Pink Eye in Babies: A Complete Guide
The World Health Organization defines pink eye in babies as inflammation of the conjunctiva in the first 28 days of the birth of a child.
It is also known as Neonatal Conjunctivitis.
The prevalence of neonatal pink eye is low in developed countries but is still quite prevalent in developing countries.
According to a 2022 study, infectious neonatal Conjunctivitis affects around 1%-2% of newborns worldwide.
The most common types of pink eye in babies, their symptoms, and treatments are discussed below.
Inclusion (chlamydial) Conjunctivitis
Chlamydial Conjunctivitis is another kind of pink eye in babies.
A pregnant woman with untreated Chlamydia can pass the infection to the baby during birth.
Sometimes the bacteria can also infect the baby’s lungs and nasopharynx.
Symptoms
Symptoms in a baby usually appear 5 to 14 days after birth.
They might develop earlier if the amniotic sac ruptures during delivery.
Symptoms of Chlamydial Conjunctivitis include:
- Redness in the eye(s)
- Swollen eyelids
- Persistent tearing
- Pus discharge
Treatment
For infants born to mothers who have Chlamydia exposure, there is no prophylaxis (preventive treatment).
Doctors usually prescribe oral antibiotics as the recommended treatment.
Topical treatment for the same is usually unnecessary and ineffective.
It can, however, be used as an adjunct to oral therapy.
Topical treatment usually consists of sulfacetamide or tetracycline ointment or drops.
1 in 5 cases usually recur after the first course of antibiotic therapy and might require a second course of medication.
Also, some of the infected neonates might develop chlamydial pneumonitis requiring treatment.
Gonococcal Conjunctivitis
Neisseria Gonorrhoeae causes Gonorrhea as well as Gonococcal Conjunctivitis (GC).
A pregnant woman with untreated Gonorrhea can pass the bacteria to her baby during childbirth.
Symptoms
The symptoms of Gonococcal Conjunctivitis start appearing two to five days after the child’s birth.
They might develop earlier if the amniotic sac ruptures during delivery.
The commonly observed symptoms include:
- Swelling of the conjunctiva
- Swollen eyelids
- Red eyes
- Stringy, mucus-like white or yellow discharge
- Preauricular lymphadenopathy
Treatment
Gonococcal Conjunctivitis can potentially lead to blindness.
Hence, early detection and quick treatment become critical.
The most effective GC treatment is prevention.
Prophylactic treatment includes Erythromycin or Tetracycline ointment.
GC treatment consists of administering intravenous (IV) or intramuscular (IM) antibiotics along with the topical application of ointment to the eye.
Eye irrigation with sterile saline is also considered to flush the eyes.
Chemical Conjunctivitis
In a lot of states, it is required by law to put antibiotic medication in the eyes of a newborn.
This protects them from unknown gonorrhea infections in the mother’s body.
Earlier, these eye drops had silver nitrate in them, which made the eyes red and irritated.
This might be diagnosed as Chemical Conjunctivitis.
However, substituting silver nitrate with erythromycin ointment has dramatically reduced the incidence of chemical Conjunctivitis in the US.
Symptoms
Symptoms of chemical Conjunctivitis usually appear 6-8 hours after the instillation of drops and include:
- Mild redness of the eyes
- Swollen eyelids
Treatment
Since irritation by chemicals cause chemical Conjunctivitis, it does not require any treatment.
It usually clears up on its own in a day or two.
Other viral and bacterial Conjunctivitis
Bacteria and viruses other than those mentioned above can also cause Conjunctivitis.
Bacteria that usually live in the vagina of a woman and are not transmitted sexually can lead to pink eye in babies.
Besides, viruses causing genital or oral herpes might also cause neonatal Conjunctivitis and eye damage.
These viruses are generally passed on to the baby during childbirth.
Herpes Simplex Conjunctivitis is less common than those previously discussed.
Symptoms
Typical symptoms of pink eye in babies include the following:
- Red eyes
- Swollen eyelids
- Pus discharge
Treatment
Doctors prescribe antibiotic drops or ointments to help with bacterial pink eye in babies.
Using a compress may be advised for both viral and bacterial pink eye.
Use a warm compress to get rid of crusting on the eyelids or discharge.
A cold compress might be helpful to control swelling and puffiness of the eyes.
Also Read: If you want to know more about pink eye treatment, go through the article A Guide to Pink Eye Treatment and Relief.
Blocked tear duct
A blockage in the tear duct, also called Lacrimal Duct Obstruction, might also lead to Conjunctivitis in newborn babies.
This blockage occurs in almost 5%- 20% of all newborns.
A blocked tear duct might cause an infection or inflammation in the conjunctiva leading to pink eye in babies.
Symptoms
The following symptoms can be observed when an infant has Conjunctivitis due to an infection caused by a blocked tear duct.
- Excessive tearing (even without crying)
- Crusting on the lashes
- Mild redness or irritation
- Swollen eyelid
Treatment
The problem generally resolves itself by six months of age in 50% of the affected neonates.
Hence, conservative treatment involving lacrimal massage and topical antibiotics is recommended.
Any obstruction that does not resolve by this time might require lacrimal probing to open the tear duct and restore functioning.
Takeaway
Pink eye in babies, also called neonatal Conjunctivitis, can be caused due to any bacteria, virus, or a blocked tear duct.
It commonly appears as redness and swelling in the eyes along with discharge.
Antibiotics are usually given in case of bacterial infection, while viral pink eye usually clears up by itself.
In all cases of pink eye in babies, warm and cold compresses are highly suggested to provide relief to the newborn.
Frequently Asked Questions
What does pink eye look like in babies?
Pink eye in babies can be seen as redness in the eyes, swollen eyelids, and pus discharge. In some cases, excessive tearing can also be observed even when the child is not crying, apart from the crusting of the eyelids.
How to treat pink eye in babies?
Pink eye in babies due to bacteria is usually treated using antibiotics. Viral Conjunctivitis is seen to clear up by itself. Doctors recommend warm and cold compresses in both cases to relieve crusting and swelling.
Is pink eye a sign of Covid in babies?
If the child has not been exposed to a person infected with Covid-19 or has not been to a large gathering, it is highly unlikely that your child has Covid. However, consult a doctor if your child exhibits other symptoms related to Covid.
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