Pinkeye in Toddlers

Pretty in pink? Not so much — if your daughter comes down with a case of pinkeye, that is. Pinkeye (aka conjunctivitis in medicalese) is an infection of the conjunctiva (the membrane lining the eyes and lids) and announces itself with —you guessed it — the white part of the eye turning pink (or even red) as the eye’s blood vessels become inflamed. You’ll also notice some swelling in the eye, and your child may wake up in the morning or from her naps with crusty, dried secretions around her eyelids. Yes, it looks awful, but it looks a whole lot worse than it actually is (in other words, no need to worry).

Because conjunctivitis can be caused by many of the same viruses that also cause colds (and in fact, kids often develop pinkeye when they get the sniffles), think of it as a “cold” in your toddler’s eye. But pinkeye can also be caused by bacteria and even allergens and irritants (like dust, smoke, or soap). Here’s how to tell what’s putting the pink in your toddler’s peepers:

• If one or both eyes are pink and there’s a lot of tearing and a yellow or green discharge, then a virus or bacteria is probably causing your tot’s conjunctivitis.
• If both eyes are pink and teary and itchy — and your toddler is also complaining of a stuffy, runny, or itchy nose — allergies may be the culprit.

Pinkeye from allergies or chemical irritants isn’t contagious. But bacterial and viral pinkeye are very contagious — and transmitted by coughing, sneezing, and hand-eye contact with those eye secretions. Because kids rub their eyes a lot and then touch things (meaning everything and everyone!), one tot with a case of contagious conjunctivitis can really start an epidemic in day care or preschool. So if your little one has a case of pinkeye, it’s best to keep her at home so she doesn’t pass the pink on to her pals. You should also get her to the pediatrician, pronto! (It’s a good idea for a doctor to check any pink discoloration in the eye, even if you suspect it’s only allergies.)

Treating pinkeye
Because it can be hard, even for doctors, to know whether a case of conjunctivitis is viral or bacterial, pediatricians often prescribe antibiotic drops when they suspect either one, just to be on the safe side — even though only the bacterial infection will respond to the medicine (viral pinkeye usually goes away on its own). If your doctor can definitively diagnose bacterial pinkeye, your child can return to day care or preschool after she’s been using the antibiotic eyedrops or ointment for 24 hours. If there’s a suspicion that it might be viral, then keep her home until she’s no longer contagious (that would be when her eye stops discharging gunk, the color goes back to normal, and she’s no longer rubbing it).

While the drops are working their magic, you can keep your child comfortable with such soothers as:

• Warm, wet cloths to wipe the goop and crusties from your toddler’s eyes — especially in the mornings and after naps.
• Compresses (warm if it’s bacterial/viral; cool if it’s allergies or other irritants) to reduce the swelling.”
• Acetaminophen or ibuprofen (taken orally) to relieve the discomfort.
• Antihistamine eyedrops for allergy-related pinkeye. Always ask your doctor first before using any eyedrops on your toddler.

To help prevent your child’s infection from spreading to the rest of the family, follow these tips:

• Change your child’s bed linens and towels after the infection has run its course — and wash them in hot water separately from the rest of the family laundry. Make sure everyone in your house uses his or her own washcloths and towels. This is one time when you don’t want to encourage sharing!
• Make sure everyone washes his or her hands frequently — with soap. Encourage your tot to keep scrubbing until she’s gotten through two verses of the "Happy Birthday” song.
• Wipe or spray commonly used items around the house — faucet and door handles, plastic toys, and so on — with disinfectants. And tell your child’s day-care teacher so that she can disinfect the day-care area. If your tot goes to swim class, alert that teacher as well — under-chlorinated pools are a prime source for bacterial pinkeye.
• Remind every family member (you too!) not to touch his or her eyes.

Pinkeye usually runs its course in three to five days. Any infection that lingers beyond a few days with treatment (or a week without), particularly if your toddler develops a fever, can mean the infection is spreading and should be reevaluated by your pediatrician.