Conjunctivitis essentially means inflammation of the surface layer – or conjunctiva – of the eye, so it is very non-specific, explains Dr Malcolm Carey, a Ballito-based ophthalmologist. “It usually means an infection – typically with bacteria,” says Dr Carey. “It is often called pink eye, but this usually refers to a viral cause.”
The causes of conjunctivitis in babies
“A lot of babies have blocked tear ducts or delayed opening of their tear ducts, which means their eyes are watery and a bit sticky,” explains Dr Carey. “In these cases, the actual white of the eye is not really affected and the pus can often come quite quickly, especially when they cry. Almost all of these go by the age of one year.”
The other common causes are bacterial and viral ones. Often when babies have an upper respiratory tract infection or a common cold, their noses get snotty and they get gunky eyes as a response to this.
The dangers of conjunctivitis in newborns
“Newborn babies can also get infections from the birth canal – these are obviously the most significant infections because they can be quite nasty bacteria,” says Dr Carey. If newborn babies develop conjunctivitis as a result of birth canal infections – which includes gonorrhoea and chlamydia – the consequences can be devastating. Because of this, babies get treated with antibiotic ointment in most hospitals when they are born.
Tested treatment options
Although many midwives and neonatal nurses recommend using breast milk to wash out your baby's eyes, Dr Carey cautions against this practice. At best, he says, it will do no harm, at worst, it can cause another concurrent infection. Although breast milk may contain antibodies, which may have some antibacterial effects, it won't provide more benefits than antibiotics or other medication will.
“The problem is that breast milk has a lot of stuff – water, fat, protein, carbohydrates – and it’s got tons of bacteria in it too. Under no circumstances is breast milk sterile. Often, if the mom has mastitis or some kind of infection, this pus will also be in the breast milk. There have been a couple of scientific studies to test this, and most of them haven't found unequivocally that breast milk works,” he says.
Conjunctivitis in children
Conjunctivitis is slightly more common in children than in adults because children spend a lot of time in close proximity with one another, get more colds and upper respiratory tract infections, have a tendency to rub their eyes, and often forget to wash their hands.
However, Dr Carey points out that these infections are usually not severe and, in most cases, are self-limiting, that is, the infections resolve spontaneously with or without treatment.
The difference between bacterial, viral and allergic conjunctivitis
- Bacterial conjunctivitis: “Bacterial infections have a very sticky, purulent discharge, and often a child’s eyelids are stuck together and need to be wiped with water to clear,” explains Dr Carey. “These infections are often in both eyes.”
- Viral conjunctivitis: “Viral infections are often associated with a concurrent sore throat or upper respiratory tract infection or cold. These are associated with a more watery discharge and cause deeply red eyes. Viral conjunctivitis often goes in little micro-epidemics, where a whole group – family or playgroup – may get it at the same time. It is very contagious.”
- Allergic conjunctivitis: “Allergic conjunctivitis is often associated with a concurrent asthma or sinusitis. In these cases, children often get a watery discharge and very itchy eyes, which they rub. This is usually quite easily distinguished from the other two causes.”
If your child shows signs of an infection…
Because most cases of conjunctivitis are relatively contagious, Dr Carey recommends that you keep your child home from school if he or she shows typical signs of conjunctivitis: redness, watery or sticky discharge, or itchy eyes. The sooner you visit the doctor for a diagnosis, the better.
“Bacterial conjunctivitis responds rapidly to treatment and is contagious for a much shorter period than viral conjunctivitis is,” Dr Carey says. “However, each case is specific and needs to be guided by a medical professional. You don't have to see a specialist, you can see your primary care physician or family doctor, who should be able to manage the conjunctivitis appropriately and refer on if necessary.”
Tips for dealing with conjunctivitis
- Teach your children to wash their hands well and often.
- If infected, do not share eye drops, washcloths, towels or pillowcases.
- Wash your own hands thoroughly after touching an infected child's eyes.
- Clean the edges of the infected eye carefully with warm water.
- Immediately throw away used gauze or cotton balls.
- Wash towels and other linen that your child has used separately in hot water.
- Relieve the discomfort by applying a warm compress to your child's closed eyelids.
- Over-the-counter lubricating drops may provide some relief.
- Be careful not to touch the eye with the eye-drops bottle.
Speak to your Clicks Pharmacist for more information and treatment options.
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