Conjunctivitis

Conjunctivitis is a common eye condition that affects children, especially under 5 years of age. It can either be caused by an infection or by an allergy. Infectious conjunctivitis is contagious and may spread to other household members. Allergic conjunctivitis is more common in children with allergies such as hay fever.

If your child has conjunctivitis, they may have:

  • a red or pink eye (or both eyes)
  • redness behind the eyelid
  • swelling of the eyelids, making them appear puffy
  • excessive tears
  • a yellow-green discharge from the eye which dries when your child sleeps, causing crusting around the eyelids
  • a gritty feeling (like there is sand in the eye)
  • itchiness of the eyes and eye rubbing
  • children with allergic conjunctivitis almost always rub their eyes excessively. They may also have an itchy or runny nose and sneezing

Your child does not need to be excluded from school or childcare if they have conjunctivitis.

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If your child has any of the following:

  • Becomes pale, mottled and feels abnormally cold to touch
  • Is going blue around the lips
  • Too breathless to talk / eat or drink
  • Has a fit/seizure
  • Becomes extremely agitated (crying inconsolably despite distraction), confused or very lethargic (difficult to wake)
  • Develops a rash that does not disappear with pressure (see the 'Glass Test')
  • Is under 3 months of age with a temperature of 38°C / 100.4°F or above (unless fever in the 48 hours following vaccinations and no other red or amber features)
  •  Eye is propped out/painful to move or vision loss 

You need urgent help

Go to the nearest Hospital Emergency (A&E) Department or phone 999

If your child has any of the following:

  • Severe pain in eyes
  • Red swollen eye
  • Extreme sensitivity to light (photophobia)
  • Changes in vision including flashing lights (vision can appear blurred or misted because of discharge smeared over the surface of the eye, but this will usually clear on blinking or wiping the eyes)
  • Severe headache
  • Persistent vomiting
  • Blisters develop on the skin next to the eye
  • Babies under 28 days with a red eye(s) or lots of pus from their eye(s) - note although a sticky eye due to a blocked tear duct is a very common condition in babies (and does not require medical review), this condition does not cause a red eye
  • Is finding it hard to breathe
  • Seems dehydrated (sunken eyes, drowsy or not passed urine for 12 hours)
  • Is becoming drowsy (excessively sleepy) or irritable (unable to settle them with toys, TV, food or picking up) - especially if they remain drowsy or irritable despite their fever coming down
  • Has extreme shivering or complains of muscle pain
  • Is 3-6 months of age with a temperature of 39°C / 102.2°F or above (but fever is common in babies up to 2 days after they receive vaccinations)
  • Continues to have a fever of 38.0°C or above for more than 5 days
  • Is getting worse or if your are worried

You need to contact a doctor or nurse today

Please ring your GP surgery or call NHS 111 - dial 111

We recognise that during the current COVID-19 crisis, at peak times, access to a health care professional may be delayed. If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, then consider taking them to your nearest Emergency Department

If none of the above features are present

Additional advice is also available to young families for coping with crying of well babies – click here

Self care

Continue providing your child’s care at home. If you are still concerned about your child, call NHS 111 – dial 111

This guidance has been reviewed and adapted by healthcare professionals across South Yorkshire and Bassetlaw with consent from the Hampshire development groups.

What should you do?

If your child has mild conjunctivitis, gentle cleaning of the eyes with cotton balls soaked in warm water may help your child feel better.

Clean in one direction only, outwards from the inside (nose side) of the eye. This prevents the other eye becoming infected if only one eye is affected. Discard the cotton ball each time to prevent reinfection.

Do not try to clean inside the eyelids as this may cause damage to the inside of the eye. Lubricating eye drops such as ‘artificial tears’ may give some relief.

Although infective conjunctivitis is contagious, the likelihood of it spreading is not high unless there is close contact with others. To reduce the risk of spread, they should wash their hands regularly (especially after rubbing their eyes) and avoid sharing towels, pillows, eye drops, make-up with others until the discharge from their eyes has cleared. Most children with conjunctivitis do not need treatment with oral antibiotics or antibiotic eye drops, irrespective of whether their infection is caused by a virus or bacteria.

Sore, inflamed and itchy eyes due to allergic conjunctivitis may be helped by antihistamines. Speak to pharmacist about antihistamine use for your child.

How long will your child's symptoms last?

Most conjunctivitis in children (bacterial or viral) is mild. It usually clears within 7 to 10 days without antibiotics.

Where should you seek help?

Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.

Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.

Contact them by phoning your Health Visitor Team or local Children’s Centre.

Sound advice

Health visitors also provide advice, support and guidance in caring for your child, including:

  • Breastfeeding, weaning and healthy eating
  • Exercise, hygiene and safety
  • Your child’s growth and development
  • Emotional health and wellbeing, including postnatal depression
  • Safety in the home
  • Stopping smoking
  • Contraception and sexual health
  • Sleep and behaviour management (including temper tantrums!)
  • Toilet training
  • Minor illnesses

For more information watch the video: What does a health visitor do?

School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.

Contacting the School Nurse

Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.

There is also a specialist nurse who works with families who choose to educate their children at home.

Sound Advice

Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.

They all have a role in preventing disease and promoting health and wellbeing, by:-

  • encouraging healthier lifestyles
  • offering immunisations
  • giving information, advice and support to children, young people and their families
  • supporting children with complex health needs

Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.

If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.

Sound advice

Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.

For information on common childhood illnesses go to What is wrong with my child?

A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.

Sound advice

  1. Many visits to A&E and calls to 999 could be resolved by any other NHS services.
  2. If your child's condition is not critical, choose another service to get them the best possible treatment.
  3. Help your child to understand – watch this video with them about going to A&E or riding in an ambulance
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