Conjunctivitis in Babies: Types, Symptoms, Causes, Diagnosis, Treatment, Prevention and Advice

The chances of your baby getting this viral condition also known as “pink eye” is relatively high as it is quite contagious.

Conjunctivitis in babies is a contagious eye infection. As it is a viral infection, doctors do not recommend medications to treat conjunctivitis.

First, because antibiotics do not work in viral infections; and secondly, if your child is younger than two years, it is better to avoid antibiotics.

Once infected, your child will become irritated and upset due to the uncomfortable and painful nature of the infection.

What are the types of conjunctivitis?

There are four main types of Conjunctivitis:

Viral : Infection caused by a virus and is accompanied by other symptoms, such as a cold and cough.

Bacterial : caused by bacteria and is characterized by swollen eyelids and thick yellow discharge that causes the eyelids to stick together.

Allergic : caused by exposure to an allergic substance such as dust, pollen, mites and pets.

Irritant : any substance that may irritate the eye and eyelids, such as chlorine in swimming pools and pollutants in the air.

What are the Symptoms of Conjunctivitis?

It can affect one or both eyes at the same time. Your baby’s eyes will appear red and watery, and you will clearly notice the inflammation around the white part of the eye, as well as the lining of the inside of the eyelids.

A vaginal discharge may leak from your eye, initially, it would appear to be white, but if the infection gets worse, the pus will appear dark green and then yellow.

As it gets worse, the baby’s eyelashes will come together, forming a crust, the crusts usually occur in the morning or each time your baby wakes up after sleeping.

Your baby may also develop a fever, ear infection or cough in some bacterial infections. The baby experiences a lot of discomfort from itching and pain.

It’s contagious?

A common misconception is that conjunctivitis spreads simply by looking at another person who has the infection. It is not true. Conjunctivitis spreads only when children come into contact with an infected person.

Conjunctivitis is contagious only when it is caused by a microorganism, its contagious period ends when the treatment ends and there are no symptoms.

Viral

Viral conjunctivitis is extremely contagious and can be caused by the same type of virus that causes the common cold. It spreads easily by air, water and direct contact. A type of viral conjunctivitis caused by the adenovirus can be contagious for weeks after the first symptoms.

They can often cause outbreaks in schools and day care centers and remain contagious as long as symptoms are present.

Bacterial

Bacterial conjunctivitis is also very contagious and spreads easily by touching and sharing objects like toys with another infected child.

Allergic

Allergic conjunctivitis is specific to each child and the substances to which they are allergic. It does not spread like the bacterial and viral type.

Causes of Conjunctivitis in Babies

Conjunctivitis occurs when the causative organism, the allergen, or the irritant chemical comes into contact with the eyes.

When children touch their eyes or nose with dirty fingers contaminated with the causative agent, the infection occurs immediately. In case of bacterial and viral infections, it spreads mainly through the following mechanisms:

Direct contact : when a child with conjunctivitis touches or rubs his eyes and then touches another child.

Indirect contact : when an object that is contaminated, such as a tissue or a towel, touches or touches the child’s eye. The same can happen with toys and contaminated objects.

Gout : when the conjunctivitis is accompanied by cold, the droplets of a sneeze can also spread.

Sexual transmission : Conjunctivitis of these types commonly occurs in newborns. If the mother, who has a sexually transmitted disease, had a vaginal delivery, the baby can contract conjunctivitis.

Common Symptoms of Conjunctivitis in Children

Conjunctivitis has clear symptoms that can be seen as:

  • The eye turns pink or red due to inflammation. If it is bacterial, it can be an eye and when it is viral, it can be in both eyes.
  • Swelling of the inside of the eyelids and the thin layer that covers the white of the eyes.
  • Increased lacrimation and secretion of pus, which is greenish yellow (in bacterial infections).
  • An impulse to rub the eyes and the feeling that there is something trapped in the eye.
  • Encastramiento of the eyelashes or the eyelids after the dream, especially in the mornings.
  • Symptoms of allergy or cold or other respiratory infection.
  • Enlargement and sensitivity of the lymph nodes in front of the ears that may feel like a small lump when touched.
  • Sensitivity to light.

Diagnosis of Conjunctivitis

Conjunctivitis can be diagnosed by its symptoms and the pediatrician can discern the exact cause. Because there are other conditions, such as hay fever, that have similar symptoms, it is important to consult the pediatrician as soon as possible.

