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Eye conditions in your baby

Eye infection

An eye infection is usually caused by a virus when a child has a cold. The condition is also referred to as viral conjunctivitis or pink eye​. Sometimes eye infection can be caused by bacteria, and this type of infection is more serious in nature.

Symptoms of viral eye infection include:

  • redness of the white part of the eye
  • redness of the inside of the eyelids
  • puffy eyelids
  • watery eyes

Symptoms of bacterial eye infection include those listed above, plus the following:

  • yellow discharge from the eye
  • eyelids matted or stuck together

Treating eye infections

The best way to take care of a viral eye infection is to rinse the eyes often with warm water, using a clean cotton ball each time. Keeping the eyes clean will help prevent a bacterial infection from arising. Breast milk can be used – simply squirt some breast milk into the corner of the eye. The child usually does not need eye drops. Viral eye infections last about four to seven days. Viral eye infections are mildly contagious but otherwise harmless.

If the eyes develop a yellow discharge or the eyelids become matted or stuck together after sleeping, the eye infection is probably bacterial rather than viral in nature. In this case, the child does need antibiotic eye drops to fight the infection. Bring him to the doctor so that he can be given a prescription for an antibiotic.

If your child’s eyelids become very red or swollen, or if he develops blurred vision or eye pain, bring him to the doctor right away.

First signs of vision problems

Your baby’s eyes are checked at each well-baby visit, and therefore any vision problems can be caught early. The Canadian Association of Optometrists and the American Optometric Association recommend that children see the optometrist for the first time before six months of age, then at age three years, and every two years once the child is in school. Various family physician and paediatric organizations, on the other hand, indicate that primary care physicians should be the ones to screen babies for vision problems. Whether or not your baby should see an optometrist is a decision that you need to make for yourself.

Other eye conditions

Below is a listing of some other eye conditions that can occur in the first year of life.

Unco-ordinated eyes

Although your baby’s eyes may not be well coordinated when he is first born, the problem should resolve itself by the time he is three months old. If by this time your baby still has problems with his eye coordination, make sure to bring this to your doctor’s attention.

Crossed eyes

Sometimes the extra folds of skin in the inner corner of the eyes can make the eyes look crossed. As the baby grows, the folds will retract and the eyes will look more even. Some babies do have truly crossed eyes, which needs to be treated early. Ignoring crossed eyes can lead to a condition called “lazy eye,” where the child depends on one eye, and the unused eye becomes weaker. If you notice that your baby’s eyes are crossed, bring him to the doctor for an assessment.

Teary eyes

Babies develop the ability to produce tears when they cry around the end of the first month. Around this time, some babies develop a blocked tear duct, which is a blockage of the pathway that carries tears from the eye to the nose. The eye may seem constantly teary, with tears spilling over at times, even when the newborn is not crying. Usually the eye is not red and the eyelid is not swollen. Blocked tear ducts usually clear up by the end of the first year, but your doctor may recommend helping it along by massaging the inner corner of the eye. However, if the eye becomes red or swollen, it could be a sign of infection, and you should have the baby seen by a doctor. If the blockage lasts past the first year, an ophthalmologist may need to open it up.

Douglas Campbell, MD, FRCPC

Andrew James, MBChB, MBI, FRACP, FRCPC