Eye redness or swelling
Redness of the eye is common in children.
Most commonly this is caused by conjunctivitis when eyes can get red, itchy and produce a sticky discharge. It can be caused by an infection or allergy. You can have conjunctivitis in one or both eyes. This can generally be managed at home or by your local community pharmacist.
Some types of red eye and when the eyelids become swollen can be more dangerous and need assessment in hospital.
Please see Red-Amber-Green tables for advice on when and where to seek care for your child.
When should you worry?
If your child has any of the following:
- Eyeball is bulging out
- Vision loss
- Severe pain in eye
- Severe headache
- Severe vomiting
- Breathing very fast, too breathless to talk, eat or drink
- Working hard to breathe, drawing in of the muscles below the ribs, or noisy breathing (grunting)
- Is pale, blue, mottled or feels unusually cold to touch
- Difficult to wake up, very sleepy or confused
- Weak, high-pitched cry or can’t be settled
- Has a fit (seizure)
- Has a rash that does not go away with pressure (the glass test)
- Is under 3 months old with temperature more than 38°C or under 36°C (unless fever in the 48 hours following vaccinations and no other red features)
You need urgent help.
Go to the nearest Hospital Emergency (A&E) Department or call 999 - dial 999.
If your child has any of the following:
- Eye so swollen it cannot be opened
- Changes in vision (blurred or very sensitive to light)
- Headache
- Vomiting
- Blisters develop on the skin next to the eye
- Breathing a bit faster than normal or working a bit harder to breathe
- Dry skin, lips or tongue
- Not had a wee or wet nappy in last 8 hours
- Poor feeding in babies (less than half of their usual amount)
- Irritable (Unable to settle them with toys, TV, food or hugs even after their fever has come down)
- Is 3 to 6 months old with temperature 39°C or above (unless fever in the 48 hours following vaccinations and no other red or amber features)
- Temperature of 38°C or above for more than 5 days or shivering with fever (rigors)
- Temperature less than 36°C in those over 3 months
- Getting worse and I am still worried
You need to contact a doctor or nurse today.
Please contact your GP surgery or call NHS 111 - dial 111.
If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, recheck that your child has not developed any red features.
If none of the above features are present
- Watch them closely for any change and look out for any red or amber symptoms
- Additional advice is also available to young families for coping with crying of well babies
- If your child has a long term condition or disability and you are worried please contact your regular team or follow any plans that they have given you.
Self care
Continue providing your child’s care at home. If you are still concerned about your child, speak to your health visitor, local pharmacist or call NHS 111– dial 111.
Children and young people who are unwell and have a high temperature should stay at home. They can go back to school, college or childcare when they no longer have a high temperature, and they are well enough to attend.
Self care and Prevention
What is conjunctivitis
Conjunctivitis is a common eye condition that affects children, especially under 5 years of age. It can either be caused by an infection or by an allergy. Infectious conjunctivitis is contagious and may spread to other household members. Allergic conjunctivitis is more common in children with allergies such as hay fever.
If your child has conjunctivitis, they may have:
- a red or pink eye (or both eyes)
- redness behind the eyelid
- swelling of the eyelids, making them appear puffy
- excessive tears
- a yellow green discharge from the eye which dries when your child sleeps, causing crusting around the eyelids
- a gritty feeling (like there is sand in the eye)
- itchiness of the eyes and eye rubbing
- children with allergic conjunctivitis almost always rub their eyes excessively. They may also have an itchy or runny nose and sneezing
Your child does not need to be excluded from school or childcare if they have conjunctivitis.
What should you do?
If your child has mild conjunctivitis, gentle cleaning of the eyes with cotton balls soaked in warm water may help them feel better.
Clean in one direction only, outwards from the inside (nose side) of the eye. This prevents the other eye becoming infected if only one eye is affected. Discard the cotton ball each time to prevent reinfection.
Do not try to clean inside the eyelids as this may cause damage to the inside of the eye. Lubricating eye drops such as ‘artificial tears’ may give some relief.
Although infective conjunctivitis is contagious, the likelihood of it spreading is not high unless there is close contact with others. To reduce the risk of spread, children should wash their hands regularly (especially after rubbing their eyes) and avoid sharing towels, pillows and eye drops with others until the discharge from their eyes has cleared. Most children with conjunctivitis do not need treatment with antibiotics (oral or drops) even if their infection is caused by a bacteria.
Sore, inflamed and itchy eyes due to allergic conjunctivitis may be helped by an antihistamine medicine such as Chlorphenamine, Cetirizine or Loratidine. Speak to your local community pharmacist about antihistamine use for your child.
How long will your child's symptoms last?
Most conjunctivitis in children (bacterial or viral) is mild. It usually clears within 7 to 10 days without antibiotics.
Where should you seek help?
If it is non urgent (rated in green above), speak to your local community pharmacist.
If your child has any of the above features (rated in amber above), urgently contact your GP.
For an urgent out of hours GP appointment, call NHS 111.
You should only call 999 or go your nearest A&E department in critical or life threatening situations. (rated in red above).
If possible give your child antihistamine.
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