How do we treat conjunctivitis in babies?

The treatment depends on the type of conjunctivitis and the severity of the infection, sometimes, the conjunctivitis disappears on its own in a few days.

Because conjunctivitis is a viral infection, it usually passes through the system in about a week. During this time, it is imperative to treat the symptoms to relieve the discomfort of your baby.

This includes keeping your baby’s eyes clean and clear by using saline drops without a prescription, or using soft cleansing wipes to clean any pus or crust. You can also use a clean, damp cloth to clean your baby’s eyes.

To clean, always start from the inside corners and move gently towards the end of the eye, making sure not to leave any residue or dirt on the eye or eyelashes. Eye drops can help relieve itching, prevent the baby from scratching his eyes and further aggravate the infection.

You can also apply a slightly warm compress on the tear ducts to help stimulate blood circulation to the area, bringing the pus to the surface and allowing it to move faster from the eye.

This will also help keep the eye area moist, preventing the formation of scabs.

Once clean, try to keep your baby busy and divert your attention from your pain and discomfort by playing with them and soothing them.

Bacterial conjunctivitis : Bacterial infections are usually treated with antibiotics that come in the form of eye drops or ointments. It can be applied directly to the eye if the child cooperates or in the corner of the eye where it can enter slowly.

Viral conjunctivitis: should be left to clear up on its own, since it does not contain antibiotics. For greater comfort, the doctor will prescribe a soothing lubricant and advise you to keep the eye clean and apply cold packs.

Allergic conjunctivitis : treated with antihistamine drops to reduce inflammation. It is possible to say what caused the infection and stay away from it. For example, a tree or bush in full bloom next to the house in a specific season.

Prevention of Conjunctivitis in Babies

Good hygiene is the best preventive measure against the spread of conjunctivitis. Wash your child’s hands frequently and remind him not to touch his eyes.

If a family member is infected, ask them to stay away from the child as much as possible until the infection clears. Your clothes, towels and handkerchiefs should be washed separately from the child’s.

Make sure towels, napkins, pillows, tissues, or eye makeup are not shared at home or daycare. It is better if all the members have theirs.

Wash your baby’s clothes, towels and bedding regularly and dry them thoroughly. On rainy days, they can be dried on the inside and pressed with an iron to eliminate excess moisture.

Wash your hands with soap before feeding or touching the baby, especially if you have returned home after traveling through the city.

Use fresh cotton balls separately to clean each eye of the baby and prevent the infection from spreading from one eye to the other.

If you are aware that your child is allergic to pollen or specific dust or other chemical irritants, be sure to limit or avoid child exposure by closing windows, vacuuming frequently, etc.

Pregnant women should undergo screening and treatment of sexually transmitted diseases to prevent the onset of conjunctivitis in newborns.

When should you call the doctor?

Conjunctivitis can cause complications in newborns less than a month old.

Conjunctivitis is most often due to underdwelling tear ducts in newborns, but can sometimes be severe when caused by a sexually transmitted disease of the mother. Call your doctor immediately in that case.

In children, a doctor should be consulted immediately if:

  • The infection does not disappear in 3-4 days, despite the treatment.
  • The child has problems with vision.
  • The child has a fever, is not feeding properly and is lethargic.
  • The skin around the eye or eyelids is swollen, red and painful.

Can your child with Conjunctivitis go to day care?

It is best not to send a child with conjunctivitis to the nursery, since the possibility of an outbreak is high. Even when conjunctivitis is allergic, the daycare policy may not allow your child to attend if you have symptoms of an active infection.

It is definitely not if your child has viral or bacterial conjunctivitis. Although it seems disturbing, conjunctivitis is not a serious infection in children. With good hygiene and preventive methods, it is possible to reduce the chances of an infection.

Helpful tips

Consult your doctor or emergency room if:

  • The infection lasts more than a week, or the above techniques do not help your baby recover
  • Your baby’s condition is getting worse, this includes a yellow discharge and a high fever of more than 38 degrees Celsius. If your eye (s) is completely crusted or you can not stop rubbing it, then you should also seek medical attention.

Conjuntivitis Neonatal (Ophthalmia Neonatorum)

Neonatal conjunctivitis, also known as ophthalmia neonatorum, occurs during the first month of life. It can be aseptic or septic.

