Children with conjunctivitis can go to förskola (municipal preschool, from age one) if they otherwise feel well, according to guidance from Folkhälsomyndigheten (the Public Health Agency of Sweden). Most cases are caused by viruses or bacteria and clear up by themselves within a week. Clean the eye with lukewarm water several times a day, and seek care if the eyelid swells, your child is sensitive to light or it is not getting better after a week.
The red, sticky eye is the most common morning sight at förskola in autumn, and there is a stubborn rule on many units that the child should be kept at home. That rule has no support in the infection control recommendations. Here is what applies, and what you do at home.
Quarter to seven on a Tuesday morning in Hägersten. The two-year-old wakes up with one eye glued shut and whimpers when she can't open it. You have a meeting at nine. What you do now, a lukewarm compress and five minutes of patience, decides whether it becomes an ordinary day or a call to take VAB (paid leave to care for a sick child). Usually it becomes an ordinary day.
Signs
- Red eye, often one first and then both
- Yellow or green discharge that glues the eyelashes together, especially in the morning
- Runny, watery eye
- Your child rubs the eye; it itches and feels gritty
- Swollen eyelids, sometimes
Why the eye goes red: four common causes
| Cause | What it looks like | What helps |
|---|---|---|
| Virus, often with a cold | Red, runny, starts in one eye and spreads to the other. Your child has a runny nose | Cleaning, time. Clears up with the cold |
| Bacteria | More discharge, yellow or green, eyelashes glued together in the morning | Cleaning. Drops from a doctor if it hasn't turned around within a week |
| Allergy, pollen or pets | Both eyes at once, very itchy, clear and watery, often with sneezing. Spring and summer | Allergy medicine on advice from the pharmacy or vårdcentral (local health centre), not antibiotics |
| Blocked tear duct in infants | Tears and a little stickiness almost every day, but the eye is not red | Cleaning. Almost always clears up during the first year, BVC (the child health clinic every family is enrolled in) follows it up |
Cleaning, step by step
- Wash your hands.
- Wet a clean cotton pad or compress in lukewarm water.
- Wipe from the outer corner towards the nose, one stroke per pad. A new pad for every stroke.
- Never use the same pad on both eyes.
- Wash your hands again. Your child gets their own towel this week.
A child who refuses: hold the compress against the closed eye for half a minute first, so the crusts soften and can be wiped away without pulling. Tell your child what you are doing and let them hold a pad of their own against their doll's eye. It takes two minutes longer and saves ten minutes of screaming.
Förskola
Folkhälsomyndigheten's guidance on infections in förskola says that children with conjunctivitis do not need to stay at home if they feel well and can take part. Spread is reduced by hand washing, not absence. If the förskola still asks you to keep your child at home, ask which recommendation they are relying on. Many change their minds when they look it up. Do tell the staff at drop-off that the eye has been cleaned at home and that you would like them to clean it once after lunch, so nobody thinks you haven't noticed.
Drops: when they are needed and how to give them
Most children need no drops. If they are prescribed: lay your child on their back with their head in your lap, ask them to close their eyes, and put the drop in the inner corner of the eye. When your child opens the eye, the drop runs in by itself. It is far easier than trying to hold a three-year-old's eye open. Give the drops for as long as the doctor said, even when the eye looks fine, and throw the bottle away afterwards. Opened eye drops keep for a short time, and they should never be shared between siblings.
How to stop the whole family getting it
- A towel of their own for your child, changed every day this week.
- Change the pillowcase every morning; that is where the night's discharge ends up.
- Wash your hands after every cleaning and after comforting a child who has rubbed their eye.
- No shared eye make-up or eye drops, not even between siblings.
- A child who rubs all the time: short nails and something to do with their hands.
When to seek care
| Seek care | Wait and clean |
|---|---|
| The eyelid is badly swollen and red | Red eye with a little discharge |
| Your child can't bear light or is in pain | Itches and feels gritty |
| Vision seems affected | Glued shut in the morning |
| No improvement after a week | Better day by day |
| Infant under one month | Child over one who feels well |
| Fever and a listless child at the same time | Your child is playing as usual |
If your child goes to förskola, conjunctivitis often comes back two or three times over an autumn, in step with the colds. It is not the same infection failing to heal; they are new ones. The routine is the same every time: clean, own towel, watch the direction.
How long does it take?
A viral infection follows the cold and is usually gone within a week, often worse on days two and three and then better. A bacterial one usually clears up by itself too but can take a few days longer, and it is the one that sometimes gets drops. Allergic eyes carry on for as long as there is pollen in the air. What decides whether you should call is the direction: an eye that is a little better every morning needs no doctor; one that is worse on day five does.
How we do it with our families
The nanny cleans the eye at pick-up if needed, and she carries a packet of compresses in her bag. Nike has a three-year-old in Sundbyberg on Mondays and Thursdays, and in October he had a red eye three weeks in a row along with his cold. She wiped the eye in the förskola toilet before they walked home, wrote on the note whether there was more or less discharge than on Thursday, and told his mother the same evening when the other eye had started too. What she contributes above all is knowing what the eye looked like on Tuesday: is it better or worse? That is the only question that decides whether you should call healthcare.
This text is general information and does not replace advice from BVC, your vårdcentral or 1177. If you are worried about your child, call 1177. In an emergency, call 112.
Would you like a nanny who knows your child, knows what is usual for them and notices when something is different? Book a free first meeting with the nanny at your home.
Read more: Hand, foot and mouth disease in children · Threadworms in children · Fever in children · FAQ
Frequently asked questions
Does my child have to stay home from förskola?
No, not if your child otherwise feels well. Folkhälsomyndigheten's guidance on infections in förskola says that children with conjunctivitis can be at förskola when their general condition allows. If the eye is so full of discharge and swollen that your child can't take part, or your child has a fever and is listless, that is another matter. Then it is how your child feels that decides, not the eye.
Are antibiotics needed?
Rarely. Most cases of conjunctivitis in children are caused by viruses or clear up by themselves within a week, even when they are bacterial. Doctors prescribe drops or ointment for severe symptoms, if it is not better after a week, or in infants. Drops left over from a sibling should not be used; they were often opened long ago.
How do you clean the eye?
With lukewarm water and a soft compress or cotton pad, from the outer corner in towards the nose, a new pad for each stroke and never the same pad on both eyes. Several times a day if needed, always in the morning when the eyelashes have glued together. Wash your hands before and after, and give your child a towel of their own this week.
How long is it contagious?
For as long as the eye has discharge, usually a few days up to a week. Own towels, clean hands and not rubbing are what reduce the spread, not staying at home. Siblings often get it anyway, because small children touch everything and then their eyes. If the conjunctivitis is part of a cold, the cold spreads just as it usually does.
My baby has a sticky eye almost every morning. Is it conjunctivitis?
Often not. In infants under one, a constantly watery, slightly sticky eye is usually a blocked tear duct, which is common and clears up by itself during the first year. The eye is not red in that case. Clean as usual and ask at BVC at the next visit. If the eye goes red or swollen, or your baby is under one month old: call 1177.