PAEDIATRIC OPHTHALMOLOGY: RED EYES IN CHILDREN

Many children are affected by atopic (allergic) conditions like hay fever, asthma and eczema. When this affects the eyes, it’s known as allergic conjunctivitis (sometimes commonly referred to as ‘red eyes’), which can potentially affect children of all ages.

This can be seasonal when associated with pollen in spring/summer or perennial if the underlying cause is an allergen that is present throughout the year like pet hair or house dust mites, for example.

Symptoms of allergic conjunctivitis:

The symptoms of allergic conjunctivitis in children can vary from individual to individual, ranging from mild to very severe.

The condition causes the ‘conjunctiva’ – the thin membrane that covers the inside of the eyelids and outer white part of the eye – to become inflamed. Typical symptoms of allergic conjunctivitis include red and bloodshot eyes that may look and feel very sore. Itching of the eyes is also a very common symptom of allergic conjunctivitis, along with watering of the eyes. Most of the time, both eyes will be affected, although it is sometimes possible to have a reaction in just one eye. Mild red eye or allergic conjunctivitis may just cause minor irritation, whereas symptoms can be very uncomfortable and distressing for some children.

Allergic conjunctivitis is not generally associated with long-term eye damage. However, in more severe forms, it can lead to involvement of the cornea called vernal keratoconjunctivitis

Treatment of red eyes in children:

Treatment of red eyes in children will often depend on the severity of the symptoms and the frequency of flare-ups. However, much of the time, allergic conjunctivitis treatment is aimed at both soothing and relieving the symptoms as well as bringing the underlying inflammatory reaction under control.

Intermittent or less serious episodes of red eyes or allergic conjunctivitis can usually be treated with antihistaminic eye drops such as Olapatadine, with tablets or syrup (Piriton) added in if there are other symptoms of hay fever alongside the eye problems.

More severe forms of allergic conjunctivitis may require steroid eyedrops. These can be very effective at treating more severe inflammation but do need to be monitored carefully, as steroid drops can lead to side effects if used for a long period unsupervised. Mr Saurabh Jain will discuss this with you before treatment begins and advise on any important points to be aware of.

For older children and teenagers who wear contact lenses, it is important to avoid wearing lenses when the eyes are inflamed, to avoid aggravating the condition. Mr Saurabh Jain can also advise on any additional self-care measures – such as how to gently clean the eyes are avoid further irritation – that may help. Wearing sunglasses when outdoors can be useful.

When it comes to allergic conjunctivitis treatment, taking appropriate steps to manage the underlying allergy can also be important. The first step is to try to identify which allergens are ‘triggering’ the reaction, so that you can then take steps to minimise exposure where possible – or be prepared to manage a flare-up if the allergen can’t be avoided entirely (for example, avoiding pollen simply isn’t possible 100% of the time).

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Mr Saurabh Jain

Saurabh Jain Is a Consultant Ophthalmic Surgeon and Clinical Director of services at the Royal Free London NHS Foundation Trust.