Eye Discharge - An Overview

Introduction:

Crusty eye discharge is formed in the corner of the eyes and along the lashes when one wakes up from sleep. This is normal. When a person is awake, they blink often, and this keeps the eyes moist and removes any debris from the eyes. While asleep, blinking is not possible, and this causes the normal eye mucus and other residues to accumulate in the corners of the eye. This is commonly called ‘eye boogers’ and technically as ‘rheum’. A normal eye discharge appears to be white or pale cream.

What Are the Reasons for Eye Discharge in Children?

Eye discharge can occur for various reasons, such as bacterial or viral infections. These causes are as follows:

• Pink Eye: Pink eye is also called conjunctivitis, and the tissue lining the eyes turns red, becomes inflamed, and is painful. Pinkeye is most commonly caused by viral infections and affects both eyes. The affected eye appears red and swollen. Viral infection differs from a bacterial infection in that the latter releases pus. Viral conjunctivitis resolves on its own within two to three weeks. The eyelids can be glued shut due to the stringy discharge.

• Bacterial Infection: When harmful bacteria target and attack the eyes, a bacterial infection can develop. Bacterial conjunctivitis is a kind of pinkeye and can occur in one or both eyes. The eyes become swollen and sore. The white portion of the eye turns red, and water flows from the eyes along with the production of green or yellow mucus. Usually, a few bacterial conjunctivitis resolve on their own, but some children may require antibiotics to treat the infection.

A classic sign of bacterial conjunctivitis is that the eyes remain shut due to pus discharge especially after one awakens from sleep. Sometimes, bacterial infections can be accompanied by fever.

• Blocked Tear Duct: This means that one or more tear ducts in the eyes have difficulty draining. This is common in 10 % of babies, and even toddlers can have blocked tear ducts. There is a continuous flow of water from the eyes down the face, and it appears as if the child is crying even when they are not. The eye does not turn red or become swollen initially, but if it does and becomes irritated, it indicates that the tear duct is infected.

• Foreign Object: Any foreign object entering the eye could irritate the eyes and cause it to water. This is a natural reflex, and the foreign object could be as small as an eyelash or a speck of sawdust or larger like a piece of glass. Usually, the particle gets caught under the upper eyelid. A toddler might refuse to open their eyes in such cases and might complain of something in the eye. A large object or an object scratches the eye; it can cause an infection.

• Cellulitis: It is a serious infection affecting the deep layers of the skin both inside and around the eye. If timely treatment is not given, it can spread to other body parts and can pose a threat to the child’s eyesight. The eye turns red, becomes swollen, and can be very painful. This can follow an eye infection or a stye (infected eyelid follicles). The child has difficulty seeing, the eye may feel hot, and there is a watery discharge. Sometimes, red streaks appear to come from the eye. Cellulitis can also cause fever. Immediate medical treatment is very important.

• Stye: A painful red lump that resembles a pimple appears on the eye called a stye. Eye pain and swelling can begin even before the pimple becomes visible. Styes occur due to an infected hair follicle on the eyelid. A discharge occurs when the stye pops or oozes. Most symptoms resolve on their own, but sometimes, they can become infected or turn into a hard lump, which is referred to as chalazion.

• Dry Eye: Tears are made up of oils, water, mucus, and proteins. An imbalance between these causes dry eyes. In response to dry eyes, the body produces ‘emergency tears’, which contain excess mucus, which can result in crusty eyes.

• Corneal Ulcers (Keratitis): Cornea is the clear lens that occupies the front of the eye. Any injury, dry eyes, or infection can lead to ulcers or small sores on the cornea. These ulcers cause crustiness and pus discharge.

• Gonorrhea: Gonorrhea is a type of sexually transmitted disease (STD) which, when left untreated, can result in serious complications like the infection of the uterus and fallopian tubes or cause pelvic inflammatory disease (PID - Infection of the woman’s reproductive organs). Eye discharge occurs in babies who acquire gonorrhea from their mothers.

