Bacterial Conjunctivitis, Pediatric

Bacterial conjunctivitis is an infection of the clear membrane that covers the white part of the eye and the inner surface of the eyelid (conjunctiva). It causes the blood vessels in the conjunctiva to become inflamed. The eye becomes red or pink and may be irritated or itchy. Bacterial conjunctivitis can spread easily from person to person (is contagious). It can also spread easily from one eye to the other eye.

What are the causes?

This condition is caused by a bacterial infection. Your child may get the infection if he or she has close contact with:

A person who is infected with the bacteria.
Items that are contaminated with the bacteria, such as towels, pillowcases, or washcloths.

What are the signs or symptoms?

A normal eye compared to an eye with bacterial conjunctivitis.

Symptoms of this condition include:

Thick, yellow discharge or pus coming from the eyes.
Eyelids that stick together because of the pus or crusts.
Pink or red eyes.
Sore or painful eyes, or a burning feeling in the eyes.
Tearing or watery eyes.
Itchy eyes.
Swollen eyelids.

Other symptoms may include:

Feeling like something is stuck in the eyes.
Blurry vision.
Having an ear infection at the same time.

How is this diagnosed?

This condition is diagnosed based on:

Your child's symptoms and medical history.
An exam of your child's eye.
Testing a sample of discharge or pus from your child's eye. This is rarely done.

How is this treated?

This condition may be treated by:

Using antibiotic medicines. These may be:
- Eye drops or ointments to clear the infection quickly and to prevent the spread of the infection to others.
- Pill or liquid medicine taken by mouth (orally). Oral medicine may be used to treat infections that do not respond to drops or ointments, or infections that last longer than 10 days.
Placing cool, wet cloths (cool compresses) on your child's eyes.

Follow these instructions at home:

Medicines

Give or apply over-the-counter and prescription medicines only as told by your child's health care provider.
Give antibiotic medicine, drops, and ointment as told by your child's health care provider. Do not stop giving the antibiotic, even if your child's condition improves, unless directed by your child's health care provider.
Avoid touching the edge of the affected eyelid with the eye-drop bottle or ointment tube when applying medicines to your child's eye. This will prevent the spread of infection to the other eye or to other people.
Do not give your child aspirin because of the association with Reye's syndrome.

Managing discomfort

Gently wipe away any drainage from your child's eye with a warm, wet washcloth or a cotton ball. Wash your hands for at least 20 seconds before and after providing this care.
To relieve itching or burning, apply a cool compress to your child's eye for 10–20 minutes, 3–4 times a day.

Preventing the infection from spreading

Do not let your child share towels, pillowcases, or washcloths.
Do not let your child share eye makeup, makeup brushes, contact lenses, or glasses with others.
Have your child wash his or her hands often with soap and water for at least 20 seconds and especially before touching the face or eyes. Have your child use paper towels to dry his or her hands. If soap and water are not available, have your child use hand sanitizer.
Have your child avoid contact with other children while your child has symptoms, or as long as told by your child's health care provider.

General instructions

Do not let your child wear contact lenses until the inflammation is gone and your child's health care provider says it is safe to wear them again. Ask your child's health care provider how to clean (sterilize) or replace his or her contact lenses before using them again. Have your child wear glasses until he or she can start wearing contacts again.
Do not let your child wear eye makeup until the inflammation is gone. Throw away any old eye makeup that may contain bacteria.
Change or wash your child's pillowcase every day.
Have your child avoid touching or rubbing his or her eyes.
Do not let your child use a swimming pool while he or she still has symptoms.
Keep all follow-up visits. This is important.

Contact a health care provider if:

Your child has a fever.
Your child's symptoms get worse or do not get better with treatment.
Your child's symptoms do not get better after 10 days.
Your child's vision becomes suddenly blurry.

Get help right away if:

Your child who is younger than 3 months has a temperature of 100.4°F (38°C) or higher.
Your child who is 3 months to 3 years old has a temperature of 102.2°F (39°C) or higher.
Your child cannot see.
Your child has severe pain in the eyes.
Your child has facial pain, redness, or swelling.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.).

Summary

Bacterial conjunctivitis is an infection of the clear membrane that covers the white part of the eye and the inner surface of the eyelid.
Thick, yellow discharge or pus coming from the eye is a common symptom of bacterial conjunctivitis.
Bacterial conjunctivitis can spread easily from eye to eye and from person to person (is contagious).
Have your child avoid touching or rubbing his or her eyes.
Give antibiotic medicine, drops, and ointment as told by your child's health care provider. Do not stop giving the antibiotic even if your child's condition improves.