Neonatal aseptic conjunctivitis is most often a chemical conjunctivitis that is induced by the silver nitrate solution, which is used at birth for Crede prophylaxis of infectious conjunctivitis.

Chemical conjunctivitis is becoming less common due to the use of erythromycin ointment or povidone iodide instead of a silver nitrate solution for the prophylaxis of infectious conjunctivitis.

Bacterial and viral infections are the main causes of septic neonatal conjunctivitis, with chlamydia being the most common infectious agent. Babies can acquire these infectious agents as they pass through the birth canal during the birth process.

Anatomy and Pathology

The conjunctiva (a thin translucent mucous membrane) can be divided into palpebral, bulbar and fornical, depending on the location.

The conjunctiva contains non-keratinizing squamous epithelium and a thin, richly vascularized substance that contains lymphatic vessels and cells, such as lymphocytes, plasma cells, mast cells and macrophages.

The conjunctiva also has accessory lacrimal glands and goblet cells.

The pathology of neonatal conjunctivitis is influenced by the anatomy of the conjunctival tissues in the newborn. Inflammation of the conjunctiva can cause dilation of the blood vessels, potentially dramatic chemosis and excessive secretion.

This infection tends to be more severe in newborns due to its lack of immunity, absence of lymphoid tissue in the conjunctiva and absence of tears at birth.

Etiology

The etiology of neonatal conjunctivitis can be chemical or microbial. Although several infectious and noninfectious agents can inflame the conjunctiva, the most common causes of neonatal conjunctivitis are silver nitrate solution and chlamydial, gonococcal, staphylococcal and herpetic infections.

Silver Nitrate Solution

The method of Crede to infuse a drop of aqueous solution at 2% silver nitrate into the eyes of a newborn was first published in 1881 and significantly advanced in the prevention of neonatal conjunctivitis.

Silver nitrate is a surface active chemical that facilitates the agglutination and inactivation of gonococci. Ironically, it was later discovered that silver nitrate was toxic to the conjunctiva, particularly at higher concentrations, potentially causing sterile neonatal conjunctivitis.

Chlamydia conjunctivitis

Chlamydia trachomatis is an obligate intracellular parasite and has been identified as the most common infectious cause of neonatal conjunctivitis.

The reservoir of the organism is the cervix or maternal urethra. Babies born to infected mothers are at high risk (approximately 25% to 50%) of developing an infection. Chlamydia pneumonitis may also accompany neonatal conjunctivitis.

Conjunctivitis of Neisseria

Neisseria gonorrhoeae is a gram-negative diplococcus and is potentially the most dangerous and virulent infectious cause of neonatal conjunctivitis. As with chlamydia, the cervical and urethral maternal mucosa provide a reservoir for N gonorrhoeae, which is acquired during birth.

Gonococci can penetrate intact epithelial cells and divide rapidly within them. Gram or Giemsa diagnostic stains obtained from scrapes of the genitourinary or ocular mucosa reveal characteristic intracellular Gram-negative diplococci.

Gonococcal conjunctivitis should be completely excluded in all cases of neonatal conjunctivitis to prevent potentially blinding cornea and conjunctival complications.

Forecast

Neonatal conjunctivitis usually responds to appropriate treatment, and the prognosis is generally good.

Antibiotics have significantly altered the prognosis of neonatal conjunctivitis, especially with infection by Neisseria gonorrhoeae .

The mortality associated with neonatal conjunctivitis is due to the systemic involvement of the infectious agent. There is no published information available on mortality.

Complications

If left untreated, peripheral corneal ulceration can occur in N. gonorrhoeae infection and rapidly progress to corneal perforation.

When not recognized and treated immediately, Pseudomonas infection can cause endophthalmitis and subsequent death.

Pneumonia has been reported in 10-20% of children with chlamydial conjunctivitis.

Keratoconjunctivitis due to Herpes simplex virus can cause scarring and corneal ulceration. In addition, infection disseminated by Herpes simplex virus often includes involvement of the central nervous system.

Patient Education

Educate parents or caregivers to wash their hands frequently to prevent the transmission of neonatal conjunctivitis.

Educate pregnant women about the importance of regular exams to detect and treat sexually transmitted infections such as herpes simplex, gonorrhea and chlamydia in order to decrease the incidence of neonatal conjunctivitis.