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Eye - Pus or Discharge

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Definition

  • Yellow or green discharge (pus) in the eye
  • The eyelids are stuck (matted) together with pus after sleep
  • After being wiped away, the pus comes back during the day
  • Often caused by a bacterial eye infection

Symptoms of Bacterial Eye Infection

  • Yellow or green discharge or pus in the eye
  • Dried pus on the eyelids and eyelashes
  • The eyelashes are more likely to be stuck together after sleep
  • The whites of the eye may or may not be red or pink
  • The eyelids are often puffy

Causes of Eye with Pus

  • Bacterial Conjunctivitis is a bacterial infection of the eye. The main symptom is eyelids stuck together with pus after sleep. Can be present in 1 or both eyes. A few viruses can cause pus in the eyes, but most don't.
  • Viral Conjunctivitis is a viral infection of the eyes. Main symptom is pinkness of the white parts of the eyes. The eyes are also watery. Most often, there is no pus. Usually on both sides.
  • Normal Discharge. A small amount of dried mucus only in the corner of the eye. It may not even be pus. A collection of mucus can be cream colored. Often due to an irritant that got in the eye from dirty hands. Needs no treatment except wiping it away with warm water.
  • Blocked Tear Duct. Present in 10% of newborns. Main symptom is a constant watery eye. Tears fill the eye and run down the face. This happens even when not crying. The eye is not red and the eyelid is not swollen. The wet eye may get secondary infections. This will cause the eyelids to become matted with pus.
  • Foreign Object in Eye (serious). Small particles such as sand, dirt or sawdust can be blown into the eyes. The grit often gets stuck under the upper eyelid. If not removed, the eye reacts by producing pus. The main clue is an eye infection that does not respond to antibiotic eyedrops. Older children complain of feeling something in the eye.
  • Eyelid Cellulitis (serious) is a deep infection of the eyelid and tissues around it. The main symptom is a red, swollen, very tender eyelid. The eye can be swollen shut. Usually only on one side. This can be a problem caused by bacterial conjunctivitis. The eye infection spreads inward. More commonly this is caused by an ethmoid sinus infection. That type occurs without any pus in the eye.
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When To Call

Call Doctor or Seek Care Now

  • Eyelid is very red or very swollen
  • Vision is blurred
  • Eye pain or discomfort is more than mild
  • Fever higher than 104° F (40° C)
  • Fever in baby less than 12 weeks old. Caution: do NOT give your baby any fever medicine before being seen.
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Pus in the eye, but none of the symptoms above. Reason: you may need antibiotic eyedrops to treat it.
  • Using antibiotic eye drops more than 3 days and pus is still there
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Care Advice

What You Should Know About Bacterial Eye Infections:

  • Bacterial eye infections are common with colds.
  • They respond to home treatment with antibiotic eye drops which need a prescription.
  • They are not harmful to vision.
  • Until you get some antibiotic eye drops, here is some advice that should help.

Remove Pus:

  • Remove all the dried and liquid pus from the eyelids. Use warm water and wet cotton balls to do this.
  • Do this whenever pus is seen on the eyelids.
  • Also, remove the pus before the antibiotic eye drops are put in. Reason: they will not work if you don't.
  • The pus can spread infection to others. So, dispose of it carefully.
  • Wash your hands well after any contact with the pus.

Antibiotic Eye Drops: How to Use

  • For a cooperative child, gently pull down on the lower lid. Put 1 drop inside the lower lid. Then ask your child to close the eye for 2 minutes. Reason: so the medicine will get into the tissues.
  • For a child who won't open his eye, have him lie down. Put 1 drop over the inner corner of the eye. If your child opens the eye or blinks, the eye drop will flow in. If he doesn't open the eye, the drop will slowly seep into the eye.

Contact Lenses:

  • Children who wear contact lenses need to switch to glasses until the infection is gone.
  • Reason: to prevent damage to the cornea.
  • Disinfect the contacts before wearing them again.
  • Discard them if they are disposable.

Return to School:

  • Your child can return to school when the pus is a small amount.
  • Antibiotic eye drops should be used for 24 hours before going back.

What to Expect:

  • With treatment, the pus discharge should clear up in 3 days.
  • The red eyes may last up to a week.

Call Your Doctor If:

  • Eyelid gets red or swollen
  • You think your child needs to be seen
  • Your child becomes worse

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Barton Schmitt MD, FAAP
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.
Copyright 2000-2024. Schmitt Pediatric Guidelines LLC.
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