Red eye typically is from conjunctivitis, which literally means “inflammation of the conjunctiva.” The conjunctiva lines the inside surface of the eyelids and covers the surface of the eye. It is usually transparent. When it is inflamed it looks pink or red.
Conjunctivitis can be from bacteria, viruses, or allergy.
Bacterial conjunctivitis — spread by direct contact with the patient. It is highly contagious. Patients complain of redness and discharge in one eye, although it can also be in both. The affected eye often is “stuck shut” in the morning.
Viral conjunctivitis —may be part of a viral illness with fever, sore throat, and upper respiratory tract infection. It is highly contagious and is spread by direct contact with the patient. Patients may have watery discharge and a burning, sandy feeling in one eye. The second eye usually becomes involved within 24 to 48 hours. The symptoms get worse for the first three to five days, and gradually get better over two weeks.
Allergic conjunctivitis — caused by airborne allergens contacting the eye. It presents as redness, watery discharge, and itching in both eyes.
Noninfectious, nonallergic conjunctivitis — The usual cause is mechanical or chemical insult. Chemical splashes can cause reddness and discharge. Foreign bodies in eyes can cause reddness and discharge for 12 to 24 hours. If you wear contacts and have red eye, stop using the contacts immediately and wait at least 24h before seeking evaluation; sometimes contacst can cause red eye.
To treat bacterial causes, ointment is preferred over drops for children. Ointment stays on the lids. There is no treatement for viral conjunctivitis. Warm or cool compresses may provide symptomatic relief. There are many medications for allergic conjunctivitis.
Because there are so many different causes of red eye, you or your child should seek evaluation and treatment if you experience this.
After treatment, the next questions is always, “When can I send my child back to daycare/school?” Bacterial and viral conjunctivitis are both highly contagious and spread by direct contact. Do not share tissues, towels, or cosmetics. Most daycare centers and schools and require that students receive 24 hours of medication before returning to school.