Children may sometimes awaken with swollen or puffy eyes that
itch and burn. These symptoms can be alarming, especially if the condition
seems to appear for no reason. But as most parents quickly learn, several
common infections and injuries – some minor and some more serious – can
easily be responsible for such eye symptoms.

Many children may obtain injuries to their eyes playing with family
or friends – they can get poked, something can fly into their
eyes, they can get hit in the eye with something, etc. The Oregon
Health & Science University cites these additional problems that
may be associated with children’s red, itchy, swollen eyes:

• Allergic conjunctivitis – Children with allergies can
  develop this problem, which causes both eyes to be red and swollen,
  itching and tearing. Antihistamines or eye drops may be needed
  for treatment. Avoiding the allergen (perfume, pet dander, reaction
  from flea bite, etc.) is the key to long-term prevention.
• Styes – A stye or hordeolum produces a tender, red swollen
  area on your child’s eyelid. It may point inward, or it may
  be on the outside of the eyelid margin. Treatment consists of warm
  compresses and sometimes topical antibiotics.
• Computer strain – Children who spend countless hours staring
  at computer or television screens may develop red, watery and itchy
  eyes, a headache and problems with focusing. Alleviation from these
  symptoms usually consists of resting the eyes.
• Foreign body – Having a foreign object in the eye, such
  as a piece of sand, can cause pain and swelling, especially with
  blinking and tearing. Older children may complain that it feels
  like something is stuck in the eye. Washing the object out of the
  eye with lukewarm water is usually the only treatment necessary.

While most of the common eye infections
previously mentioned will disappear within a week, it is important that your
child visits a doctor to rule out any long-term or serious eye problems.
The Nemours Foundation suggests the following strategies to prepare your
child for his or her visit with the doctor:

• Explain the purpose of the visit – Use very non-threatening
  language to explain to your child that the doctor “needs
  to examine you in order to find out how to fix this and help you
  get well.”
• Tell your child what to expect – You may not know what
  to expect during the examination. When you call to make the appointment,
  you can ask to speak to the doctor or a nurse to find out, in a
  general way, what will take place during the office visit and exam.
  Then you can explain some of the procedures and their purpose in
  gentle language, appropriate to your child’s age level. Your
  child will feel more secure if he or she understands what is going
  to take place and why it is necessary.
• Involve your child in the process – If the situation is
  not an emergency, allow your child to contribute to a list of symptoms
  that you create for the doctor. Include all symptoms you have observed,
  no matter how unrelated they may seem to the problem at hand. Ask
  your child to think of questions that he or she would like to ask
  the doctor. Write them down and give them to the doctor, or, if
  your child is old enough, let him or her write down and ask the
  questions himself or herself.

While some eye injuries and infections cannot be prevented, it
is still important that your child has his or her eyes examined on
a regular basis. The American Academy of Ophthalmology recommends
a first eye exam at 6 months of age, again at the age of 3 or 4,
and then every one to two years thereafter. In addition, the American
Academy of Pediatrics cautions you to call your pediatrician or eye
doctor immediately if you notice any of the following warning signs
of any eye problem in your child:

• Eyes flutter quickly from side to side or up and down
• Eyes are always watery
• Eyes are always sensitive to light
• Any change in the eyes from their usual appearance
• White, grayish-white or yellow-colored material appears in the
  pupil
• Redness in either eye that does not go away in several days
• Continued pus or crust in either eye
• Eyes look crossed, turn out or do not focus together
• Frequent rubbing of an eye
• Frequent squinting
• Frequent tilting (or turning) of the head
• Eyelid(s) that appear(s) to droop
• Eye(s) that appear(s) to bulge

The American Optometric Association (AOA) recommends that children
should have their first thorough eye examination at about 6 months of age.
This may seem early, but vision development and eye health problems can be
more easily corrected if caught early. Conditions such as nearsightedness,
farsightedness, astigmatism and eye movement problems can affect a child’s
ability to do well in school. The A merican Academy of Ophthalmology and
the American Academy of Pediatrics (AAP) recommend that children be screened
in four stages:

• In the newborn nursery – Pediatricians and ophthalmic
  practitioners should examine all infants prior to their discharge
  from the nursery to check for infections and structural defects,
  cataracts, or glaucoma. All premature babies or children with multiple
  medical problems should be examined by an ophthalmologist.
• By the age of 6 months – Pediatricians should screen infants
  at the time of their well-baby visits to check for alignment (eyes
  working together).
• At the age of 3 to 4 years – All children should be examined
  by a pediatrician at this stage. The visual acuity is checked and
  the eyes are examined for any other abnormality that may cause
  a problem with the child’s educational development. Any abnormality
  requires referral to an ophthalmologist.

At the age of 5 and older – Pediatricians should screen children
annually if this is not provided by school personnel or volunteer
organizations. Visual acuity is tested, as well as evaluation of
other ocular functions.

The following symptoms may indicate that your
preschooler has a vision problem:

• The child’s eyes become misaligned (strabismus).
• The child’s eye begins showing a white pupil.
• The child suddenly develops pain and redness in one eye or both
  eyes.

These signs can be representative of a variety of vision-related
problems ranging from simple pink eye to blinding eye disease. The
presence of any of these signs suggests that your child should be
evaluated by his or her pediatrician or ophthalmologist as soon as
possible. The good news is that a simple consultation with the pediatrician
will generally result in the correct diagnosis and proper treatment.

Regardless of your child’s age, experts at the AAP suggest
that any of the following signs of eye problems warrant a consultation
with a pediatrician:

• Your child’s eyes flutter quickly from side-to-side or up-and-down
  (nystagmus).
• The eyes are always watery and/or sensitive to light.
• Any change in the eyes from their usual appearance.
• You see white, grayish-white or yellow-colored material in the
  pupil.
• There is redness in either eye that doesn’t go away in several
  days.
• There is continued pus or crust in either eye.
• The eyes look crossed, turn out or don’t focus together (strabismus).
• Your child often squints or rubs the eye(s).
• Your child often tilts (or turns) his or her head.
• The eyelid(s) appears to droop.
• The eye(s) appears to bulge.

As with any medical problem, the best action for a parent to take
to avoid long-term vision problems in their child is to remain vigilant
and consult a medical professional if any questions or concerns arise.