Discharge from the eyes of a child: purulent, yellow, green

Our eyes are a sensitive organ, which, however, has several protective factors at once. One of these factors is small transparent discharge in the morning after waking up, which performs an exclusively protective function and is considered a completely normal phenomenon. But it happens when the discharge from the eyes of a child is not only abundant, but also unusual in color and consistency, and sometimes even causes discomfort. This problem cannot be ignored: in the absence of medical care, the pathology can worsen, and the disease can become chronic.

Epidemiology

Discharge from the eyes of a child, especially a small one, is a common occurrence. The baby's immune system is imperfect, and besides, small children tend to explore everything around them, pick up different objects (including dirty ones), rub their eyes with unwashed fingers. As a result, an infection is introduced into the mucous membranes, increased lacrimation begins, etc.

According to statistics, the appearance of discharge is most often associated with a bacterial infection, less often allergies are “to blame”. The least number of cases concerns viral infections and other ophthalmological diseases. [ 1 ], [ 2 ]

Causes eye discharge from the baby's eyes

The most common causes of eye discharge in childhood are:

• viral or microbial inflammatory processes such as blepharitis, conjunctivitis, keratitis, dacryocystitis, canaliculitis;
• non-inflammatory processes such as dry eye syndrome, disorders of the secretory function of the glandular system.

Inflammatory processes affecting the eyelids are often of staphylococcal origin, or may be associated with seborrheic dermatitis, demodicosis, glandular disorders. Discharge in blepharitis is usually thick, pasty, sometimes foamy, prone to accumulation and sticking together. [ 3 ]

In viral conjunctivitis, lacrimation is often mistaken for normal discharge from the eyes of a child with a cold. But viral lesions can occur both independently and accompanied by other symptoms, as well as against the background of a general poor condition. The cause is often acute respiratory viral infections, influenza, adenovirus infection. [ 4 ]

In a bacterially caused disease, there is a massive reproduction and spread of bacteria, so one of the characteristic symptoms is considered to be yellowish or green discharge from the eyes of a child. The main reason for this phenomenon is non-compliance with hygiene rules. The infection is transmitted with dirty hands, from one child to another, through personal items, etc.

Yellow discharge from the eyes of a child is often detected when using contact lenses. If children use lenses, then, as a rule, they touch their eyes with their hands more often, and do not always follow the recommendations for handling and storing lenses.

Discharge from the eyes of a child in the morning sometimes appears against the background of a reduced protective function of the conjunctiva. Cleaning of the conjunctival cavity is always carried out with the help of tear fluid, but in some cases the protective functions of tears weaken, and it ceases to fulfill its purpose. For example, this is observed after hypothermia, long-term use of corticosteroid drugs, etc.

Among other things, discharge from the eyes of a child often occurs due to overdrying of the eye mucosa. This reason is relevant if the baby spends most of the time in a room with low humidity, in front of a computer monitor.

Risk factors

Local risk factors include:

• mechanical damage to the organs of vision;
• ingress of foreign bodies;
• some types of dermatological diseases (eg, erythema multiforme);
• infectious processes.

Additional provoking factors include:

• prolonged closed state of the eyelids;
• use of contact lenses; [ 5 ]
• failure to comply with individual hygiene rules;
• avitaminosis, prophylactic use of local antibiotics, immunodeficiency states.

Those at risk include children who are sedentary, poorly nourished, spend a lot of time on computers and smartphones, as well as frequently ill and premature babies. [ 6 ], [ 7 ]

Pathogenesis

The visual organs are very sensitive to all kinds of infections. The lacrimal fluid has antibacterial properties, as it contains immunoglobulins, components of the complement system, lactoferrin, beta-lysine and lysozyme. The eyelids themselves also perform a protective function, mechanically cleaning the ocular surface. External injuries and other lesions of the ocular tissues lead to the release of macrophages and polymorphonuclear leukocytes and their exit from the conjunctival vascular network into the lacrimal secretion. If there are favorable conditions - for example, low temperature or increased adhesion of the mucous membranes - an acute infectious process develops. [ 8 ], [ 9 ], [ 10 ]

The eyelids and conjunctival surface can be seeded with all sorts of microflora, which often includes staphylococci, propionobacteria, diphtheroids, which begin to actively participate in the inflammatory reaction. Subsequently, they can be identified during a diagnostic study of eye discharge.

