A red spot on the white part of your baby’s eye, known as the sclera, is understandably alarming. While this visual sign causes immediate concern, the physical manifestation of a red spot is most often due to a minor and temporary condition. Observing surrounding symptoms is key to determining the cause, as most spots are harmless and resolve on their own. Parental observation of the spot’s size, color, and accompanying symptoms will help guide the decision on whether a medical consultation is needed.
The Most Frequent Cause of Red Spots
The most common reason for a red spot in a baby’s eye is a subconjunctival hemorrhage (SCH), which is simply a broken blood vessel on the eye’s surface. The conjunctiva is a thin, clear membrane covering the sclera, and it contains many small, fragile blood vessels that can rupture easily. When one of these vessels breaks, the blood collects between the conjunctiva and the sclera, resulting in a bright red patch.
In infants, this condition frequently occurs due to the intense pressure changes during birth, especially following a prolonged or difficult delivery. The forceful contractions and physical compression cause a sudden spike in venous pressure, leading to vessel rupture. For older babies, non-traumatic events can trigger an SCH, such as vigorous crying, coughing, vomiting, or straining during a bowel movement.
A subconjunctival hemorrhage is typically painless and does not affect the baby’s vision. The spot may appear quite large, but it is a benign condition that requires no specific treatment other than observation. The body will naturally reabsorb the collected blood over a period of about one to three weeks. As the blood begins to break down, the red color may change to an orange or yellowish tint before disappearing completely.
Red Spots Caused by Injury or Infection
A red spot can sometimes signal irritation or inflammation caused by an external factor, which is distinct from the internal bleeding of an SCH. Minor physical contact, such as a baby poking their eye or rubbing their face against bedding, can cause a small abrasion or general irritation. These minor traumas often result in localized redness accompanied by increased tearing or general fussiness.
Infection, such as conjunctivitis (pink eye), is another common cause of redness that may present as a diffuse red spot or generalized redness. Unlike an SCH, an infection is characterized by accompanying symptoms. These symptoms include a noticeable discharge that can be watery, thick, yellow, or greenish, often causing the eyelids to stick together after sleeping.
Other signs of infection include eyelid swelling and increased irritation, with redness potentially spreading to involve the other eye. Viral conjunctivitis typically presents with watery discharge, while bacterial forms produce a thicker, pus-like discharge. Irritants like dust, smoke, or chemicals can also cause redness and tearing, but these usually resolve quickly once the irritant is removed.
When the Red Spot Signals Something Serious
While most red spots are harmless, certain accompanying symptoms require immediate medical attention. If the red spot is part of a larger presentation, it may indicate a deeper or more urgent issue. Concerning signs include observable changes in vision, such as difficulty tracking objects or excessive light sensitivity.
A fever paired with eye redness suggests a systemic infection and requires urgent medical consultation. Excessive pain, increased fussiness, or a refusal to open the eye are also concerning signs that go beyond the asymptomatic nature of an SCH. Another serious sign is the appearance of a white or grayish spot within the pupil.
Immediate evaluation is necessary if the red spot is accompanied by bruising around the eye or if there is blood pooling in the colored or black part of the eye (hyphema). In rare instances, an SCH can be associated with non-accidental trauma, which medical professionals consider if the injury history is unclear or inconsistent.
Medical Evaluation and Next Steps
A healthcare provider, such as a pediatrician or ophthalmologist, will begin the evaluation by taking a detailed medical history, focusing on the onset of the red spot and any potential triggers. They will perform a visual inspection of the eye, often using a specialized light to examine the surface and internal structures of the eye under magnification. This examination helps confirm if the spot is indeed an SCH or if it is a sign of a different condition, such as conjunctivitis or a corneal abrasion.
If an infection is suspected due to discharge, the doctor may gently swab the eye to collect a sample for laboratory testing to identify the specific pathogen, which guides the correct treatment. For a confirmed subconjunctival hemorrhage, the treatment remains simple observation, as the body heals the broken vessel without intervention. If the SCH is recurrent or exceptionally large, the doctor may check for underlying issues like a bleeding disorder or high blood pressure.
If the diagnosis is bacterial conjunctivitis, the common treatment involves antibiotic eye drops or ointment to clear the infection. Viral conjunctivitis is typically managed with supportive care, such as keeping the eye clean, as it must run its course. It is important to avoid attempting to self-treat with over-the-counter eye drops not approved for infants, as these can contain ingredients that may cause irritation. Following the medical advice and prescribed treatment plan ensures the best outcome for the baby’s eye health.