All of us at some point or the other experienced a red eye. Red eyes are when the white of the eye becomes red. There are different reasons that cause a red eye in children.
Some of the causes of red eye are:
This is caused when the conjunctiva, or the layer that covers the white of the eyes, gets inflamed. The most common reasons for conjunctivitis are bacteria, viruses (pink eye), or allergies. Kids with conjunctivitis also have accompanying symptoms of discharge, light sensitivity or pain in the eyes. Bacterial and allergic conjunctivitis require treatment with eye drops, whereas viral conjunctivitis does not have to be treated. This can be unilateral (involving one eye) or bilateral (involving both eyes). Vision is minimally affected unless the conjunctivitis is severe.
Blepharitis is characterized by inflammation, scaling, reddening, and crusting of the eyelids. It can cause burning, itching, and/or redness in the eye(s) with a grainy sensation in the eyes. This is a chronic condition and although is not sight-threatening, can lead to permanent alterations of the eyelid margin.
Corneal abrasions are often the result of some type of direct injury to the eye. They are common in younger children as they often play around with siblings and can scratch the cornea. Abrasions usually occur unilaterally (involving only one eye). The eye will be painful with lots of watering from the eye and redness accompanied by light sensitivity. The eye is treated with some eye drops. Depending on where the abrasion is, centrally or peripherally, vision may or may not be affected.
Foreign bodies in the eye and trauma can often occur in children who play sports and fail to wear proper protective sports googles. Trauma to the eye can vary in severity. In some cases, the eye may become bruised and no treatment is necessary; time will heal it. In other cases, there could be a corneal abrasion with inflammation in the eye (uveitis), while more severe cases can cause harm and damage to deeper parts of the eye like the retina. Treatment in each of these cases will vary.
When a small blood vessel breaks under the tissue that covers the white of the eye (sclera), a subconjunctival hemorrhage develops. Eye trauma and/or vigorous coughing/sneezing can cause the hemorrhage. In some cases, rare life-threatening diseases such as Vitamin K deficiency or blood clotting disorders can also cause the hemorrhages. Treatment usually includes cold compresses and lubricating drops. The condition is self-limiting and usually takes 2-3 weeks to go away.
Contact lens induced red eye
One of the main culprits of redness in older children is over-wearing or improper care of contact lenses, which includes cleaning, storing and appropriately replacing the lenses. Failing to follow proper contact lens care guidelines can cause irritants to deposit on the lenses which can further develop into an infection. Any child who experiences red eyes with contact lens wear should immediately seek care from a skilled eye care professional to ensure there is no sight threatening infection.
Uveitis is inflammation of the middle layer of the eye (uvea). In this condition, the eye(s) may become red, painful and/or light sensitive. Vision may also be affected. Uveitis is most commonly seen with trauma.
Children with some systemic conditions like JIA (juvenile idiopathic arthritis), psoriasis, and Crohn's have an increased risk for developing uveitis in their eyes. Uveitis resulting from one of these conditions is called silent uveitis since the child does not really experience any issues early on. These children should be screened periodically to check for uveitis.
Ocular herpes is a viral infection that is caused by type 1 herpes simplex virus. It is accompanied by vesicles around the eye(s) but may or may not be accompanied by cold sores. Signs and symptoms include: eye redness, light sensitivity, pain in the eye, and watery discharge. Treatment is crucial since it can cause scarring of the cornea which in turn can cause a permanent decrease in vision.