Symptoms eye discharge from the baby's eyes

While eye discharge and other similar inflammatory manifestations may not affect general well-being in adults, eye diseases are much more complicated in small children. The first signs may include sleep disturbances, refusal to eat, increased capriciousness and irritability. The child may constantly scratch the eye area and cry. The next morning after sleep, eyelids stick together, crusts form: clots of discharge form in the corners. Some children experience sensitivity to light, and the eyelids may be swollen and reddened. [ 11 ]

Older children can already talk about their complaints: most often, additional symptoms include itching, a feeling of “sand in the mouth,” and blurred vision.

In case of a viral disease, the child has discharge from the eyes and a runny nose at the same time – that is, the first signs of an acute respiratory viral infection. At first, the process may affect only one eye, and only after some time the other is affected. The discharge is mostly transparent, like tears, and only when a bacterial pathogen is added does a purulent component appear. [ 12 ]

Purulent discharge from the eyes of a child is most often caused by the activity of staphylococci and pneumococci. As a rule, these bacteria get into the eyes with unwashed hands and do not always reveal their presence immediately. The infection can "sleep" for some time, waiting for the immune system to weaken.

Discharge from the eyes of a newborn baby is often caused by infection of the baby during passage through the birth canal, provided that they are seeded with pathogens. This type of disease can be detected in one or both eyes at the same time. The main symptoms are swelling, discharge of pus, and sticking of the eyelids.

Both clear and white discharge from the eyes of a child sometimes have an allergic nature. This means that they arise under the influence of various allergens - for example, animal hair, dust, medications, mites, etc. In addition to the obvious manifestations of allergic conjunctivitis, allergic rhinitis can also develop. The appearance of pus is not typical for allergies. [ 13 ]

Acute conditions, accompanied by discharge from the eyes, are usually typical for childhood. But in some cases, a chronic process develops: such a transformation occurs almost unnoticed and indicates some shortcomings in the treatment or care of the baby. Chronic pathology is accompanied by visual discomfort, swelling and redness of the conjunctiva, constant presence of discharge - especially after waking up.

Complications and consequences

It is unlikely that it will be possible to predict in advance what complications may arise against the background of the appearance of discharge from the eyes of a child. To do this, it is necessary, at least, to know the cause of this phenomenon. For example, the most undesirable complication of conjunctivitis can be keratitis - this is an inflammatory reaction in the cornea of the eye. The disease manifests itself as turbidity, pain, hyperemia and ulceration of the cornea. In addition, any acute inflammatory process always has the possibility of becoming chronic. [ 14 ]

To avoid unpleasant consequences, it is necessary to seek medical help at the first painful signs, especially if it concerns infants and preschool children whose immune system is not yet fully formed. A superficial pathological process can easily transform into a deep one, spreading to internal tissues. This, in turn, can lead to the formation of scars, deterioration of visual function and even loss of vision.

Diagnostics eye discharge from the baby's eyes

To establish a diagnosis of eye discharge in a child, complaints are collected and analyzed, and the visual organs are examined externally. Additionally, microscopy of the lacrimal fluid and bacteriological analysis of discharge from the conjunctival cavity are performed. [ 15 ]

The doctor will definitely pay attention to possible systemic manifestations and, depending on their presence, determine the further course of diagnosis.

It is suggested that the following laboratory tests be performed:

• general blood test;
• stool analysis for worm eggs;
• scraping for enterobiasis;
• blood test for specific IgE; [ 16 ]
• cytological analysis of a smear from the conjunctiva.

If a viral infection is suspected, a PCR test is performed to check a smear from the conjunctiva for the presence of adenovirus, enterovirus, and influenza infections.

Instrumental diagnostics are prescribed according to individual indications. This may include tonometry, keratometry, refractometry, etc. [ 17 ]

Differential diagnosis

Since discharge from the eyes of a child may be present with various eye diseases, differential diagnostics are mandatory. As a rule, it is necessary to distinguish between viral, bacterial, allergic diseases, pathologies of the lacrimal glands and dry eye syndrome. [ 18 ]

Treatment eye discharge from the baby's eyes

When discharge from the eyes appears, it is imperative to begin treatment. If the process is left to its own devices, it can lead to serious visual impairment in the child. However, self-medication is also not welcomed: the baby should definitely be shown to an ophthalmologist or pediatrician.

Of course, there are recommended remedies that are allowed to be used to eliminate discharge - for example, before consulting a doctor. Such remedies are:

• barely pink solution of potassium permanganate;
• boric acid solution;
• strong tea.

To prepare the first solution, add a small amount of potassium permanganate to warm boiled water and mix well: you should get a liquid of a slightly pinkish hue. Wash the baby's eyes with it several times a day, using a cotton pad or gauze napkin. A more concentrated solution cannot be used: it can cause burns.

