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Allergic Conjunctivitis (Child)

Adult hands putting eyedrops in child's eye.

Conjunctivitis is an irritation of a thin membrane on the surface of the eye. This membrane is called the conjunctiva. It covers the white of the eye and the inside of the eyelid. Conjunctivitis is also known as pink eye or red eye because the eye looks pink or red. The eye can also be swollen. A thick fluid may leak from the eyelid. The eye may itch and burn, and feel gritty or scratchy. It’s common for the eye to drain mucus at night. This causes crusty eyelids in the morning.

Allergic conjunctivitis is caused by an allergen. Allergens are substances that cause the body to react with certain symptoms. Allergens that cause eye irritation include things such as house dust or pollen in the air.

Home care

Your child’s healthcare provider may prescribe eye drops or ointment. These medicines are to help reduce itching and redness. Your child may need to take antihistamines by mouth. These are to help ease allergy symptoms. You may be told to use saline solution or artificial tears to help rinse the eyes and soothe the irritation. Follow all instructions when using these medicines.

To give eye medicine to a child

  1. Wash your hands well with soap and clean, running water. This is to help prevent infection.

  2. Remove any drainage from your child’s eye with a clean tissue. Wipe from the nose out toward the ear, to keep the eye as clean as possible.

  3. To remove eye crusts, wet a washcloth with warm water and place it over the eye. Wait 1 minute. Gently wipe the eye from the nose out toward the ear with the washcloth. Do this until the eye is clear. If both eyes need cleaning, use a separate cloth for each eye.

  4. Have your child lie down on a flat surface. A rolled-up towel or pillow may be placed under the neck so that the head is tilted back. Gently hold your child’s head, if needed.

  5. Using eye drops: Apply drops in the corner of the eye where the eyelid meets the nose. The drops will pool in this area. When your child blinks or opens their lids, the drops will flow into the eye. Give the exact number of drops prescribed. Be careful not to touch the eye or eyelashes with the dropper.

  6. Using ointment: If both drops and ointment are prescribed, give the drops first. Wait 3 minutes, and then apply the ointment. Doing this will give each medicine time to work. To apply the ointment, start by gently pulling down the lower lid. Place a thin strip of ointment along the inside of the lid. Begin at the nose and move outward. Close the lid. Wipe away excess medicine from the nose area outward. This is to keep the eyes as clean as possible. Have your child keep the eye closed for 1 or 2 minutes so the medicine has time to coat the eye. Eye ointment may cause blurry vision. This is normal. Apply ointment right before your child goes to sleep. In infants, the ointment may be easier to apply while your child is sleeping.

  7. Wash your hands well with soap and clean, running water again. This is to help prevent the infection from spreading.

General care

  • Apply a damp, cool washcloth to the eyes 3 to 4 times a day. This is to help ease swelling and itching.

  • Use saline solution or artificial tears to rinse away mucus in the eye.

  • Make sure your child doesn’t rub their eyes.

  • Shield your child’s eyes when in direct sunlight to avoid irritation.

  • Don’t let your child wear contact lenses until all symptoms are gone.

  • Avoid the allergen as much as possible, if the allergen is known.

Follow-up care

Follow up with your child’s healthcare provider, or as advised. Your child may need to see an allergist for allergy testing and further treatment.

When to seek medical advice

Call the healthcare provider if any of these occur:

  • Fever (see Fever and children section, below)

  • Your child has trouble seeing

  • Your child shows signs of infection getting worse, such as more warmth, redness, or swelling

  • Your child’s pain gets worse (babies may show pain as crying or fussing that can’t be soothed)

Call 911

Call 911 if any of these occur:

  • Trouble breathing

  • Confusion

  • Extreme drowsiness or trouble waking up

  • Fainting or loss of consciousness

  • Rapid heart rate

  • Seizure

  • Stiff neck

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

  • Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

  • Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

  • Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

  • Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

  • Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use a rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

Below is when to call the healthcare provider if your child has a fever. Your child’s healthcare provider may give you different numbers. Follow their instructions.

When to call a healthcare provider about your child’s fever

For a baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

  • A fever of ___________as advised by the provider

For a child age 3 months to 36 months (3 years):

  • Rectal or forehead: 102°F (38.9°C) or higher

  • Ear (only for use over age 6 months): 102°F (38.9°C) or higher

  • A fever of ___________ as advised by the provider

In these cases:

  • Armpit temperature of 103°F (39.4°C) or higher in a child of any age

  • Temperature of 104°F (40°C) or higher in a child of any age

  • A fever of ___________ as advised by the provider

Online Medical Reviewer: Chris Haupert MD
Online Medical Reviewer: Jessica Gotwals RN BSN MPH
Online Medical Reviewer: Whitney Seltman MD
Date Last Reviewed: 11/1/2022
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