Few childhood infections are as obvious or contagious as conjunctivitis (also known as 'pink eye'), which affects the thin membrane that lines the inside of the lids and the eyeball (the conjunctiva).
There are three main types: infectious, allergic and those resulting from an injury, such as chemicals or foreign bodies in the eye. Only the infectious forms are contagious, and they are spread by contact or touch, not through the air. It is often present in both eyes, as children tend to rub one eye and then the other, and it spreads quickly in households and childcare facilities, as it can be passed on toys, towels, and even by holding hands.
Symptoms of acute infectious conjunctivitis include reddened, puffy eyelids and red eyes. The eyes will appear weepy, and pus usually drains from the inner corners. The itching can be extremely uncomfortable, and children may feel as though there is a speck of dirt in their eyes. Some children experience fever, but this is not common. Bacterial conjunctivitis is caused by bacteria such as staphylococci, streptococci or haemophilus.
Viral conjunctivitis is often associated with the common cold. This type of conjunctivitis can spread rapidly between children and may cause an epidemic of conjunctivitis.
Children with infectious conjunctivitis should be excluded from childcare until they have been seen by a doctor, and treated. All signs of infection should be eliminated before they are re-admitted.
Infectious conjunctivitis is rarely serious and will usually clear on its own within a few days. Antibiotic eye drops or ointments are usually prescribed in the case of bacterial conjunctivitis.
There is no effective treatment for viral conjunctivitis, but the eyes can be soothed with a lubricant ointment such as Lacri-Lube. Chloramphenicol ointment will also help to prevent secondary bacterial infection.
The eyes should be cleaned with cotton wool soaked in cooled boiled water to remove any crusts or stickiness. Use a separate cotton ball for each eye, and clean from the inside out. Apply Vaseline to the child's eyelids and lashes at night, using a clean cotton ball to make crust removal easier and less painful.
Childcarers may be asked to administer drops or ointments. The best way to do this is to:
* Lay the child on his back, pull the lower lid downward, and put a couple of drops on the eyeball.
* Pull the lower eyelid down and forward, and put a couple of drops in the space between the lower lid and the eye. Keep him reclining a minute or so.
Ask the child to look to one side, put a couple of drops in the inner corner of the eye on the side toward which he is looking. Keep him on his back for a minute or so.
* Be very careful to not touch the eye!
If an ointment is prescribed, pull the lower lid down a bit, exposing its inner surface, and quickly squeeze ointment on to the lid close to the eyeball.
* Do not touch the eyeball itself.
If you have an 'outbreak', careful handwashing is crucial, and it's best to wash toys, door handles and anything else the affected child may have been in contact with, using antibacterial sprays or throw-away wipes.
Allergic conjunctivitis is not, of course, contagious, and sufferers do not need to be excluded from school. Unlike infectious conjunctivitis, there is no pus draining from the corner of the eye. Characteristically it itches, is usually in both eyes, and is not painful.
Resources
* A good fact sheet is available online at www.bbc.co.uk/health/conditions/ conjunctivitis2 or visit hcd2.bupa.co.uk/ fact_sheets/html/conjunctivitis.
* Try freshly squeezed cucumber juice, applied on a clean cotton ball, to soothe itching. Herbal tinctures can be added to warm water to bathe the eye and prevent infection. Chamo- mile, elderflower, eyebright (euphrasia) and golden seal are all safe for external use in children.
www.healthlibrary.epnet.com offers information on other herbal treatments.
* Visit www.truestarhealth.com for details of appropriate herbal remedies and dosages.
* Remedies and herbal tinctures can also be purchased online at www.
yourhealthfoodstore.co.uk.
* www.nhsdirect.uk offers advice on treatment and prevention.
Further reading
* Some children will be embarrassed by their appearance, and by being excluded from their nursery or childcare environment.
Good books to help to explain the condition include Franklin Has Conjunctivitis (Dr Spot's Casebook) by Jenny Leigh and Woody Fox (Red Kite Books, 5.99) or Pinkeye (Rookie Read-About Health by Sharon Gordon (Children's Press, Pounds 3.20 via www.amazon.co.uk).
