Clearing the Red: Understanding and Treating Conjunctivitis in Kids - January 2025

Conjunctivitis or 'pink eye' can raise a lot of alarm bells. Unfortunately, kids get them quite frequently. And what's worse, such eye infections can easily spread from child to child. We sat down with Pharmacist Nazatul Amira Hamzah from Primabumi Sdn Bhd to learn more about understanding and treating conjunctivitis in kids. Nazatul Amira Hamzah, Pharmacist at Primabumi Sdn Bhd Nazatul is a qualified pharmacist with 10 years of experience in pharmacy practice involving both hospital and community settings. She currently holds the position of Pharmacist and Key Account Manager at a renowned pharmaceutical company in Kuala Lumpur. Here's some advice from a certified pharmacist on what parents need to know about eye infections in children. What is conjunctivitis? Conjunctivitis is an infection or inflammation of the eye. More specifically, the inflammation of the conjunctiva; the transparent membrane covering the inner surface of the eyelids and the white portion of the eye. When this happens, the conjunctiva becomes red and swollen. Because the affected eye appears pink or red, this is what earned conjunctivitis the alternative name of 'pink eye'. How do I tell if my child has conjunctivitis? The telltale signs of conjunctivitis is a pink or red eye, redness behind the eyelids, swollen eyelids, and itching and rubbing of the eyes. Other symptoms include a yellow-green discharge coming from the eye that dries while your child sleeps, leaving the eyelids crusted over. If you child experiences a gritty sensation in the eye or photophobia (or dislike of bright lights), they may be suffering from conjunctivitis, too. How did my child get conjunctivitis? Conjunctivitis is often caused by one of two things. An infection (infectious conjunctivitis) or an allergy (allergic conjunctivitis). Infectious conjunctivitis occurs when a virus or bacteria comes into contact with your child’s eye(s). The infection can come from many sources. The most likely one is usually the discharge from an infected person's eyes, nose, or throat that is brought on by touching, coughing or sneezing. Contaminated objects or fingers can be to blame as well as sharing of contaminated water or towels. Allergic conjunctivitis is when your child’s eyes overreact to an allergen. These are substances that can trigger an allergic reaction. Anything from dust to pollen to animal dander. It’s more common children with a history of other allergies. Other than red, itchy, and watery eyes, your child is more likely to have sneezing and runny noses too. Since allergic conjunctivitis is not an infection, it’s not contagious. Is conjunctivitis dangerous? How long does it last? Conjunctivitis is pretty common, particularly in children under five. As long as there is a discharge coming from their eye, a person with infectious conjunctivitis will remain infectious. Never let your child share eye drops, tissues, makeup, towels, or pillowcases with others if they have infectious conjunctivitis. Make sure to wash their hands (and yours) thoroughly and frequently to stop the infection from spreading to others. After contracting the infection, symptoms often appear 24 to 72 hours later and can linger for two to three weeks. How is conjunctivitis treated? If your child is experiencing mild symptoms, you can try cleaning their eyes gently with cotton balls dipped in warm water. Simply wipe the interior (nose side) of the eye outward in one direction. This helps prevent the infection from spreading to the other eye if only one eye is affected. To stop recontamination, discard the cotton ball after each use. For infectious conjunctivitis, your doctor or pharmacist may recommend a treatment with an antibiotic eye drop or eye ointment, often for 5 to 7 days. Treatment should be applied to both eyes, even if only one eye seem to be affected. Your child should continue the treatment for two days after the discharge stops to ensure that the infection is completely cleared. For allergic conjunctivitis, anti-allergy eye drops are helpful in relieving sore, irritated, and itchy eyes. Your child may also be given an oral antihistamine to ease the symptoms further. The table below highlights some eye treatments that are commonly used in Malaysia. Content(s) Active Ingredient(s) Example(s) of Available Brand Treatment Purposes One or more types of antibiotics Chloramphenicol Nicol® Eye Drops 0.5% w/v Kloraxin® Eye Ointment 1% w/w Certain types of eye infections including infectious conjunctivitis. Fusidic acid Fucithamic® Viscous Eye Drops Tobramycin Tobrex® Ophthalmic Solution 0.3% Moxifloxacin hydrochloride Vigamox® 0.5% Eye Drop Ofloxacin Tarivid® Ophthalmic Solution Oxytetracycline hydrochloride Polymyxin B Terramycin® Opthalmic Ointment One or more types of antibiotics plus a corticosteroid Neomycin sulphate Dexamethasone Neo Deca® Eye/Ear Dops Eye inflammations where concurrent use of an antibacterial is necessary. Neomycin sulphate Polymyxin B sulphate Dexamethasone Maxitrol® Suspension Maxitrol® Sterile Ophthalmic Ointment A corticosteroid Dexamethasone Maxidex® Ophthalmic Suspension Certain eye inflammations including allergic conjunctivitis. Prednisolone acetate Pred Forte® Sterile Ophthalmic Suspension Fluorometholone FML® Liquifilm® Sterile Ophthalmic Suspension A non-corticosteroid Sodium cromoglycate Allergo-comod® Eye Drops Treatment of the signs and symptoms of allergic conjunctivitis. Olapatadine Patanol® 0.1% Ophthalmic Solution Pataday® Ophthalmic Solution 0.2%w/v *The table above serves as general guidance only. Please consult your healthcare professional before starting any treatment for your child. If more than one product is being used, the medicines must be administered at least 5 minutes apart. Ointments should be administered last. Any corticosteroid-containing eye drops or ointments must NOT be used on children under 2 years old. Use them only if and as advised by your doctor. Inappropriate use of corticosteroid-containing eye drops or ointments could cause serious issues, including cataracts, glaucoma, and vision loss. Your doctor or pharmacist will be able to advise you on the most appropriate treatment for your child. How long can I keep an opened eye drop or ointment? Should I keep it in the fridge? Any unused products must be discarded after 4 weeks of opening. This includes most prescription eye drops or ointments (those that you can buy only from a licensed doctor or pharmacist). This is to ensure that the product is sterile (free from living germs or microorganisms) upon use. Lubricant or moisturising eye drops or ointments (OTC) may be used within one to six months after opening, depending on the product. Please check and follow the instructions on the product label before using. It’s best to record the date on which you first open the product so you’ll remember when to discard it. Unless specified on the product label, eye drops or ointments need not be refrigerated. I’m a little concerned about using a prescription eye drop on my kid. Can other eye drops like those that people use to soothe and moisturise their eyes help? Artificial tears or other lubricating eye drops may lessen some discomfort. However, they will not get rid of any infection if your child has infectious conjunctivitis. Discuss your concerns with your doctor or pharmacist about this. They’ll be able to advise you if the use of a prescription product is really necessary for your child. Should my child stay at home while undergoing treatment for conjunctivitis? Yes, your child should ideally stay at home while they are recovering from conjunctivitis. This is especially important if they are suffering from infectious conjunctivitis. Children who have infectious conjunctivitis should not attend daycare or school until their eye discharge has subsided. This is to prevent your child from unknowingly spreading their infection to the rest of their classmates or the entire school. How does one prevent conjunctivitis? Here are some good practices to prevent you and you family from having conjunctivitis. Firstly, avoid touching or rubbing your eyes with your hands and wash your hands properly and regularly, especially if you already have conjunctivitis. Use a clean towel every day and avoid sharing towels and eye care products, or cosmetics, with other people. To prevent allergic conjunctivitis, avoid contact with potential triggers for allergic reactions. When should I bring my child to see a doctor? Sometimes conjunctivitis doesn't get better or is caused by some dangerous, underlying condition. Seek medical help immediately if your child has any of the below issues: Symptoms didn’t get better after two days of treatment Extreme pain or discomfort in the eye Has fever White spot in the cornea (the clear ‘window’ at the front of the eye) that doesn’t go away Source: Nazatul Amira Hamzah, Pharmacist at Primabumi Sdn Bhd Disclaimer: The information provided in this article is for informational purposes only and should not be considered as medical advice from Motherhood. For any health-related concerns, it is advisable to consult with a qualified healthcare professional or medical practitioner. 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