Conjunctivitis in Children: Sore Eyes and When to Worry
In short: Sore eyes in children, or conjunctivitis, is usually caused by a virus, bacteria or an allergy, and most cases clear by themselves within 1 to 2 weeks. Gentle cleaning and good handwashing are often all that is needed. A newborn with red or sticky eyes, eye pain, sensitivity to light, blurred vision or a swollen red eyelid should see a doctor the same day.
Key takeaways
Conjunctivitis is inflammation of the thin clear layer covering the white of the eye and the inside of the eyelids, and it is one of the most common eye problems in children.
Bacterial conjunctivitis usually causes thick yellow or green discharge, viral conjunctivitis causes watery eyes with a cold, and allergic conjunctivitis causes itchy, watery eyes in both eyes.
Most infective conjunctivitis settles within 7 to 14 days without treatment; antibiotic eye drops shorten bacterial cases only slightly.
Any red or sticky eye in a baby under 4 weeks old needs a doctor's review the same day.
Haze and smoke can irritate children's eyes, and Malaysian health authorities monitored rises in conjunctivitis during haze episodes in 2026.
What is conjunctivitis, and what causes it in children?
Conjunctivitis means the conjunctiva, the clear lining of the eye and eyelids, is inflamed, most often from an infection, an allergy or an irritant such as haze or smoke.
Many Malaysian families call it "sore eyes" or sakit mata.
Viral conjunctivitis
This is the most common type overall. It often comes with a cold, sore throat or fever. The eye is pink, watery and gritty, and it may start in one eye and spread to the other within a few days. Adenovirus is a frequent cause and can be very contagious. Viral conjunctivitis can take 1 to 2 weeks, sometimes longer, to settle.
Bacterial conjunctivitis
Bacterial infection is relatively common in young children. The key sign is thick yellow or green discharge, with eyelashes stuck together on waking. It may come with an ear infection, especially in toddlers. Most cases improve within a week.
Allergic and irritant conjunctivitis
Allergic conjunctivitis causes itching, watering and puffy eyelids in both eyes, often with sneezing. It is more common in children with eczema, asthma or a dust mite allergy. Irritant conjunctivitis follows exposure to haze, smoke, chlorine in swimming pools, or soap and shampoo in the eyes. Neither type is contagious.
How can you tell which type your child has?
The type of discharge, whether one or both eyes are affected, itching, and any cold or fever give the most useful clues, although only a doctor can confirm the cause.
Signs that point to each type
Bacterial: thick yellow or green pus, crusted lids in the morning, often starting in one eye.
Viral: watery discharge, gritty feeling, a recent cold or fever, sometimes a tender lump in front of the ear.
Allergic: marked itching, both eyes at once, clear watery discharge, sneezing or a runny nose, often seasonal or after dust exposure.
Irritant: redness and stinging soon after haze, smoke, pool water or soap, improving once away from the trigger.
Is a sticky eye in a baby always conjunctivitis?
Not always. Many babies have a blocked tear duct, which causes watering and sticky discharge while the white of the eye stays white. It is common in the first year and often clears by the first birthday. Gently massaging the inner corner of the eye as shown by your doctor can help. A red eye with discharge is different and needs to be checked.
How is conjunctivitis treated?
Most children only need gentle cleaning of the eyes and time, while some bacterial cases benefit from antibiotic drops or ointment prescribed by a doctor.
Does my child need antibiotic eye drops?
Not always. Guidance from NICE notes that most infective conjunctivitis gets better on its own, and antibiotic drops only shorten bacterial cases by a small amount. Your doctor may still prescribe them if the discharge is heavy, it is not settling after a few days, or your child's taska requires treatment before returning. Antibiotic drops do not help viral or allergic conjunctivitis.
What about allergic conjunctivitis?
Avoiding the trigger helps most. Cool compresses ease itching. Your doctor may suggest anti-allergy eye drops or an oral antihistamine suitable for your child's age. If allergic eyes keep coming back, it is worth looking at the wider picture of allergy and eczema; see our page on eczema and allergy in children.
