Q&A: What can I do to prevent pink eye (conjunctivitis)?

Pinkeye is going around my son's preschool class. I have heard that it is very contagious. What can I do to prevent it and how can I determine if my son has it?

You are correct that pink eye, medically referred to as conjunctivitis, is quite common. Technically speaking, conjunctivitis is a term that by definition means the thin layer of tissue that covers the white parts of the eye and the inside of the eyelids (the conjunctiva) is red and/or swollen (it is). While all sorts of things can cause this sort of inflammation, including an allergic reaction or irritating substances, for example, when we're talking about the contagious form of conjunctivitis, we're talking about pink eye caused by either viruses or bacteria.

Distinguishing between viral and bacterial pink eye isn't always easy (and not always necessary). There are some rough rules of thumb regarding distinguishing differences, in that bacterial conjunctivitis tends to be associated with a redder eye and more green or yellow eye discharge than viral pink eye, whereas viral pink eye is more likely to involve pink, swollen and sensitive, watering eyes. In either case, pink eye infections are easily spread from one person (or child) to the next simply by touching hands or surfaces contaminated with the germs responsible for the infection.

As the owner of a private preschool myself, I can tell you that preventing the spread of pink eye altogether isn't always possible, much in the way that completely preventing children from sharing their snotty nose colds is unrealistic. That said, there are definite measures you (and your child's preschool) can take to significantly limit the spread. They include:

  • Having a child with pink eye see their doctor to determine if it is bacterial, in which case antibiotic eye drops can be prescribed
  • Promoting routine and careful hand washing before and after touching the eyes, nose, and/or mouth
  • Extra attention given to the routine disinfection of all toys that are frequently touched by children
Especially in the case of preschool and childcare, the question is often raised as to whether a child with pink eye needs to be sent home. While the standard has long been to send children home in hopes of limiting the spread of infection, it has recently been determined that doing so is not, in most instances, necessary (with the possible exception of a particular type of viral conjunctivitis caused by adenovirus that is more commonly known to cause epidemics). It is for this reason that the American Academy of Pediatrics, in the 2009 edition of Managing Infectious Diseases in Child Care and Schools, recommends exclusion only in instances of pink eye where:

  • A child is unable to participate and staff determine that they cannot care for the child without compromising their ability to care for the health and safety of the other children in the group
  • The child meets other exclusion criteria, such as fever with behavior change
  • There is a recommendation of the health department or the child's health professional

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