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 a small transparent discharge the next morning after waking up, which performs an exclusively protective function and is considered quite normal. 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 brings discomfort. Such a problem cannot be ignored: in the absence of medical care, the pathology may worsen, and the disease will acquire a chronic course.

Epidemiology

Discharge from the eyes of a child, especially a small child, is a common phenomenon. The baby's immune system is imperfect, and besides, young children tend to explore everything around them, take various objects (including dirty ones) in their pens, rub their eyes with unwashed fingers. As a result, an infection is introduced into the mucous membranes, increased tear production begins, etc.

According to statistics, most often the appearance of discharge is associated with a bacterial infection, less often allergies are "to blame". Least of all cases concerns the defeat of a viral infection and other ophthalmic diseases. [1], [2]

Causes discharge from the eyes of a child

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 like dry eye syndrome, dysfunction of the secretory function of the glandular system.

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

With viral conjunctivitis, lacrimation is often mistaken for the usual 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 ARVI, influenza, adenovirus infection. [4]

With a bacterially caused disease, there is a massive multiplication and spread of bacteria, therefore, one of their characteristic symptoms is yellowish or green discharge from the eyes of a child. The main reason for this phenomenon is non-compliance with hygiene rules. The transmission of infection occurs with dirty hands, from one baby to another, through personal items, etc.

A yellow discharge from the eyes of a child is often found with contact lenses. If children use lenses, then, as a rule, they often touch their eyes with their hands, do not always adhere to 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, however, in some cases, the protective functions of tears are weakened, and it ceases to fulfill its purpose. For example, this is observed after hypothermia, prolonged use of corticosteroid drugs, etc.

Among other things, discharge from the eyes of a child often occurs against the background of overdrying of the ocular mucosa. This reason is relevant if the baby spends most of the time in a room with low humidity, at 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 (for example, erythema multiforme);
• infectious processes.

Additional provoking factors are:

• prolonged closed condition of the eyelids;
• use of contact lenses; [5]
• non-compliance with individual hygiene rules;
• avitaminosis, preventive use of local antibiotics, immunodeficiency states.

The risk group includes children who move little and eat poorly, spend a long time at computers and smartphones, as well as often sick and premature babies. [6], [7]

Pathogenesis

The organs of vision 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 damage and other lesions of the ocular tissues lead to the release of macrophages and polymorphonuclear leukocytes and their release from the conjunctival vasculature into the lacrimal discharge. If there are favorable conditions - for example, a low temperature or increased adhesion of mucous membranes - an acute infectious process develops. [8],  [9], [10]

The eyelids and the conjunctival surface can be seeded with all kinds of microflora, which often include 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 discharge from the eyes of a child

If in adults, discharge from the eyes and other similar inflammatory manifestations may not disturb the general well-being, then in young children eye diseases are much more complicated. The first signs can be expressed in sleep disturbance, refusal to eat, in increased moodiness and irritability. The child can constantly scratch the eye area, cry. The morning after sleep, the eyelids stick together, the formation of crusts: clots of secretions form in the corners. Some children have light sensitivity, and the eyelids are swollen and reddened. [11]

Older children can already tell about their complaints: most often, additional symptoms are itching, a feeling of "getting in the sand", blurred vision.

With a viral disease, a 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. In this case, at first, the process can affect only one eye, and only after a while the second is also affected. The discharge is predominantly transparent, like tears, and only when a bacterial pathogen is attached, a purulent component appears. [12]

Purulent discharge from the eyes in a child is often caused by the activity of staphylococci and pneumococci. Typically, these bacteria enter the eyes with unwashed hands and do not always detect their presence immediately. For some time, the infection can "sleep", waiting for the weakening of the immune system.

Discharge from the eyes of a newborn child is often caused by infection of the infant while passing through the birth canal, provided that they are contaminated with pathogens. This type of disease can be detected both in one and in two eyes at the same time. The main signs are puffiness, discharge of pus, sticking of the eyelids.

