Red Eye (Conjunctivitis) in Babies

Content reviewed against published AAP, CDC, AAP guidelines

Editorial policy

Last reviewed:

Red or pink eye in babies can result from infection (bacterial or viral conjunctivitis), blocked tear ducts, irritation, or allergies. In newborns, eye redness in the first month of life requires prompt evaluation as it may indicate a serious infection acquired during birth. In older infants and toddlers, viral conjunctivitis is the most common cause.

Key takeaways

  • Red or pink eye in babies can result from infection (bacterial or viral conjunctivitis), blocked tear ducts, irritation, or allergies.
  • Most common cause: Viral conjunctivitis (often with a cold)
  • Emergency: Red eye with significant eyelid swelling that prevents eye from opening
  • Home care: Gently clean discharge with a warm, wet cotton ball, wiping from inner to outer corner

Possible Causes

Viral conjunctivitis (often with a cold)common
Blocked tear duct (dacryostenosis) with secondary irritationcommon
Bacterial conjunctivitiscommon
Irritation from smoke, chlorine, or winduncommon
Allergic conjunctivitis (more common after 2 years)uncommon
Neonatal conjunctivitis (ophthalmia neonatorum) from chlamydia or gonorrhearare
Herpes simplex virus eye infectionrare
Kawasaki disease (with other symptoms)rare

When to Seek Help

Emergency — Call 911 or go to ER:

  • Red eye with significant eyelid swelling that prevents eye from opening
  • Red eye following penetrating eye injury or chemical splash
  • Red eye with proptosis (eye bulging forward)
  • Newborn (under 4 weeks) with purulent eye discharge and eyelid swelling

Urgent — See doctor today:

  • Red eye with fever and eyelid swelling (possible periorbital cellulitis)
  • Red eye after trauma or foreign body that won't flush out
  • Severe pain with light sensitivity in a toddler
  • Blisters near the eye with redness (possible herpes)

Same-day appointment:

  • Thick yellow or green discharge from one or both eyes
  • Red eye in a newborn (any redness in first month needs same-day evaluation)
  • Red eye with moderate discharge lasting more than 3 days

Monitor at home:

  • Mild pink eye with watery discharge and cold symptoms
  • Mild redness with blocked tear duct and no thick discharge
  • Brief redness after crying that resolves quickly
  • Mild irritation from identifiable cause (wind, soap)

By Age

0-4 weeks

Normal: Mild chemical conjunctivitis from prophylactic eye drops at birth can cause redness in first 1-2 days and resolves spontaneously.

Worry if: Purulent (thick yellow/green) discharge, significant eyelid swelling, onset between day 2-14 of life (possible gonococcal or chlamydial infection), or redness with inability to open the eye.

1-12 months

Normal: Mild redness from a blocked tear duct is common and often improves by 12 months. Watery eyes without significant redness are usually a blocked duct.

Worry if: Thick green or yellow discharge matting eyes shut, redness around the eye (not just in it), fever with eye redness, significant swelling of the eyelids, or redness after eye injury.

1-3 years

Normal: Pink eye from daycare exposure is very common. Viral conjunctivitis causes watery discharge and often accompanies a cold. Usually self-limited.

Worry if: Severe pain (constant crying, won't open eye), vision changes (not tracking or reaching), redness only around the iris (iritis), redness after eye trauma, or redness with blisters near the eye.

Home Care

  • Gently clean discharge with a warm, wet cotton ball, wiping from inner to outer corner
  • Use a clean cotton ball for each wipe and for each eye
  • Apply warm compresses for 5-10 minutes several times daily to loosen crusted discharge
  • For blocked tear duct: gently massage the inner corner of the eye (lacrimal sac) 2-3 times daily
  • Wash hands thoroughly before and after touching baby's eyes
  • Do not share towels or washcloths with other family members
  • Avoid touching or rubbing the baby's eyes
  • Do NOT use over-the-counter eye drops without physician guidance in babies

Frequently asked questions

What causes red eye (conjunctivitis)?
Viral conjunctivitis (often with a cold) (common); Blocked tear duct (dacryostenosis) with secondary irritation (common); Bacterial conjunctivitis (common); Irritation from smoke, chlorine, or wind (uncommon); Allergic conjunctivitis (more common after 2 years) (uncommon); Neonatal conjunctivitis (ophthalmia neonatorum) from chlamydia or gonorrhea (rare); Herpes simplex virus eye infection (rare); Kawasaki disease (with other symptoms) (rare)
When is this an emergency?
Red eye with significant eyelid swelling that prevents eye from opening. Red eye following penetrating eye injury or chemical splash. Red eye with proptosis (eye bulging forward). Newborn (under 4 weeks) with purulent eye discharge and eyelid swelling
What can I do at home?
Gently clean discharge with a warm, wet cotton ball, wiping from inner to outer corner. Use a clean cotton ball for each wipe and for each eye. Apply warm compresses for 5-10 minutes several times daily to loosen crusted discharge. For blocked tear duct: gently massage the inner corner of the eye (lacrimal sac) 2-3 times daily. Wash hands thoroughly before and after touching baby's eyes. Do not share towels or washcloths with other family members. Avoid touching or rubbing the baby's eyes. Do NOT use over-the-counter eye drops without physician guidance in babies
When should I call the doctor?
Thick yellow or green discharge from one or both eyes. Red eye in a newborn (any redness in first month needs same-day evaluation). Red eye with moderate discharge lasting more than 3 days

Sources

All content follows our editorial policy and is reviewed against published clinical guidelines.

2,705 evidence-based guides6 authoritative medical sources

Related Symptoms

Bottom line

Most cases of red eye (conjunctivitis) in babies are not emergencies. However, seek immediate care if red eye with significant eyelid swelling that prevents eye from opening.

Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.