Conjunctivitis Baby’s & Children

Conjunctivitis is inflammation of the tissue that lines the inside of the eyelids. Conjunctivitis comes in a variety of forms and causes. Infectious conjunctivitis is caused by bacteria or viruses. Non-infectious conjunctivitis can be caused by allergies or irritation. Conjunctivitis is usually a minor ailment that goes away on its own after 5 to 14 days, depending on the cause.

There are 4 main types of conjunctivitis inflammation:

Viral Conjunctivitis

• Infection of the eye caused by a virus
• Can be caused by several different viruses, such as adenoviruses
• Very contagious
• Sometimes can result in large outbreaks depending on the virus

Bacterial Conjunctivitis

• Infection of the eye caused by certain bacteria
• Can be caused by Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, or, less commonly, Chlamydia trachomatis and Neisseria gonorrhoeae
• Can be spread easily, especially with certain bacteria and in certain settings
• Children with conjunctivitis without fever or behavioural changes can usually continue going to school
• More common in kids than adults
• Observed more frequently from December through April

Allergic Conjunctivitis

• The body’s reaction to an allergen
• Not contagious
• Occurs more frequently among people with other allergic conditions, such as hay fever, asthma, and eczema
• Can occur seasonally when allergens such as pollen counts are high
• Can also occur year-round due to indoor allergens, such as dust mites

Conjunctivitis Caused by Irritants

• Caused by irritation from a foreign body in the eye or contact with smoke, dust, fumes, or chemicals
• Not contagious
• Can occur when contact lenses are worn for longer than recommended or not cleaned properly

Symptoms of conjunctivitis include:

• Red irritated eye(s)
• Grittiness and discomfort in the eye(s)
• Sticky mucous/ discharge from the eye(s)
• Light sensitivity
• Redness behind the eyelid
• Swelling of the eyelids, making them appear puffy
• Excessive tears
• You should not have any change in your vision

How a pharmacist can help with conjunctivitis

• A pharmacist can provide you with information about medications that may be of use
• They can help you to determine if your conjunctivitis may be contagious or not
• They can also advise the best eye drops, eye ointments & eye wipes to lessen the symptoms

Treating conjunctivitis at home:

• Avoiding rubbing the eyes
• Washing your hands regularly with soap and water before touching the eye
• Avoid wearing contact lenses while you have conjunctivitis
• Using separate towels to others to avoid spread
• Avoiding close contact with others during the contagious period (up to approximately 7 days after onset of symptoms)
• Applying a cold compress and/ or refrigerated artificial tears drops to relieve irritation.
• Washing the eye with a saline eye bath or cooled, boiled water
• Using sterile eye wipes or cotton wool dipped in cool, boiled water to wipe the eye clean.
• Applying antihistamine drops if your conjunctivitis is caused by allergies such as hay fever

fusion-allergy-day-night-gel-10-ml, lloydspharmacy-eyelid-wipes, medicare-emergency-eye-wash-20-ml, fusion-allergy-face-eye-lid-wipes-20, optrex-multi-action-eye-wash-100-ml

When to see a GP:

• You have pain in the eye
• You have changes in your vision
• Your symptoms don’t improve after a week
• You keep getting conjunctivitis
• The person with conjunctivitis is less than one month old

Treatment for conjunctivitis from a GP:

• Antibiotic eye drops
• Antibiotic eye ointments
• Antihistamine eye drops
• Steroid eye drops
• Antiviral tablets

Neonatal Conjunctivitis

Neonatal conjunctivitis in a new-born can be caused by infection, irritation, or a blocked tear duct. New-borns with symptoms of conjunctivitis should be seen by a doctor right away. When caused by an infection, neonatal conjunctivitis can be very serious.

The most common types of neonatal conjunctivitis include the following:

1. Inclusion (chlamydial) conjunctivitis: Chlamydia trachomatis can cause inclusion conjunctivitis and genital infections (chlamydia). A woman with untreated chlamydia can pass the bacteria to her baby during childbirth. Symptoms of inclusion conjunctivitis include redness of the eye(s), swelling of the eyelids, and discharge of pus. Symptoms are likely to appear 5 to 12 days after birth. Symptoms can develop earlier if the amniotic sac is ruptured during delivery. Some new-borns with chlamydial conjunctivitis can have the infection in other parts of their bodies. The bacteria can infect the lungs and nasopharynx (where the back of the nose connects to the mouth).
2. Gonococcal conjunctivitis: Neisseria gonorrhoeae can cause gonococcal conjunctivitis, as well as the sexually transmitted infection called gonorrhoea. A woman with untreated gonorrhoea can pass the bacteria to her baby during childbirth. Symptoms usually include red eyes, thick pus in the eyes, and swelling of the eyelids. This type of conjunctivitis usually begins in the first 2-5 days of life. It can also progress to serious infections of the bloodstream and lining of the brain and spinal cord (meningitis) in new-borns.
3. Chemical conjunctivitis: When eye drops are given to new-borns to help prevent a bacterial infection, the new-born’s eye(s) may become irritated. This may be diagnosed as chemical conjunctivitis. Symptoms of chemical conjunctivitis usually include mildly red eye(s) and some swelling of the eyelids. Symptoms are likely to last for only 24 to 36 hours.
4. Other neonatal conjunctivitis: Viruses and bacteria other than Chlamydia trachomatis and Neisseria gonorrhoeae can cause conjunctivitis. For example, bacteria that normally live in a woman’s vagina and are not sexually transmitted can cause conjunctivitis. Additionally, the viruses that cause genital and oral herpes can cause neonatal conjunctivitis and severe eye damage. The mother may pass such viruses to her baby during childbirth. However, herpes conjunctivitis is less common than conjunctivitis caused by gonorrhoea and chlamydia. Symptoms usually include red eye(s) and swollen eyelids with some pus.

Symptoms and Causes of Conjunctivitis in New-borns

1. New-borns with conjunctivitis develop drainage from the eyes within a few days to several weeks after birth. Their eyelids become puffy, red, and tender. The cause of neonatal conjunctivitis is often difficult to determine because, in many instances, the symptoms don’t vary by cause.
2. Conjunctivitis in a new-born may be caused by a blocked tear duct, irritation produced by the topical antimicrobials given at birth, or infection with a virus or bacterium passed from the mother to her baby during childbirth. Even mothers without symptoms at the time of delivery can carry and pass bacteria or viruses to babies during birth.

Treatments for the common causes of neonatal conjunctivitis are as follows:

Inclusion (chlamydial) conjunctivitis: Doctors usually use oral antibiotics to treat inclusion conjunctivitis.

1. Gonococcal conjunctivitis: Doctors give intravenous (IV) or intramuscular (IM) antibiotics to treat gonococcal conjunctivitis. If untreated, the new-born could develop corneal ulcerations (open sores in the cornea) and blindness.
2. Chemical conjunctivitis: Since this type of conjunctivitis is caused by chemical irritation, treatment is usually not required. The new-born will usually get better in 24 to 36 hours.
3. Other bacterial and viral conjunctivitis: Doctors usually give antibiotic drops or ointments to treat conjunctivitis caused by other bacteria For both bacterial and viral conjunctivitis, a warm compress to the eye may relieve swelling and irritation. Be sure to wash hands before and after touching the infected eyes.

References
conjunctivitis-undertheweather.pdf (hse.ie)
CS48440_NHS_Conjunctivitis_in_children_Advice_Sheet_Oct_18_FINAL.pdf (what0-18.nhs.uk)
What is conjunctivitis? (visiondirect.ie)