Both transparent and white discharge from the eyes of a child are sometimes allergic in nature. This means that they arise under the influence of various allergens - for example, animal hair, dust, drugs, ticks, 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]

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

Complications and consequences

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

To avoid unpleasant consequences, it is necessary to seek medical help at the first painful signs, especially when it comes to infants and preschool children who have not yet sufficiently developed the immune system. A superficial pathological process can easily transform into a deep one, with spreading into internal tissues. This, in turn, can lead to scarring, deterioration of visual function, and even loss of vision.

Diagnostics discharge from the eyes of a child

To make a diagnosis in case of discharge from the eyes in a child, the collection and analysis of complaints, an external examination of the organs of vision are performed. Additionally, microscopy of the lacrimal fluid, bacteriological analysis of secretions from the conjunctival cavity is performed. [15]

The doctor necessarily pays attention to possible systemic manifestations, depending on their presence, determines the further course of the diagnosis.

It is presumably recommended to pass such laboratory tests:

• general blood analysis;
• analysis of feces 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, PCR is performed - examination of a smear from the conjunctiva for the presence of adenovirus, enterovirus, influenza infection.

Instrumental diagnostics is assigned according to individual indications. This can be tonometry, keratometry, refractometry, etc. [17]

Differential diagnosis

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

Treatment discharge from the eyes of a child

When discharge from the eyes appears, it is imperative to start treatment. If you let the process take its course, it can lead to serious visual impairment in the child. However, self-medication is also not encouraged: the baby must 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 means are:

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

To prepare the first solution, a small amount of potassium permanganate is added to warm boiled water and mixed well: a slightly pinkish liquid should be obtained. She is washed with children's eyes 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). Tea should be chosen natural, without aromatic and flavoring additives (and, of course, without sugar).

In addition to these funds, an infusion of chamomile color or a furacilin solution is also suitable, which perfectly removes dried secretions. [19]

The eyes are flushed, moving from the outside of the eye to the inner corner.

Important: you cannot apply bandages without a doctor's recommendation. Closed conditions facilitate the development and spread of infection, which can greatly exacerbate 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% Sulfacil (Albucid, sodium sulfacil) is used to treat children. With the allergic nature of the discharge, antiallergic external drugs, immunosuppressants, hormonal agents are prescribed. 

Medicines that a doctor may prescribe

Sulfacil sodium	Eye drops with an antimicrobial sulfanilamide component with extensive activity. The drug is allowed to be used from birth, one drop 3-6 times a day. During use, a short burning sensation and irritation of the mucous membrane may occur.
Levomycetin drops	The antibiotic drug chloramphenicol (chloramphenicol), which has bacteriostatic properties. Can be used to treat children over 4 months old, 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 the age of eight.
Futsitalmik	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 application is one week. If an allergy to the drug is found, then the treatment is stopped.
Aktipol	The drug is an interferon inducer, has an antioxidant, immunomodulatory, regenerative effect. It is used to treat viral, degenerative and traumatic eye lesions. Aktipol is prescribed according to an individually selected scheme. In the course of application, conjunctival redness may occur in rare cases.
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 in the evening. Possible side effects: transient eye irritation, bitter taste in the mouth.

Vitamins

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

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

In what form to prescribe vitamins, the doctor decides. 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

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

Different types of therapy are prescribed, depending on the cause of the discharge from the eyes. This is laser treatment, and electrical stimulation, or electrophoresis (a way of getting a drug directly into the tissue using an electric current). For some pathological processes, magnetostimulation and manual therapy are appropriate. For inflammatory eye diseases, physical therapy helps to get rid of the infection faster.

