From the Guidelines
To diagnose pink eye in a child, look for redness in the white part of the eye, discharge that may be clear, yellow, or greenish, crusty eyelids especially upon waking, itchiness, tearing, and sensitivity to light, and seek medical attention promptly if you notice significant redness, discharge that doesn't improve within 24-48 hours, eye pain, vision changes, or if the child has a fever, as recommended by the most recent conjunctivitis preferred practice pattern 1. When diagnosing pink eye, it's essential to consider the different types of conjunctivitis, including viral, bacterial, and allergic, as each has distinct clinical signs and requires specific treatment.
- Viral conjunctivitis typically affects both eyes and produces a watery discharge.
- Bacterial conjunctivitis often starts in one eye with thicker, yellowish-green discharge.
- Allergic conjunctivitis is usually accompanied by itching and affects both eyes. For a proper diagnosis, gently clean any discharge with a warm, damp cloth and examine the eye in good lighting. If you notice any of the following, seek medical attention promptly:
- Significant redness
- Discharge that doesn't improve within 24-48 hours
- Eye pain
- Vision changes
- Fever A healthcare provider can determine the specific cause and recommend appropriate treatment, which might include antibiotic eye drops for bacterial infections (such as polymyxin B-trimethoprim or erythromycin ointment), antihistamine drops for allergic reactions, or supportive care for viral cases, as outlined in the conjunctivitis preferred practice pattern 1. Early diagnosis helps prevent spread to others, as pink eye is highly contagious, especially in school and daycare settings. It's also crucial to refer patients with conjunctivitis to an ophthalmologist in certain circumstances, such as visual loss, moderate or severe pain, severe purulent discharge, corneal involvement, or lack of response to therapy, as recommended by the conjunctivitis preferred practice pattern 1.
From the Research
Diagnosing Pink Eye in a Child
To diagnose pink eye in a child, it is essential to identify the symptoms and signs of conjunctivitis. The following are some key points to consider:
- Conjunctivitis can be caused by a viral or bacterial infection, and the symptoms can vary depending on the cause 2.
- Common symptoms of conjunctivitis include redness, itching, foreign body sensation, tearing, and lid swelling 3, 4.
- A clinical diagnosis of conjunctivitis can be made based on the presence of these symptoms and signs, such as conjunctival injection, conjunctival chemosis, conjunctival mucus, and lid edema 3.
- Artificial tears can be used to relieve the symptoms of conjunctivitis, and they have been shown to be effective in reducing the duration of symptoms 2, 5.
- Topical antibiotics may also be prescribed to treat bacterial conjunctivitis, and they have been shown to be effective in reducing the duration of symptoms 2.
Key Symptoms to Look Out For
Some key symptoms to look out for when diagnosing pink eye in a child include:
- Redness and inflammation of the eye
- Itching or burning sensation in the eye
- Excessive tearing or discharge
- Swelling of the eyelids
- Foreign body sensation in the eye
- Conjunctival injection or chemosis
Treatment Options
Treatment options for conjunctivitis include: