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Conjunctivitis: What’s the difference between babies and adults?

Conjunctivitis is distressing for anyone, but none more so than […]

By Published On: 6 October 20173.8 min read

Conjunctivitis is distressing for anyone, but none more so than the parent of a new baby with this condition. But is it more serious for babies than for adults?

This post looks at the important facts about this potentially serious condition in infants.

Why does my baby have conjunctivitis?

Conjunctivitis in babies tends to fall into two distinct categories – affecting either newborns or babies over 3 months of age.

Newborn babies can pick up the condition as they pass through the birth canal. It can vary from serious, sight-threatening bacterial infection (e.g. from Chlamydia or Gonorrhoea) to less serious eye infections from more common bacteria or viruses resident in the birth canal. STDs can be transferred from mother to baby during birth. These are a cause for serious concern as they can cause scarring and permanent damage in babies’ eyes.

Your new baby can also get a short-lived episode of this condition from a reaction to the antibiotic eye drops used to treat or protect against eye infection following birth.

If your baby is over three months old, he or she will likely be grabbing hold of everything they can get those little hands on – hands that then go into their mouth or rub their eyes.  It is easy to pick up a bacterial or, more rarely, viral conjunctivitis in this way.

Whereas this condition is more likely to be caused by a bacterial infection in babies, adults are more likely to have viral conjunctivitis, which is self-limiting within a week or ten days and often requires no treatment.

What does conjunctivitis look like in babies?

Symptoms of bacterial conjunctivitis include redness, swelling and discharge or thick pus. This can cause lashes to stick together and crusting around the eyelid margins. The pus may be yellowish and mucousy, rather than watery.

If these symptoms appear within 2-4 days of birth, your baby could have gonococcal conjunctivitis. Similar symptoms appearing 5 days to 2 weeks after birth are more likely to be associated with chlamydial eye disease. Either way, these conditions require urgent treatment from a paediatrician.

Adults tend to get the viral form of this condition, which is also associated with redness, swelling and discomfort, but the discharge tends to be watery, rather than thick.

How is it treated?

Bacterial conjunctivitis requires an antibiotic. In infants, babies and very young children, this should ALWAYS be prescribed by a paediatrician (or paediatric ophthalmologist) as it is important to rule out other serious eye diseases that could mimic this condition. Treatment is in the form of antibiotic eye drops. For adults or children over two, this is often chloramphenicol (or Chlorsig) which is effective against a broad spectrum of bacterial infections. Babies under two may be prescribed an alternative antibiotic.

Older babies, with milder cases of this condition may also require an antibiotic to be prescribed. An essential part of the management of this disease is to keep the eye area completely clean, by removing the sticky or crusty discharge from the eyelids and lashes. Your baby’s eye care practitioner will explain how to do this effectively.

Can this harm my baby?

Chlorsig eye drops are NOT associated with Grey Baby Syndrome (or GBS). This rare condition can occur in infants (particularly if premature) when injected chloramphenicol builds up in their bodies and cannot be metabolised by their immature organs. GBS is associated with intravenous (injected) use of chloramphenicol, a powerful antibiotic used to treat serious infections that are not responding to other treatment. This drug may be used intravenously on a mother who is in late pregnancy or labour, where it can cross into the baby’s bloodstream.

What if it’s not conjunctivitis?

Red, swollen, sticky eyes usually means there is some sort of conjunctivitis going on, but  the important thing is to find out why, and to rule out nasty bacterial infections and other serious eye infections, such as congenital dacryocystitis or canaliculitis, which can spread to other tissues.

What if my baby has it?

REMEMBER: Don’t treat your baby’s eye infection with over the counter medications or eye drops. This bypasses an essential step in the diagnosis of your baby’s condition and can potentially lead to missing a serious or possibly blinding condition.

Older children or adults with symptoms of bacterial conjunctivitis can be seen by their GP or, preferably, a therapeutically-qualified optometrist, who can examine their eyes thoroughly, diagnose their condition accurately and treat it with the appropriate medication.

Worried by red eyes? Come and see the experts. Call The Eye Practice on (02) 9290 1899 or make an appointment online today.


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