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

Alternative treatment

• With a pneumococcal nature of secretions, with purulent processes, an infusion of kombucha is dripped into the eyes. This speeds up the healing process.
• Make lotions from the infusion or decoction of rosehips. Brew in 200 ml of boiling water 2 tsp. Fruits, insist for half an hour, and then filtered.
• In the absence of allergies, honey is diluted in warm water, based on a ratio of 1: 2. Use the solution instead of eye drops or lotions. It is also recommended to consume honey internally to strengthen the immune system and overall positive effect on visual function.
• Give the child 1 tbsp daily. L. Fresh or dried blueberries.
• Apply fresh and clean grape leaves to the eyes.

Herbal treatment

• Drops based on the eyebright plant eliminate pathological discharge from the eyes, relieve infection. Mix 5 drops of eyebright and 15 ml of saline, drop 1-2 drops of the resulting liquid into each eye three times a day.
• Regularly wash off the discharge with a cotton pad dipped in anise infusion.
• Prepare dill water: half a tablespoon of dry dill is poured with 200 ml of boiling water, infused until it cools, filtered well. Use the infusion for washing up to three times a day.
• Fresh plantain juice, diluted with saline (1: 3), is instilled in 1-2 drops three times a day.
• Prepare an infusion of medicinal calendula: 3 tsp. Dried flowers are poured into a thermos with 500 ml of boiling water, insisted for one and a half hours. The infusion is added to tea and is also used for washing.
• Make lotions based on medicinal marshmallow: pour 200 ml of boiling water 2 tbsp. L. Plants and insist for half an hour. [23]

Homeopathy

The most common homeopathic remedy for eliminating various discharge from the eyes of a child is Similasan drops, made in the United States. The drops are suitable for use in adults and children from 2 years of age. The preparation is 100% natural, safe and does not cause side effects.

The homeopath can pick up other remedies for the child in the form of monopreparations: children are most often offered low dilutions - for example, 6X, 12X, 6C, 3-4 times a day.

With discharge from the eyes, such homeopathic remedies help:

• Apis melifika - with burning lacrimation, eyelid edema;
• Argentum nitrikum - with thick discharge in newborns;
• Arsenicum album - with strong transparent discharge, general disturbance of well-being;
• Belladonna - with discharge accompanied by photophobia;
• Euphrasia - with allergic lacrimation;
• Gepar sulfuris - with yellow thick discharge;
• Mercurius solubilis or vivus - with profuse, unpleasant-smelling discharge from the eyes;
• Pulsatilla - with yellowish and green discharge, sticky eyelids after sleep;
• Sulfur - when forming dry crusts.

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

Surgery

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

On an outpatient basis, in which the child does not necessarily go to the hospital, operations are performed that do not require prolonged postoperative observation. This is usually useful in the treatment of abnormal ciliary growth, lacrimation, chalazion, volvulus, or pterygium.

Until the reasons for the appearance of discharge from the eyes in a child are clarified, surgical treatment cannot be prescribed, since a wide range of diagnostic procedures is required.

Prevention

The main way to prevent the appearance of discharge from the eyes in a child is to observe hygiene rules. Therefore, parents themselves need to follow all the recommendations for personal hygiene, as well as teach the baby to this.

It is easier to prevent any pathology than to take the child to the doctors afterwards and try to find the cause of the discharge from the eyes, in order to then engage in treatment. According to experts, in most children, the problem is associated with a violation of the temperature regime, with 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 bed, 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 monitor their cleanliness;
• walk often, ventilate the rooms regularly, and, if necessary, use a humidifier;
• to provide a complete balanced nutrition of the child with high-quality and fresh products;
• make sure that the baby only uses his own clean towel;
• avoid communication of the child 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 winds. Do not rub your face and eyelids with dirty hands.

Forecast

With timely treatment started, the prognosis is favorable: within 1-4 weeks, complete recovery should occur. The main thing is that even at the first signs of the disease, you need to consult a doctor, especially if a child under five years of age is sick, whose immune system is not yet sufficiently formed. If you ignore the treatment, then 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 state of the entire body. This is why it is important to seek medical attention as early as possible. We must not forget that timely therapy and competent doctor's prescriptions are the key to children's health.