A baby’s red eye is often alarming for parents, prompting concern about pain, vision, or infection. Redness in an infant’s eye is common, and many causes are minor and resolve without intensive treatment. However, some causes require prompt medical evaluation. This article provides a general overview of common reasons a baby’s eye may be red, helping to distinguish between benign issues and those needing professional attention.
Non-Infectious and Mechanical Causes of Redness
Redness not caused by a contagious illness often results from mechanical obstruction or minor physical trauma. A common non-infectious cause is dacryostenosis, or a blocked tear duct, which affects about 6% of all infants. This blockage occurs when a thin membrane at the end of the nasolacrimal duct has not fully opened at birth. This leads to a backup of tears that can pool and irritate the eye surface.
Another mechanical cause, particularly in newborns, is a subconjunctival hemorrhage, which appears as a bright red patch on the white of the eye. This occurs when tiny blood vessels rupture beneath the conjunctiva, often due to intense pressure changes during birth or from vigorous crying. While visually dramatic, these hemorrhages are harmless and resolve on their own within a few weeks as the blood is reabsorbed.
Environmental irritants can also cause temporary redness in a baby’s sensitive eyes. Exposure to common household factors like dust, pet dander, perfume, or chemical vapors from cleaning products can trigger a mild reaction. A foreign body, such as an eyelash, dirt, or dried mucus, can scratch the corneal surface or cause redness and excessive tearing until it is flushed out.
Infectious Causes: Recognizing Conjunctivitis
The most common infectious cause of a red eye is conjunctivitis, or “pink eye,” which is an inflammation of the membrane covering the white part of the eye. Differentiating the type of infection often relies on the nature of the discharge present.
Bacterial conjunctivitis typically produces a thick, sticky, yellow or green discharge that can cause the eyelids to crust over and stick together, especially after sleeping. This form is highly contagious and usually requires antibiotic eye drops prescribed by a healthcare provider. Viral conjunctivitis, the most common type, is often associated with a cold or respiratory infection and presents with a watery, clear discharge and general eye redness.
Viral infections do not respond to antibiotics and usually clear up on their own within one to two weeks, though they are highly contagious. Newborns are susceptible to a serious form of infectious conjunctivitis known as ophthalmia neonatorum, which may result from exposure to bacteria or viruses during birth. Chemical conjunctivitis can also occur in newborns due to the prophylactic eye drops administered shortly after birth, which usually resolves within 24 to 36 hours.
Immediate Home Care and Soothing Measures
While awaiting a medical assessment, parents can take gentle steps to soothe the baby and manage symptoms. Cleaning the eye is paramount and should be done with sterile water or a non-irritating saline solution. Use a fresh cotton ball or gauze pad for each wipe, always moving from the inner corner of the eye near the nose outward.
This technique prevents reintroducing discharge back into the tear duct opening and helps keep the eye clear of crusting. A warm compress can be gently applied to the closed eye to loosen sticky discharge and provide comfort. If the redness is accompanied by swelling, a cool compress may be more effective at reducing puffiness.
Strict hygiene practices are necessary to minimize the risk of infection spreading to the other eye or to other family members. Handwashing with soap and water before and after touching the baby’s eyes is mandatory. Towels, washcloths, and bedding that contact the baby’s face should be kept separate and washed frequently.
Critical Red Flags and When to Seek Urgent Medical Attention
While many cases of red eye are minor, certain signs suggest a potentially serious condition that demands immediate medical evaluation. The presence of a fever in a baby under 12 weeks old, especially when accompanied by eye symptoms, requires urgent attention.
Swelling of the eyelid or the area surrounding the eye may indicate a deeper infection like orbital cellulitis and necessitates immediate care. Parents should watch for severe light sensitivity, known as photophobia, or excessive blinking or tearing, which can signal pain or a corneal abrasion.
Any change in the baby’s ability to track objects or the appearance of a white spot on the cornea points to a vision-threatening issue and warrants emergency consultation. If the redness or discharge persists for more than 48 hours without improvement, or if the baby appears generally ill or distressed, a healthcare provider should be contacted promptly.