What can you do at home?
Clean the eyes gently several times a day, wash hands often, and keep your child's towels and pillowcases separate until the discharge settles.
For babies
Remember that a red or sticky eye in the first 4 weeks of life needs a doctor's review the same day.
Clean each eye with cotton wool dipped in cooled boiled water.
Wipe from the inner corner outwards, using a fresh piece for each wipe and each eye.
Wash your hands before and after every clean and nappy change.
For toddlers and school-age children
Clean crusts in the morning with cooled boiled water as above.
Use a cool, damp cloth over closed eyes for itching or discomfort.
Remind your child not to rub their eyes, and trim their nails.
Give your child their own towel, face cloth and pillowcase, and wash them in hot water.
Keep children with contact lenses out of their lenses until the eye has fully recovered.
On haze days, keep children indoors with windows closed when the Air Pollutant Index is high. Our article on haze and children has more practical steps.
What not to do
Do not put breast milk in your child's eye. It is a common home remedy, but there is no good evidence it works and it can introduce germs.
Do not use herbal water, betel leaf water, tea or honey in the eyes.
Do not use leftover eye drops from another family member, or drops containing steroid unless an eye specialist prescribed them.
Do not share eye drops between children.
Do not cover the eye with a patch; it can trap discharge and warmth.
Do not ignore eye pain or reduced vision, even if the redness looks mild.
When to see a doctor, and when not to worry
Most sore eyes are mild, but a few signs suggest a deeper eye problem or a spreading infection around the eye that needs prompt treatment.
Usually fine to manage at home
Pink or red eye with watery or mild sticky discharge in a child older than 4 weeks.
Your child can see normally and is not in pain, only gritty or itchy.
Eyes are improving after 2 to 3 days of cleaning.
Mild redness after haze or swimming that settles within a day.
Book an appointment soon
Thick yellow or green discharge that is not improving after 3 to 4 days.
Symptoms lasting more than 7 to 10 days.
Repeated episodes of itchy, watery eyes, which may be allergy.
Conjunctivitis with ear pain, or a cough and fever that are not settling.
A baby whose eye has watered or been sticky for months with a white eye, suggesting a blocked tear duct.
See a doctor the same day
Any red or sticky eye in a baby under 4 weeks old.
Eye pain rather than grittiness, or your child keeps the eye shut.
Sensitivity to light, or blurred or reduced vision.
Swollen, red, warm or tender eyelids or skin around the eye, which may be periorbital cellulitis.
Pain or difficulty moving the eye, or the eye looks pushed forward.
An injury to the eye, or chemicals splashed into it. Rinse with clean running water for at least 15 minutes and go to the emergency department.
A child who wears contact lenses and has a red, painful eye.
Fever with a child who seems very unwell, a rash, or red eyes with red lips and swollen hands, which can be signs of other illnesses.
From Dr Nisa's clinic [DR NISA TO CONFIRM OR REWRITE]: Red eyes tend to arrive in waves. When one child in a taska has sore eyes, I often see several of their classmates over the following week. Most of them only need cleaning, handwashing and time. The question I always ask parents is whether the eye hurts or whether their child is avoiding light. Grittiness is common. True pain, light sensitivity or a swollen, red eyelid is not, and those children need to be examined the same day.
Is conjunctivitis contagious, and when can my child return to school?
Viral and bacterial conjunctivitis spread easily through hands and shared items, but many health authorities do not require children to stay home once they feel well, although Malaysian taska and schools often set their own rules.
How long is it contagious?
Bacterial conjunctivitis is contagious while there is discharge, and usually becomes much less so within about 24 hours of starting antibiotic drops. Viral conjunctivitis can spread for as long as the eyes are red and watery, sometimes for 1 to 2 weeks. Allergic and irritant conjunctivitis are not contagious.
Does my child need to stay at home?
