper illumination from a direct ophthalmoscope, a bulb flashlight, or a slit lamp. The doctor will look for signs of inflammation, redness, discharge, trauma, or entropion.
- It will also check the cornea to see if there are foreign objects or ulcers, which can cause corneal ulcer or microbial keratitis.
- The intraocular pressure is measured using a tonometer.
- The upper eyelid is examined in detail, specifically looking for foreign objects. The ability to turn the eyelid depends on the child’s cooperation and cannot be done if the eyelid is very swollen.
- The iris is also checked – if it is prominent, it is possible that the cornea is perforated, which requires emergency surgical intervention.
- The Brückner test is used to evaluate the symmetry of reflexes in both eyes. If there are discrepancies, it may be due to retinal abnormalities, significant refractive errors, or eye deviations.
Available treatment options
If the eye only has mild irritation, it is recommended to practice local hygiene, use artificial tears, and avoid wearing contact lenses (if applicable). If the symptoms are more severe, such as purulent discharge, eye pain, or decreased visual acuity, it is advisable to see an ophthalmologist. Ophthalmic treatment depends on the cause of the red eyes.
- Viral conjunctivitis treatment
There is no direct treatment for viral strains of conjunctivitis, but the doctor can reduce the child’s discomfort. It may recommend eye drops for red eyes, without antibiotics, ocular rest, and applying warm compresses to the eyes. The infection should resolve over time.
- Bacterial conjunctivitis treatment
To treat this eye disorder, the doctor may prescribe eye drops for red eyes in children or antibiotic-based ointments.
- Allergic conjunctivitis treatment
The treatment for allergic conjunctivitis involves eliminating the allergic factor, relieving present symptoms, and minimizing future exposure to allergens.
- Treatment for corneal abrasion
This problem requires urgent ophthalmological treatmentto prevent the occurrence of an infection. Before going to the doctor, rinse the child’s eye with artificial tears or a saline eye wash solution. If you don’t have them on hand, use drinking water and have the child blink several times to remove as many irritating particles as possible.
How can red eyes in children be prevented?
Red eyes in children can be prevented with the help of a few basic rules regarding hygiene and health.
- Avoiding prolonged exposure to electronic device screens
- Adequate hydration
- Maintaining proper ocular hygiene (avoiding eye contamination by touching them with dirty hands or improper use of contact lenses)
- Refraining from rubbing the eyes
- Preventing eye contamination with various harmful substances
- Using artificial tears
When should you seek specialized examination?
Red eyes in children are usually not a cause for concern. The redness usually goes away on its own, but sometimes it may indicate a more serious problem. Schedule an ophthalmological consultation for your child if you also notice the following symptoms, in addition to red eyes:
- Eye pain
- Worsening of vision
- Sensitivity to light
- Symptoms that persist for more than a few days
- Worsening of symptoms
- Pus or mucus draining from the eyes
- Fever
Dr. Holhoș clinics provide you with top specialists and state-of-the-art ophthalmological technology. Your child will be in good hands.