Pink Eye in Babies: Causes, Symptoms, Treatment

baby eye exam

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Your little one’s eyelid is red and swollen, with a bit of yellow crust in the corner. Otherwise, your baby is content—no fever, no obvious discomfort. What is going on? Is it just an irritated eye, or something more serious? Could it be pink eye? Can babies even get pink eye? If so, how serious is pink eye in babies?

If you are feeling concerned and confused about the redness or swelling in your baby’s eye, you are not alone.

Pink eye in babies is relatively common and usually easily treatable. Let’s talk about what to do if you think your baby has a touch of pink eye.

What Is Pink Eye?

Pink eye, otherwise known as conjunctivitis, is the inflammation of the part of the eye called the conjunctiva, which is the membrane lining the inside of the eyelid as well as the eyeball.

The condition is known as “pink eye” because the eyelid and eyeball take on a pink hue when they are inflamed and irritated.

Inflammation of the conjunctiva is usually caused by viruses, bacteria, chemicals, allergies, or other irritants. In babies, pink eye can also be caused by a blocked tear duct.

Causes of Pink Eye in Babies

Pink eye in babies can be divided up into two categories:

  1. Pink eye that happens within the first few weeks of life
  2. Pink eye that happens later in a baby’s life

When a baby gets pink eye in the first few weeks of life, it is often caused by something that happened during the birthing process—either the chemicals used to treat the eyes at birth, or an infection passed along from the mother in the birth canal.

Is Pink Eye Ever Serious?

Although pink eye during the newborn period isn’t serious all the time, it requires a prompt medical evaluation, because it can be a sign of a serious infection. If left untreated, bacterial pink eye in newborns can cause serious infections in other parts of their body or—in the cases of herpes—blindness and vision problems.

Pink eye later in a baby’s life is usually caused by viruses and bacterial infections, and is not usually considered a medical emergency.

Pink Eye in Newborns

If your newborn develops a case of pink eye, it will usually happen within 1 to 2 weeks after birth. Here’s what to know about each of these causes.

Blocked Tear Duct

Sometimes newborns experience a blocked tear duct. This is caused by an inability of your baby’s tears to drain and usually clears up as your baby matures. It's a relatively common, benign occurrence, but you should always have it evaluated by your doctor to rule out anything more serious.

Topical Antimicrobial

Eye drops given to your baby at birth to prevent bacterial infections may cause a condition called “chemical conjunctivitis,” where the eye becomes irritated. These irritations usually clear up easily and aren't considered medical emergencies.

Bacterial Infections Acquired at Birth

If a mother has a bacterial infection at the time of birth, that infection may be passed to her newborn during childbirth. Most commonly, the bacteria that cause these infections include chlamydia and gonorrhea.

Less commonly, herpes infections in moms can be passed along during childbirth. Unfortunately, these infections don’t just affect the eye and can become very serious if not treated promptly.

Other Viral or Bacterial Infection

Besides bacterial infections acquired at birth, your newborn can acquire a bacterial or viral infection that affects their eye and causes pink eye symptoms.

These infections may also cause other symptoms in the body, most commonly respiratory symptoms or fever. Any bacterial or virus infection in a newborn should be taken seriously and requires prompt medical evaluation.

Pink Eye in Older Babies

Older babies may experience pink eye for some of the same reasons as newborns, including:

  • Pink eye caused by bacterial infections (though these infections will not be the ones acquired at birth)
  • Older babies may experience pink eye from common viral infections—and you may notice that their eyes become irritated when they have colds and other respiratory infections
  • Older babies may also experience pink eye as a result of allergies
  • Though less common after the newborn stage, older babies may experience pink eye as a result of blocked tear ducts

Symptoms

Pink eye symptoms are generally pretty obvious—you will notice that your baby’s eyelid is pink and swollen, there may be a crusty buildup in the corners of their eyes, and their eyeball itself may look pinkish.

Depending on the cause, pink eye presents itself in slightly different ways. Most importantly, if pink eye is accompanied by other concerning symptoms of illness, this could signal a more serious issue.

Blocked Tear Ducts

Symptoms include wetness of the eye, redness or swelling of the eye, and crusty build-up in the corner of the eye. Most babies outgrow blocked tear ducts within the first few months of life, but in rare cases, these symptoms can last for the entire first year of life. Speak to your doctor if your baby’s blocked tear duct hasn’t cleared up by their first birthday.

Topic Antimicrobial

If your newborn’s pink eye is from the eye drops they received at birth, their symptoms may include a slightly red eye and some mild swelling of the eyelid. Pink eye caused by antimicrobials usually clears up on its own without treatment within 24 to 36 hours.

Bacterial Infections Acquired at Birth

Symptoms of bacterial infections from bacteria such as chlamydia, gonorrhea (and less commonly, herpes) include swelling of the eyelid, drainage of pus, and red eyes. Chlamydia infection symptoms usually present 5 to 12 days after birth and gonorrhea infection symptoms present about 2 to 4 days after birth.

Without treatment, these infections can include serious symptoms affecting other parts of a newborn’s body. Chlamydia can affect the lungs and nasopharynx. Gonorrhea can cause infection of the bloodstream, spinal cord, and lining of the brain. If left untreated, herpes infection can cause vision loss or blindness.

