Sticky eyes, pink eye and squint in babies and children

Most eye problems in babies are minor. A watery, sticky eye in the first months is usually a blocked tear duct that opens by itself. Pink eye in older children often clears without antibiotic drops. A squint that stays after 3 to 4 months, or any sign of lazy eye, needs an eye check early, because treatment works best when children are young.

Why is my newborn's eye sticky and watery?

The most common cause is a blocked tear duct, the small channel that drains tears from the inner corner of the eye into the nose. Tears pool and spill over, and the lashes get crusty.

In a study of almost 4,800 babies, about 1 in 5 had signs of a blocked tear duct during the first year, and most started in the first month.¹ The white of the eye stays white, and the baby is otherwise well. That is the key difference from an infection.

Will a blocked tear duct open on its own?

Yes, in almost all babies. In the same study, 96 percent had cleared by the first birthday without any procedure.¹

That is why eye doctors usually wait until around 12 months before considering a probing (a small procedure to open the duct). If the eye is still watering after that, or if there is swelling at the inner corner, ask for a referral.

How do I massage a blocked tear duct?

Gentle massage over the tear sac may help the duct open and empties trapped fluid. It is safe when done gently with clean hands and short nails.

1. Wash your hands well.
2. Place your little finger or index finger at the inner corner of the eye, on the side of the nose.
3. Press gently and stroke downwards towards the nostril a few times.
4. Repeat a few times a day, for example at nappy changes.

To clean crusts, use cotton wool dipped in cooled boiled water. Wipe from the inner corner outwards, with a fresh piece for each wipe and each eye.

When is a sticky eye in a newborn serious?

A sticky eye with a red, swollen eyelid or red white of the eye, especially in the first 4 weeks, needs a doctor the same day.

This can be a true infection called neonatal conjunctivitis. Some infections passed during birth can damage the eye quickly. Also see a doctor urgently if there is a red, tender lump at the inner corner of the eye, or if your baby has fever or feeds poorly.

Is breast milk in the eye helpful or harmful?

Dr Dutta does not recommend putting breast milk in a baby's eye. There is no good trial showing it treats eye infections, and milk can carry germs from the skin.

Many grandmothers suggest it with love, and a few drops of milk are unlikely to cause harm in a blocked tear duct. But using it can delay proper care for a real infection. Clean water and gentle massage are enough for a simple sticky eye.

What is pink eye?

Pink eye (conjunctivitis) is inflammation of the thin clear layer over the white of the eye. The eye looks pink or red, feels gritty, and may water or produce sticky discharge.

In children it is usually caused by viruses or bacteria. Allergy can also cause it, with itching and watery eyes in both eyes. Pink eye on its own does not affect vision. Pain, light sensitivity or blurred vision suggest something more serious.

Is pink eye contagious?

Yes. Infectious pink eye spreads easily through hands, towels and pillows. Allergic pink eye is not contagious.

Wash hands after touching the eyes, use separate towels and pillowcases, and teach your child not to rub the eyes. In the UK, children with pink eye are not routinely kept away from school unless they feel unwell.² Some schools in India have their own rules, so check with them.

Does pink eye need antibiotic drops?

Often not. Most pink eye in children clears within a week without antibiotics.

In a UK trial of 326 children, 83 percent given placebo drops were better by day 7, compared with 86 percent given chloramphenicol drops.³ A 2023 Cochrane review found antibiotic drops do modestly speed recovery: about 68 percent were better by days 4 to 9 with antibiotics compared with about 56 percent without.⁴ So drops can help a little, especially with thick yellow discharge, but they are not essential for mild cases. Clean the eyes often and see a doctor if it is not improving in a few days.

When are crossed eyes not normal in a baby?

Brief, on-and-off crossing of the eyes is common in young babies while they learn to focus. A squint that is constant, or that is still there after about 3 to 4 months of age, should be checked by an eye doctor.

In normal babies, the eyes line up better and better between 2 and 4 months of age, and true squints tend to show up during this same period.⁵ A squint (strabismus) means the two eyes do not point the same way. Some babies only look cross-eyed because of a wide, flat nose bridge, which is normal. A photo where the light reflection is in a different spot in each pupil, or a white reflection instead of the usual red eye in flash photos, needs an urgent eye check.

What is lazy eye?

Lazy eye (amblyopia) is reduced vision in one eye because the brain has learned to ignore it. The eye itself may look normal.

It develops when one eye sends a blurred or misaligned picture during early childhood, for example from a squint or a big difference in focus between the eyes. Because the eye looks fine, it is often missed until a vision test. A vision check, at the latest when your child starts school, helps find it.⁶

Why should lazy eye be treated early?

Lazy eye responds best when treated in early childhood, while the brain's vision pathways are still developing.

Treatment usually starts with glasses if needed, then patching the stronger eye or using atropine eye drops in it. Patching for as little as 1 to 2 hours a day can work in many children.⁶ Older children still benefit, but less. In a trial of children aged 7 to 17, about half of those aged 7 to 12 improved with treatment, while response was much lower in teenagers who had been treated before.⁷ Waiting to see if a child "grows out of it" costs valuable time.

How do I treat a stye?

A stye is a painful red bump on the eyelid edge caused by an infected oil gland or lash root. Most drain and heal on their own within a week or two.

In her practice, Dr Dutta suggests a clean, warm (not hot) compress held on the closed eye for a few minutes, several times a day. This is traditional advice rather than trial-proven. For the related lump on the inside of the eyelid, a Cochrane review found no trials of any treatment, and it did not study the usual outer stye.⁸ Never squeeze or prick a stye. See a doctor if the whole eyelid swells, the redness spreads, or the stye keeps coming back.

When should I take my child to a doctor or hospital?

See a doctor promptly, or go to hospital urgently, if you notice:

• A red, swollen eye or eyelid with discharge in a baby under 4 weeks.
• Swelling and redness spreading around the eye, or fever with a swollen eyelid.
• Eye pain, dislike of light, or blurred vision.
• A cloudy cornea (the clear front of the eye) or a very large, watery eye.
• A white reflection in the pupil in photos.
• A squint that is constant or still there after 3 to 4 months of age.
• An injury to the eye, or a chemical splash (rinse with clean water first).
• A watery eye still present at 12 months.