In a similar way, the child's eyes are washed with 2% boric acid or fresh warm black or green tea (pre-filtered). The tea should be natural, without aromatic and flavor additives (and, of course, without sugar).

In addition to the above mentioned remedies, chamomile infusion or furacilin solution are also suitable, which perfectly remove dried discharge. [ 19 ]

The eyes are washed, moving from the outer part of the eye to the inner corner.

Important: Do not apply bandages without a doctor's recommendation. Closed conditions promote the development and spread of infection, which can significantly worsen the problem. [ 20 ]

Depending on the cause of the discharge from the eyes, the doctor may prescribe drops or ointments, or even antibiotics. Often, 20% Sulfacyl (Albucid, sodium sulfacyl) is used to treat children. If the discharge is of an allergic nature, antiallergic external drugs, immunosuppressants, and hormonal agents are prescribed.

Medicines that a doctor may prescribe

Sodium sulfacyl	Eye drops with an antimicrobial sulfanilamide component that has broad activity. The drug is approved for use from birth, one drop 3-6 times a day. During use, short-term burning and irritation of the mucous membrane may occur.
Levomycetin drops	The antibiotic drug levomycetin (chloramphenicol), which has a bacteriostatic property. Can be used to treat children over 4 months, one drop three times a day. Possible side effects are associated with individual hypersensitivity.
Tetracycline ointment 1%	An ointment containing the antibiotic tetracycline is placed behind the lower eyelid up to five times a day. The drug is usually well tolerated, but it is not recommended for children under eight years of age.
Fucithalmic	Local drops based on fusidic acid. They are prescribed for the treatment of bacterial infections, one drop in each eye twice a day, for a week. The average duration of use is one week. If an allergy to the drug is detected, then the treatment is stopped.
Aktipol	The drug is an interferon inducer, has antioxidant, immunomodulatory, regenerative effects. It is used to treat viral, dystrophic and traumatic eye lesions. Aktipol is prescribed according to an individually selected regimen. In rare cases, conjunctival redness may occur during use.
Allergodil	Decongestant and antiallergic ophthalmic drops, which are prescribed for allergic processes in children, starting from 4 years of age. As a rule, one drop of the drug is dripped in the morning and evening. Possible side effects: transient eye irritation, bitter taste in the mouth.

Vitamins

In case of discharge from the eyes, it is recommended to feed the child products containing vitamin A (pumpkin and carrots, peach, sweet potato, parsley or broccoli) and ascorbic acid (citrus fruits, tomatoes and bell peppers, kiwi, cabbage or asparagus). You should also avoid eating sweets and baked goods, as such products negatively affect the state of the immune system.

• Ascorbic acid helps strengthen the immune system. The required amount of this vitamin is determined by the doctor: usually the daily dose for children under one year is 30 mg, for children under 3 years - 40 mg, and for children under 12 years - 45 mg. At the doctor's discretion, the dosage may be slightly increased.
• Vitamin A is necessary for normal function of the visual organs, as well as for supporting local immunity. The daily dose is: for children under one year old 1875 IU, for children under three years old – 2000 IU, for children under six years old – 2500 IU, for children under ten years old – 3500 IU, for teenagers – 4-5 thousand IU.

The doctor decides what form to prescribe vitamins in. Most often, these are liquid drops or capsules for internal use. In mild cases, it is enough to simply adjust the diet, without additional intake of medicinal and vitamin supplements.

Physiotherapy treatment

In outpatient settings, in various children's medical institutions, physiotherapy is used quite widely. Large clinical centers always have specialized physiotherapy departments, where the use of physiotherapy procedures for children is more active.

Different types of therapy are prescribed depending on the cause of the discharge from the eyes. This includes laser treatment, electrical stimulation, or electrophoresis (a method of delivering a drug directly to the tissue using electric current). Magnetic stimulation and manual therapy are appropriate for some pathological processes. In case of inflammatory eye diseases, physiotherapy procedures help to get rid of the infection faster.

As a rule, such procedures are painless and easily tolerated by sick children. In pediatrics, relatively soft methods and low-power effects are most often used. For example, the electric current used is approximately 10 times less than for treating adult patients. [ 21 ], [ 22 ]

Folk remedies

• In case of pneumococcal nature of discharge, in case of purulent processes, kombucha infusion is dripped into the eyes. This allows to speed up the recovery process.
• Make poultices from an infusion or decoction of rose hips. Brew 2 teaspoons of fruit in 200 ml of boiling water, leave for half an hour, then filter.
• If there is no allergy, honey is diluted in warm water in a ratio of 1:2. The solution is used instead of eye drops or lotions. It is also recommended to take honey internally to strengthen the immune system and for a general positive effect on visual function.
• Give the child 1 tablespoon of fresh or dried blueberries daily.
• Apply fresh and clean grape leaves to the eyes.

