Why do newborns' eyes become inflamed?
The mucous membrane of a baby's eye is thin, and the defense mechanisms are still immature, so the infection takes hold easily. Germs can enter the eyes during childbirth from the mother's birth canal, and later from hands, towels, and dirty pacifiers. A separate reason is chemical irritation from drops that are instilled immediately after birth: it goes away in a couple of days. Finally, in many children, the lower end of the nasolacrimal canal is blocked by a thin film, the tears do not go into the nose, they stagnate and become infected.
- Bacterial infection acquired during childbirth or later
- Viral infection, including herpes
- Chlamydial infection with later onset
- Chemical irritation from eye drops
- Obstruction of the nasolacrimal duct
- Transfer of germs from hands and care items
What it looks like and what to look for
Parents notice that the eye is sour, the eyelids are stuck together after sleep, the eyelashes are covered with yellow crusts. The white of the eye turns red, the eyelids swell, and tears constantly flow from the eye. If the canal is obstructed, lacrimation is pronounced even without redness, and when pressure is applied to the inner corner of the eye, mucus or pus is released. It is important to assess whether one eye is affected or both, when the symptoms began and how the child is feeling overall. The time of onset helps the doctor suspect a specific pathogen.
- Sticking of eyelids and crusts after sleep
- Redness of the white of the eye and swelling of the eyelids
- Constant lacrimation, standing tear
- Purulent or mucous discharge
- Discharge when pressing on the area of the lacrimal sac
- Restlessness and photophobia with severe inflammation
Conjunctivitis or tear duct obstruction
This is the most common question at the reception. With isolated obstruction, the main symptom is persistent lacrimation and standing tears in the eye with a calm white; symptoms are usually one-sided and appear in the second or third week of life. With conjunctivitis, redness and pus predominate, often involving both eyes. The doctor checks the patency of the lacrimal ducts and examines the lacrimal sac area. Often the conditions are combined: stagnation of tears supports the infection, and then both are treated.
- Obstruction: lacrimation with a quiet eye, usually one eye
- Conjunctivitis: bright redness and pus, often in both eyes
- Test for patency of lacrimal ducts
- Inspection and pressure on the lacrimal sac area
- Smear and culture of discharge in case of persistent flow
Care and treatment
The basis of care is proper toileting of the eyes: with clean hands, a separate sterile swab for each eye, moving from the outer corner to the inner one, with boiled water or sterile saline solution. The crusts are softened and not peeled off. If the canal is obstructed, the doctor teaches massage of the lacrimal sac, which is performed several times a day before feeding. Antibacterial drops and ointments are prescribed only by a doctor; you cannot drip breast milk, tea, herbal decoctions or adult drops on your own - this is a common cause of complications. If the canal has not opened by 6–12 months, the ophthalmologist performs probing.
- Toilet the eyes with sterile swabs, separately for each eye
- Rinse with saline solution or boiled water
- Massage of the lacrimal sac as trained by a doctor
- Antibacterial drops only for their intended purpose
- No breast milk, tea or herbs in the eyes
- Probing the nasolacrimal duct if the problem persists
Prevention and when to urgently see a doctor
Examination and treatment of infections in a woman during pregnancy, as well as careful care of the newborn: washing hands before contact with the baby, a separate towel, clean pacifiers, help reduce the risk. You need to see a doctor in any case when a newborn’s eye is purulent—it’s dangerous to make a diagnosis on your own. You need to see an emergency patient if there is abundant pus and severe swelling in the first days of life: some infections can damage the cornea in a short time and lead to permanent vision loss.
- Testing and treating infections during pregnancy
- Washing hands before caring for a child
- Separate towel and clean care items
- Examination by a doctor for any purulent discharge
- Emergency visit for severe swelling of the eyelids in the first days
- Observation by an ophthalmologist for prolonged lacrimation