The American Academy of Pediatrics and UK public health guidance say most children with conjunctivitis do not need to be kept away from school or childcare, unless they have a fever or are too unwell to take part. In practice, many taska and schools in Malaysia ask children to stay home until the discharge has cleared or until they have had 24 hours of treatment. Check your child's centre policy, and keep your child at home if they have a fever or cannot keep their hands away from their eyes.
How to stop it spreading at home
Wash hands with soap after touching your child's face or eyes.
Wipe door handles, light switches and tablet screens daily.
Do not share towels, pillows, face cloths, or swimming goggles.
Avoid swimming pools until the eyes are clear.
Worried about your child's red or sore eyes?
I am Dr Nisa Khalil, a consultant paediatrician with more than 18 years of experience, seeing children at ParkCity Medical Centre in Desa ParkCity, Kuala Lumpur. If your child's eyes are not settling, keep coming back, or you are unsure whether it is infection or allergy, you can book an appointment or start with an online eConsult. For eye injuries, chemical splashes or sudden vision changes, go to the emergency department.
You may also find these helpful:
Frequently asked questions
How long does sore eyes last in a child?
Most bacterial conjunctivitis improves within 5 to 7 days, often sooner with antibiotic drops. Viral conjunctivitis usually lasts 1 to 2 weeks and can take up to 3 weeks with some viruses. Allergic conjunctivitis lasts as long as your child is exposed to the trigger. If symptoms are not improving after a week, or are getting worse, see a doctor.
Can sore eyes go away without treatment?
Yes, most infective conjunctivitis clears without medicine. Cleaning the eyes, handwashing and not sharing towels are usually enough. Antibiotic drops may be offered for heavy discharge or slow recovery. Sore eyes in a newborn, or eyes that are painful, sensitive to light or affecting vision, should never be left to clear by themselves.
Is breast milk good for a baby's sore eyes?
Breast milk is not recommended as an eye treatment. Small laboratory studies have been mixed, and there is no good evidence that it cures conjunctivitis in babies. Milk in the eye can also carry germs. Cooled boiled water on clean cotton wool is safer. A baby under 4 weeks with a red or sticky eye should be seen by a doctor the same day.
Can haze cause conjunctivitis in children?
Yes. Haze particles and smoke can irritate the eyes and cause redness, stinging and watering, known as irritant conjunctivitis. It is not contagious and usually settles once your child is away from the haze. Keeping children indoors on poor air days and rinsing eyes with clean water helps. Persistent redness, discharge or pain needs a doctor's check.
Can my child go to school with pink eye?
Many health authorities say children with conjunctivitis can attend school if they feel well and have no fever. However, many taska and schools in Malaysia ask children to stay home until the discharge has cleared or they have had 24 hours of treatment. Check your school's policy and teach your child to wash hands and avoid rubbing their eyes.
Can adults catch conjunctivitis from a child?
Yes. Viral and bacterial conjunctivitis spread easily to parents and siblings, especially through hands, towels and pillowcases. Wash your hands after cleaning your child's eyes or giving drops, and keep personal items separate. Allergic and irritant conjunctivitis cannot be passed on. If a parent develops a painful red eye, blurred vision or eye symptoms that last more than a week, they should see their own doctor.
Medically reviewed by Dr Nisa Khalil on [DATE]. This article is general information and does not replace a consultation with your own doctor.
References
National Institute for Health and Care Excellence (NICE). Clinical Knowledge Summaries: Conjunctivitis, infective. cks.nice.org.uk/topics/conjunctivitis-infective
American Academy of Pediatrics, HealthyChildren.org. Do I need to keep my son home if he has pinkeye? healthychildren.org
American Academy of Ophthalmology. Pink eye and returning to school. aao.org
NHS. Conjunctivitis. nhs.uk/conditions/conjunctivitis
New Straits Times. Haze: MOH monitoring URT, conjunctivitis cases (September 2026). nst.com.my
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