| Serious eye problems can occur after injury to the eye, and you should seek treatment immediately if you child has any change in his vision, sensitivity to light or severe pain in his eye.
Less serious eye problems that children can have include conjunctivitis or pinkeye, an infection caused by a virus or bacteria, that can cause redness in one or both eyes and a watery discharge. Bacterial conjunctivitis causes a red eye and matting of the eyes with a green or yellow discharge and it requires treatment with antibiotics (usually a topical ointment or drops). Conjunctivitis caused by a virus can also produce a red eye, but the discharge is usually just watery or cloudy. This type of infection is usually accompanied by symptoms of an upper respiratory tract infection, such as a runny nose and cough, and he may have an enlarged lymph gland in front of his ear. No treatment is usually required for this type of infection.
A foreign body in the eye, such as a grain of sand or an eyelash, can cause irritation and redness, and your child may feel pain in the eye when he blinks and it may be tearing excessively. Foreign bodies can usually be washed out with warm water or you may need to see your pediatrician.
A corneal abrasion can occur after having a foreign body in the eye or after scratching the eye. This causes pain, tearing, and sensitivity to light. An abrasion can be detected by your pediatrician by putting fluorescein dye drops in the eye and looking at it with a special blue light. Treatment is with antibiotic ointment until the abrasion has healed, unless the abrasion is over the pupil, in which case your child should probably see an ophthalmologist.
Children with allergies can develop allergic conjunctivitis, which causes both eyes to be red and swollen, itching and tearing. Antihistamines or eye drops may be needed for treatment.
A stye or hordeolum produces a tender, red swollen area on your child's eyelid. It may point inward or it may be on the outside of the eyelid margin. Treatment is with warm compresses and sometimes topical antibiotics.
If there is a nodule or swollen area, but it isn't tender, then it is probably a chalazion, which is an inflamed meibomian gland that improves by using warm compresses several times each day for several weeks or months. Persistent cases sometimes require excision.
Blepharitis is an inflammation of the eyelids that causes them to have redness, crusting and scaling and the eyes may be itchy or irritated. Treatment is usually with daily cleansing of the eyelids with a no-tears shampoo and a soft cloth. Sometimes an antibiotic cream is also needed.
Other eyelid abnormalities include having an entropion, which occurs when the eyelid margin turns inward (inverted), or an ectropion, which is an eyelid that is everted or turns outward.
Ectropions can cause an overflow of tears and can lead to inflammation and scarring.
Entropions can either be congenital or secondary to inflammation of the eyelid. The eyelashes can lead to discomfort and corneal scarring, so a visit to a Pediatric ophthalmologist would be a good idea. Other symptoms can include tearing and sensitivity to light (photophobia).
Treatment for both entopions and ectropions often requires surgical correction, especially if it is leading to scarring.
There is another similar condition called epiblepharon in which there is a roll of skin that causes the eyelashes to turn inward, but the eyelid itself is not inverted. This condition often goes away on its own.
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