What Causes Pink Eye in Newborns?

Newborns can develop pinkeye if a pregnant mother who has a sexually transmitted disease transmits the infection to the baby during delivery as the bacteria can travel from the vagina (birth canal) into the baby’s eyes. If it is not treated immediately in babies, it can cause serious issues. To avoid this, doctors give eye drops or antibiotic ointment to these babies soon after birth. Rarely following this treatment, there can be mild chemical conjunctivitis, which usually goes away.

Doctors can even check pregnant women for sexually transmitted diseases and begin the treatment during pregnancy to avoid the transmission of infection to the baby.

What Are the Symptoms of Eye Discharge in Children?

Some amount of discharge soon after the child wakes up is normal and these usually appear cream in color. If there is an abnormal increase in the amount of discharge and if it appears greenish-yellow, it is advisable to consult a doctor. Some symptoms include:

• Red or pinkish color in the white portion of the eye.

• The eyelashes get stuck together as the child awakens from sleep.

• The child becomes sensitive to light.

• Puffy eyelids.

• Constant rubbing of eyes due to burning or itchiness.

• Eyes feel tender.

Immediate medical help is necessary when the child shows the following signs:

• Fever above 104 °F.

• Any fever in a baby who is less than 12 weeks old.

• Severe pain in the eyes.

• Very red or swollen eyelids.

• The child complains of blurred vision.

• The child appears very sick.

How Is Eye Discharge Diagnosed?

The doctor will ask about the child’s medical history, enquire about the symptoms, and examine the eyes physically. Sometimes, a sample of the pus, fluid, or other material may be obtained from the eyes to test for bacteria.

What Is the Treatment for Eye Discharge?

Mild infections such as viral pink eye resolve on their own. A considerable amount of discharge is normal and does not require any treatment. Other cases of eye discharge can be treated in the following ways:

• Washing foreign objects or dirt from the eye with water or saline solution.

• Steroid eye drops can minimize ulcers and inflammation.

• Antibiotics may be prescribed to treat bacterial infections and can be given in the form of oral medications or eye drops.

• If the child’s eyelids are glued together, the discharge can be wiped with a warm compress. Warm compresses provide relief from the symptoms. If the situation does not get better with warm compresses, then it can be a sign of infection. The eyes should be wiped from the inside to the outside.

• The child should be asked not to touch the eye in case of infections.

• In case of eye allergy, the irritants should be kept away from the child. Antihistamine eye drops or tablets prescribed by the doctor can relieve allergies.

• A blocked tear duct clears on its own without any treatment by the time the child reaches one year of age.

• Over-the-counter medications (OTC) should not be given without consulting a doctor.

• Surgery might be advised in case of an injury or to remove a bigger foreign object from the eye.

The parents or caretaker should wash their hands after cleaning the discharge from the eyes of the children to avoid the spread of infection. Certain studies show that breastmilk can also be used to clean the baby’s eye and is not harmful.

How to Prevent Eye Discharge in Children?

Some ways to prevent eye discharge in children are as follows:

• Ensure that the child washes their hands regularly to prevent the spread of infection.

• The child must be taught to touch their eyes only if their hands are clean.

• Lotion or other skin products should not be used on the child’s eyes.

• They must be encouraged to wear eyewear when indulging in activities that may injure the eyes.

• The child should be refrained from going to school in case they have an eye infection.

• The towels of children should not be shared with anyone and they should be washed frequently and dried in sunlight.

• When cleaning the eyes, a new cotton wool should be used for each eye to prevent the transfer of infection into the other eye.

Conclusion:

The appearance of eye mucus is normal and healthy and is produced to protect the eyes. A considerable amount of discharge or crusts found on the corners of the eyes after awakening from sleep is common and normal in both children and adults. A change in consistency of the discharge accompanied by symptoms like redness, itchiness, swelling, blurred vision, pain, and sensitivity to light can be issues that need to be addressed.