Conjunctivitis in Children: Pink Eye Signs, Care and Spread

Conjunctivitis, or pink eye, is inflammation of the thin, clear layer covering the white of the eye and the inside of the eyelids. In children it is usually caused by a virus or bacteria, and sometimes by an allergy. Most cases are mild and settle within one to two weeks with gentle cleaning at home. A newborn under 4 weeks old with red, sticky eyes, or any child with eye pain, sensitivity to light, changes in vision or a swollen, red eyelid, needs to see a doctor promptly.

This guide explains how to tell the main types apart, how to clean your child’s eyes, what Singapore preschools usually expect, and the red flags to act on.

What causes conjunctivitis in children?

Singapore’s Communicable Diseases Agency (CDA) notes that conjunctivitis is usually due to a viral or bacterial infection, or an allergic condition. The type matters, because it changes how contagious your child is and whether medicine helps.

Type	Typical signs	Contagious?	Usual care
Viral	Pink, watery eyes, often with a cold, cough or sore throat. Often starts in one eye and spreads to the other.	Yes, very	Settles on its own. Clean the eyes and ease discomfort.
Bacterial	Thick yellow or green discharge, crusty lashes that may be stuck together in the morning	Yes	Often clears on its own; a doctor may prescribe antibiotic eye drops or ointment
Allergic	Itchy, watery eyes, usually both at once, sometimes with sneezing or a runny nose	No	Avoid the trigger; a doctor may suggest antihistamine drops
Irritant	Red, watery eyes after chlorinated pool water, smoke or something in the eye	No	Rinse gently; usually settles quickly

You can’t always tell viral from bacterial by looking, so a doctor’s view helps if you’re unsure.

Symptoms to look out for

Pink or red white of the eye
Watery eyes, or a sticky yellow or green discharge
Crusts on the lashes, especially after sleep
Itchy, gritty or sore eyes; older children may say it feels like sand in the eye
Mildly puffy eyelids
Babies and toddlers may rub their eyes, be fussy or sleep poorly

Conjunctivitis on its own should not affect your child’s vision once the discharge is wiped away, and it should not cause real pain. If either happens, see a doctor the same day.

Newborn sticky eye or conjunctivitis?

Many newborns have a watery or slightly sticky eye in the first weeks. Very often this is a blocked tear duct, where tears can’t drain into the nose. The white of the eye stays white, the baby is well, and the stickiness comes and goes over weeks or months.

Conjunctivitis in a newborn is different and needs prompt attention. The NHS advises that babies under about 30 days old with red, sticky eyes should be seen urgently, because some infections picked up around birth can harm the eye if not treated quickly.

Our baby fever guide explains why any fever under 3 months needs urgent care.

Caring for pink eye at home

Gentle cleaning is the most useful thing you can do, whatever the type.

Wash your hands before and after touching your child’s eyes.
Use cooled boiled water and a clean cotton wool pad. Wipe from the inner corner of the eye outwards, once, then throw the pad away.
Use a fresh pad for each eye, and do the cleaner-looking eye first, so you don’t spread infection.
Soften crusts by holding a damp pad on closed eyelids for a minute before wiping.
A cool or warm compress can soothe itchy or sore eyes in older children.
Don’t use leftover eye drops, someone else’s prescription or traditional remedies such as breast milk or tea in the eye unless your doctor advises it.
Treat the cold, too. If your child is congested, saline drops and fluids help. See our guide to baby cough and cold remedies.

Do children need antibiotic eye drops?

Not always. The American Academy of Pediatrics notes that antibiotics shorten pink eye only slightly, and that most children improve within about 5 to 6 days without them. Antibiotic drops don’t help viral or allergic conjunctivitis. Your doctor may still prescribe drops or ointment if the discharge is heavy, if your child is very young, or if a preschool requires treatment before return. Use them exactly as directed and finish the course.

Allergic conjunctivitis

If itchy, watery eyes keep coming back, think about triggers such as dust mites, pet dander or haze. Wiping the face after outdoor play, washing pillowcases often and keeping bedrooms dust-free can help. Ask your doctor or pharmacist before using any antihistamine drops or medicine, as not all suit young children.

Childcare and school: when to stay home

Viral and bacterial conjunctivitis spread through hands, shared towels, toys and coughs and sneezes, which is why outbreaks are common in infant care and preschool classes. Guidance on keeping children home varies between countries. In the UK, the NHS says children don’t need to stay off school unless they feel very unwell. Singapore centres often take a stricter line.

Many Singapore preschools and infant care centres ask that a child with red, sticky eyes stays home and is seen by a doctor, and some ask for a medical certificate or a doctor’s note before return, or for antibiotic drops to have been started. Rules differ between operators, so check your centre’s health policy. As a general guide:

Keep your child home while the eyes are very red and discharging, or if they have a fever or feel unwell
Tell the centre, so they can watch other children and step up cleaning
Follow your doctor’s medical certificate and the centre’s return rules

Our guide to childcare options in Singapore covers planning for sick days.

Stopping it spreading at home

Give your child their own towel, face cloth and pillowcase, and wash them hot
Wash hands after cleaning eyes, wiping noses or applying drops
Discourage eye rubbing, and keep nails short
Clean shared toys and surfaces
Avoid swimming pools until the eyes have cleared

When to see a doctor

See your GP, polyclinic or paediatrician if your child’s symptoms aren’t improving after a few days, are getting worse, or haven’t cleared within about a week.

Red eyes can also come with other illnesses. Spots near the eyes with chickenpox need a doctor’s check, as our chickenpox guide explains, and red eyes with a high fever lasting several days should always be seen. CDA’s conjunctivitis page has more on how it spreads.

The bottom line

Conjunctivitis is usually viral, bacterial or allergic, and most cases clear within one to two weeks
Clean the eyes with cooled boiled water and a fresh cotton pad each time
Antibiotic drops help some bacterial cases but not viral or allergic ones
Check your preschool’s rules, as many Singapore centres ask children to stay home and see a doctor
Newborns with red, sticky eyes, and any child with eye pain, light sensitivity or vision changes, need prompt medical care

For more on common childhood illnesses, visit our baby health hub.

How long is pink eye contagious?

Viral conjunctivitis can be contagious for as long as the eyes are red and watery, and sometimes longer. Bacterial conjunctivitis is usually much less contagious once treatment has started or the discharge has cleared. Allergic conjunctivitis is not contagious.

Can my child go to preschool with conjunctivitis?

It depends on your centre. Many Singapore preschools ask children with red, sticky eyes to stay home and see a doctor, and some require a doctor’s note or treatment before return. Check your centre’s health policy.

Is a sticky eye in a newborn conjunctivitis?

Not always. A watery or sticky eye with a white eyeball in a well baby is often a blocked tear duct. If the white of the eye is red, the eyelid is swollen or there is a lot of pus in a baby under 4 weeks old, see a doctor the same day.

Should I put breast milk in my baby's eye?

It is a common traditional remedy, but there isn’t good evidence that it treats conjunctivitis. Clean the eye with cooled boiled water instead, and see a doctor if a newborn’s eye is red or the discharge is heavy.