Other Bacterial Infections

Bacterial causes of pink eye include swelling of the eyelid, and pinkness of the eyelid and eyeball. This type of infection is often associated with discharge from the eye. This discharge can cause the eyelids to stick together. Bacterial pink eye infections often coincide with ear infections.

Viral Infections

Viral pink eye usually coincides with respiratory infections like colds or flus. Symptoms may include inflammation of the eyelid and pink eyeball; however, the discharge from the eye is often thinner than the discharge from a bacterial infection. You may notice watery discharge and the infection may spread from one eye to another.  

Allergies

Pink eye caused by allergies usually involves other allergy symptoms such as sneezing, itchiness, tearing, scratchy throat, coughing, or asthma symptoms. Pink eye as a result of an allergy will generally involve both eyes.

Diagnosis and Treatment

Any signs of pink eye in a newborn should be relayed to a healthcare provider promptly.

Often, the cause will be something less serious like a blocked tear duct or irritation from eye drops. But sometimes pink eye in a newborn can be more serious, like a bacterial infection acquired at birth or a sign of a viral infection. Any suspected bacterial or viral infection in a newborn should be taken seriously, as newborns are more susceptible to dangerous symptoms and outcomes than older babies.

If you have an older baby with a puffy, swollen, or reddening eyelid or eyeball, you can call your doctor to discuss whether your baby needs to be seen. Usually, if your baby has no other serious symptoms or if the pink eye isn’t bothering them too much, the visit can wait until the next available appointment.

If your doctor thinks immediate care is necessary, they will have you come in right away or refer you to an urgent care center.

How Is Pink Eye Diagnosed?

When you visit your doctor, your baby will be thoroughly examined, and your doctor will ask you questions about when the pink eye symptoms emerged, what other symptoms your baby has, and may ask you questions about their general medical history.

In some cases, your doctor will take a sample of your baby’s eye discharge for testing. This is to determine whether a bacterial infection is present, and if so, what the infection might be. Antibiotic medication can then be tailored to fight the particular bacteria. This procedure will not hurt your baby, though they might find it irritating.

What Medications Are Used to Treat Pink Eye?

After you receive a proper diagnosis for your baby’s pink eye, treatment can begin. It’s important to receive a diagnosis from a medical professional because of the fact that there are many different causes of pink eye, and the treatment for pink eye depends on the cause.

Learn how the different causes that lead to pink eye are treated below.

Bacterial

Depending on which bacteria is causing the infection, your doctor will prescribe antibiotic drops or ointments. In the case of newborn bacterial infections acquired at birth, such as chlamydia and gonorrhea, oral or IV antibiotics may be needed. In addition to antibiotics, warm compresses can help soothe antibiotic infections.

Viral

Unfortunately, there is no medication to treat pink eye caused by viral infections. However, in some cases, a secondary bacterial infection develops, and antibiotic drops are prescribed. Warm compresses may be recommended. It’s important to practice good hand hygiene so viral infections of the eye don’t spread.

Allergic

In the case of allergic pink eye, allergy medication or drops may be prescribed. You must check with your doctor before administering allergy medication to an infant, as these medications are not usually safe for babies under the age of two.

Blocked Tear Duct

Blocked tear ducts can be soothed by warm compresses a few times a day. Your doctor may also instruct you to massage the duct. This is something you should only do with guidance from your pediatrician.

Can Pink Eye Be Prevented?

The best way to prevent bacterial infections caused at birth is to make sure you’ve been tested and treated for common bacterial infections like chlamydia, gonorrhea, and herpes. The antibiotic drops that babies receive at birth are also important preventative measures.

When it comes to all viral and bacterial infections for newborns and older babies, good hygiene is paramount. Wash your hands frequently if anyone in your household is ill. Wash your baby’s hands as well. Thoroughly clean anything that may make contact with your baby’s eye. When possible, discourage your baby from touching their eyes.

Remember, too, that infections can spread from one eye to another, or from your eye to your baby’s eye. If your baby is being treated for an infection, the eye may still be infectious 24 to 48 hours after starting treatment, and can still spread from one eye to another at that time.

A Word From Verywell

It can be shocking and upsetting if you notice a swollen, red eyelid or eyeball in your baby. You may jump to scary conclusions about what may be causing the problem. Usually, the causes of pink eye aren’t very serious and can easily be treated. However, if you have recently given birth, it’s important to rule out any bacterial infections caused by childbirth.

Either way, any new swelling or redness in the eye should be discussed with your pediatrician. As you prepare to consult with your pediatrician, it can be helpful to write up a list of questions and beforehand, as it can sometimes be overwhelming in the moment to remember what all your concerns are.

Again, while pink eye in babies might be upsetting to look at and consider, usually there is nothing to serious to worry about. Most cases of pink eye are also easily treatable, and before you know it, your baby’s beautiful eyes will be good as new.

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Article Sources
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  1. Centers for Disease Control and Prevention. Conjunctivitis (Pinkeye) in Newborns. Updated January 4, 2019. 

  2. Stanford Children’s. Blocked Tear Duct (Dacryostenosis) in Children. Updated January 27, 2021.

  3. Stanford Children’s. Conjunctivitis in Children. Updated January 27, 2021.