Skip to main content

Search
Should Your Child See a Doctor?

Eye – Red Without Pus

|

Definition

  • Redness or pinkness of the white of the eye and inner eyelids
  • May have increased tearing (watery eye)
  • Eyelid may be puffy or mildly swollen
  • No pus or other discharge

Causes 

  • Pinkeye: When the white of the eye (sclera) becomes pink or red, it's called pinkeye. Conjunctivitis is another name for pinkeye. The conjunctiva is the membrane that covers the white of the eye. It becomes pink when it is infected or irritated. Pinkeye (conjunctivitis) has many causes.
  • Viral conjunctivitis (part of a cold) is the main cause of pink eyes without pus.
  • Allergic conjunctivitis from pollens. Most children with eye allergies also have nasal allergies (hay fever) with sneezing and clear nasal discharge.
  • Irritant conjunctivitis from sunscreen, soap, chlorinated pool water, smoke, or smog, etc.
  • Irritants can also be transferred by touching the eye with dirty fingers (e.g., food or plant resins on the fingers)
  • Foreign body (FB): If only one side has pinkeye, a FB in the eye must be considered.

Return to School 

  • Pink eye with a watery discharge is harmless and mildly contagious. Children with colds in the eye usually do not need to miss any child care or school.

When to Call Your Doctor for Eye - Red Without Pus

Call Your Doctor Now (night or day) If

  • Your child looks or acts very sick
  • Eyelid is very red or very swollen
  • Constant tearing or blinking
  • Blurred vision
  • Eye pain that's more than mild
  • Cloudy spot on or haziness of the cornea (clear part of the eye)
  • Turns away from any light
  • Age under 12 weeks with fever above 100.4° F (38.0° C) rectally (Caution: Do NOT give your baby any fever medicine before being seen.)
 

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

  • You think your child needs to be seen
  • Only 1 eye is red and present over 24 hours
  • Fever returns after gone for over 24 hours
 

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns
  • Age under 1 month old
  • Redness lasts over 7 days
 

Parent Care at Home If

  • Red eye is part of a cold and you don't think your child needs to be seen
  • Red eye caused by mild irritant (e.g., soap, sunscreen, food, smoke, smog, chlorine, perfume) and you don't think your child needs to be seen
 

Home Care Advice for Red Eye without Pus

Treatment For Viral Eye Infections

  1. Reassurance: Some viruses cause watery eyes (viral conjunctivitis). It may be the first symptom of a cold. It isn't serious and we can treat that at home. Colds can also cause a small amount of mucus to collect in the inner corner of the eye.
  2. Eye Cleansing: Cleanse eyelids with warm water and a clean cotton ball at least every 2 hours while your child is awake and at home. This usually will keep a bacterial infection from occurring.
  3. Artificial tears:
    • Artificial tears often make red eyes feel better (no prescription needed).
    • Use 1 drop per eye three times a day. Use them after cleansing the eyelids.
    • Antibiotic and vasoconstrictor eyedrops do not help viral eye infections.
     
  4. Contacts: Children with contact lenses need to switch to glasses temporarily (reason: to prevent damage to the cornea).
  5. Contagiousness: Pink eye with a watery discharge is harmless and mildly contagious. Children with colds in the eye do not need to miss any child care or school. Pinkeye is not a public health risk and keeping these children home is overreacting. If asked, tell the school your child is on eyedrops (artificial tears).
  6. Expected Course: Pink eye with a cold usually lasts about 7 days.
  7. Call Your Doctor If:
    • Yellow or green discharge develops
    • Redness lasts for more than 1 week
    • Your child becomes worse
     

Treatment For Mild Eye Irritants

  1. Reassurance: Most eye irritants cause transient redness of the eyes. We can treat that at home.
  2. Face Cleansing: Wash the face with mild soap and water. Wash off eyelids with water. This will remove any irritants.
  3. Eye Irrigation: Irrigate the eye with warm water for 5 minutes.
  4. Eye Drops:
    • Red eyes from irritants usually feel much better after the irritant has been washed out.
    • If they remain uncomfortable and bloodshot, instill artificial tears or a long-acting vasoconstrictor eye drops (no prescription needed).
    • You can ask your pharmacist to recommend a brand.
    • Use 1 drop every 8 to 12 hours as necessary.
     
  5. Expected Course: After removal of the irritant, the eyes usually return to normal color in 1 to 2 hours.
  6. Prevention: Try to avoid future exposure to the irritant.
  7. Call Your Doctor If:
    • Develops yellow or green pus in the eye
    • Redness lasts over 7 days
    • Your child becomes worse
     

And remember, contact your doctor if your child develops any of the "When to Call Your Doctor" symptoms.


References

  1. Fisher MC. Conjunctivitis in children. Pediatr Clin North Am. 1987;34:1447-1456.
  2. Gigliotti F. Acute conjunctivitis. Pediatr Rev. 1995;16:203-208.
  3. Greenburg MF, Pollard ZF. The red eye in childhood. Pediatr Clin North Am. 2003;50:105-24.
  4. Nakanishi AK and Soltau JB. Common viral infections of the eye. Pediatr Ann. 1996;25:542-554.
  5. Soparkar CN, Wilhelmus KR, Koch DD, Wallace GW, Jones DB. Acute and chronic conjunctivitis due to over-the-counter ophthalmic decongestants. Arch Ophthalmol. 1997;115:34-38.

Disclaimer

This information is not intended to be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.


Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 8/1/2010

Last Revised: 9/30/2010

Copyright 1994-2011 Barton D. Schmitt, M.D.

Should your child see a doctor?

Find out by selecting your child’s symptom or health condition in the list below:

Summer 2014: Good Growing Newsletter

In This Issue

  • Understanding the Power and Influence of Role Models
  • Legal Marijuana Means Greater Poisoning Risks for Children
  • Why Choose Pediatric Emergency Care?

Download Summer 2014 (PDF)