By Sue Hubbard, M.D.
Conjunctivitis is defined as reddening of the outermost layer of the eye; it is also called "pink eye." I have to laugh when I tell a patient that their child has conjunctivitis, and the parent replies, "at least they don't have pink eye." If your eye is pink, then it is called pink eye, but the question arises, what is causing the pink eye?
There are several common causes for conjunctivitis in children. Like many other illnesses, pink eye may be caused by a viral infection, a bacterial infection or allergies. There are certain physical findings that may point to the type of infection that is causing pink eye.
Bacterial conjunctivitis is more common in infants, toddlers and preschool children. Did you know that one in 8 children has an episode of conjunctivitis each year and there are 5 million cases in the U.S every year? Those little "germy" toddlers are good at touching their eyes, toys and each other and can readily spread pink eye.
Bacterial conjunctivitis typically causes a "gooey" discharge as well as matting of the eyelids. Children awaken with an eye that is "glued" shut with gunk. It's usually present in both eyes and may be associated with an infected ear, as well, so if your toddler has gooey eyes they should be examined. If they have both otitis (ear infection) and conjunctivitis, they will need an oral antibiotic and not just eye drops.
Viral conjunctivitis is more common in older children (and adults), than in the preschool set. It is also very contagious but the discharge is usually more watery. The most common cause of a viral pink eye is adenovirus - and this may cause one really red eye.
Viral pink eye is more often one-sided than a bacterial infection. It is also not uncommon to have a sore throat along with a viral pink eye. Viral conjunctivitis does not improve with antibacterial eye drops, so if you have a pink eye and it is not getting better with antibiotic eye drops, it is most likely viral in origin. I often just use over-the-counter artificial tears for a viral pink eye, just to help soothe the eye if the child/adolescent is "bugged" by it. Contact lenses should not be worn at this time, either.
Allergic conjunctivitis is more commonly seen during allergy season. Its symptoms seem to come and go and may include itchy red eyes, watery or gooey discharge, swelling of the eyelids and area beneath the eye (allergic shiners) and a runny nose. Sometimes, the conjunctiva becomes so affected that there are even blebs present.
So if you have a child with draining pink eyes, keep up that hand-washing in hopes that you are not going to catch pink eye! We can always tell which doctors/nurses and staff have succumbed to pink eye as they show up wearing glasses.
Dr. Sue Hubbard is a nationally known pediatrician and co-host of "The Kid's Doctor" radio show. Submit questions at www.kidsdr.com
This was printed in the April 7, 2013 - April 20, 2013 Edition