Herbal treatment

• Eyebright-based drops eliminate pathological discharge from the eyes and get rid of infection. Mix 5 drops of eyebright and 15 ml of saline solution, drip 1-2 drops of the resulting liquid into each eye three times a day.
• Regularly wash away the discharge with a cotton pad soaked in anise infusion.
• Prepare dill water: pour 200 ml of boiling water over half a tablespoon of dry dill, leave to cool, filter well. Use the infusion for rinsing up to three times a day.
• Instill fresh plantain juice diluted with saline solution (1:3), 1-2 drops three times a day.
• An infusion of medicinal calendula is prepared: 3 teaspoons of dried flowers are poured into a thermos with 500 ml of boiling water and infused for an hour and a half. The infusion is added to tea and also used for rinsing.
• They make compresses based on medicinal marshmallow: pour 200 ml of boiling water over 2 tbsp of the plant and leave for half an hour. [ 23 ]

Homeopathy

The most common homeopathic remedy for eliminating various eye discharges in children is Similasan drops, manufactured in the United States. The drops are suitable for use in adults and children from 2 years of age. The drug is 100% natural, safe and does not cause side effects.

A homeopath can also select other remedies for a child in the form of single-drug preparations: children are most often offered low dilutions - for example, 6X, 12X, 6C, 3-4 times a day.

The following homeopathic remedies help with eye discharge:

• Apis mellifica - for burning lacrimation, swelling of the eyelid;
• Argentum nitricum - for thick discharge in newborns;
• Arsenicum album - for strong transparent discharge, general malaise;
• Belladonna - for discharge accompanied by photophobia;
• Euphrasia - for allergic lacrimation;
• Hepar sulfuris - for thick yellow discharge;
• Mercurius solubilis or vivus - for profuse, foul-smelling discharge from the eyes;
• Pulsatilla - for yellowish and green discharge, stuck together eyelids after sleep;
• Sulfur - when dry crusts form.

Experts say that with the right selection of a homeopathic remedy, improvement should occur within the first two days from the start of treatment.

Surgical treatment

Surgeries for the appearance of discharge from the eyes of children are rarely performed and only in special cases, if there are clear indications for this. Treatment is performed both in hospital conditions - in the hospital, and on an outpatient basis, when the patient goes home after the intervention.

In outpatient settings, where the child does not necessarily have to be hospitalized, surgeries are performed that do not require long-term postoperative observation. This is usually applicable in the treatment of abnormal eyelash growth, lacrimation, chalazion, entropion, or pterygium.

Until the causes of eye discharge in a child are determined, surgical treatment cannot be prescribed, since a wide range of diagnostic procedures is required.

Prevention

The main way to prevent discharge from the eyes of a child is to follow hygiene rules. Therefore, parents themselves need to follow all recommendations for personal hygiene, and also teach the baby to do the same.

It is easier to prevent any pathology than to take the child to doctors and try to find the cause of discharge from the eyes, in order to treat it later. According to experts, in most children the problem is associated with a violation of the temperature regime, infectious diseases and allergies. Therefore, for prevention, the following recommendations should be followed:

• carefully adhere to all hygiene rules: regularly bathe the baby, ensure the cleanliness of his linen and bedding, do wet cleaning in the apartment and the children's room, monitor the cleanliness of hands, toys, etc.;
• if the child uses glasses or lenses, then you need to keep them clean;
• take frequent walks, regularly ventilate the rooms, and, if necessary, use a humidifier;
• provide the child with a complete, balanced diet with high-quality and fresh products;
• make sure that your baby only uses his own clean towel;
• avoid the child's contact with sick people, try not to appear in public places during periods of increased risk of viral diseases (autumn-winter, winter-spring periods).

In addition, to maintain eye health, it is necessary to protect them from exposure to smoke, dust, and strong wind. Do not rub your face and eyelids with dirty hands.

Forecast

If treatment is started in a timely manner, the prognosis is favorable: full recovery should occur within 1-4 weeks. The main thing is to see a doctor at the first signs of the disease, especially if the child is under five years old, whose immune system is not yet fully formed. If treatment is ignored, the superficial process can transform into a deep one, which is accompanied by inflammation of the inner layers of the cornea.

Any pathology, including discharge from the eyes of a child, negatively affects the condition of the entire body. That is why it is important to seek medical help as soon as possible. We must not forget that timely therapy and competent doctor's prescriptions are the key to children's health.