3 year old complains of eye pain, but no crusting, no redness

[alifarns]

My son is 3 years and 3 months old.  He has been complaining here and there for about 2 months about eye pain only in his left eye.  He has extremely long eyelashes, as do I, and I know that them getting into his eye can be the cause.  But his mention of the eye pain and rubbing has become more frequent, a couple of times a day, sometimes causing him to cry, but it seems to go away pretty quickly.  He complains the most when he lays down for a nap.  But there is no swelling, no conjunctivitis/crust.  Any ideas?  I am thinking a sty?  But it has been going on for so long, is it possible that he would have an infection for that long without showing more ill effects???

[JohnHaganMD]

Not sure what the above means

[Tashamarie0488]

Hi John, I know this is like a year and a half later but my daughter poked herself in the eye about 4 weeks ago and has been complaining of eye pain about 5 times a day, every day. It’s usually very brief but she almost looks panicked. Could she have scratched her cornea and is it possible that it would still be bothering her even now? Thank you.

[John C Hagan III, MD, FACS, FAAO]

Yes, the problem is called recurrent corneal erosions.  We have written about it, you can use the search feature to find previous discussions. I would suggest seeing an ophthalmologist. Treatment usually involves using lubricating gel in the eye at bedtime, artificial tears on awakening and several times per day, avoiding drying the eye (sleeping under fan, having air blow in face in car). Treatment has to be carried out many months (4-6 months) until she has gone 3 months without pain.

[CassandraKarm]

John, you got something you're figuring out over there?

[Tae2016]

My 3 year old keep rubbing his eyes he been doing it for a while now. So I just asked him, why you holding your eyes tight and he told me that they hurt. What do I do I'm getting scared what can I give him for it are do I need to take him to the doctor. Plzz help

[JohnHaganMD]

If he still has pain and a great deal of discomfort by the time you read this you likely need to call your pediatrician or visit an ER   May have something in his eye

[JohnHaganMD]

I like happy endings.

[JohnHaganMD]

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[gregory777]

It seems to have faded away, but it took time...he still got to the point of feeling like something was in his eyes and needed to be dug out. Just a lot of telling him not to, and training him not to touch his eyes and to trust when I tell him his eyes are okay...and this always happened at the same time of the evening.

It's been about a month now that he hasn't complained at all.

[JohnHaganMD]

The most common cause would be a scratched cornea. You can try artificial tears. If its still painful tomorrow call your pediatrician or check out an ER with ophthalmology coverage. Pink eye or conjunctivitis is usually not painful

[JohnHaganMD]

Thanks for the follow up. Hope this just fades away.

[gregory777]

I haven't had anything new to report because thankfully my son hasn't had any more episodes and no more doctor follow-ups. But then just last week, while sick from one of the fairly bad colds going around, he developed a small rash again, and started with the eye pain again, curiously, right at the same time as all the previous times (7:30pm). But it only happened for that one night...not much to go on.

[JohnHaganMD]

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[Burcumm]

My 3 years old son complains of eye pain for 3 weeks. He is crying for 15-30 seconds then he seems fine. The pediatric eye doctor checked him and told us there is nothing wrong with his eyes. Did you find any solution for your kids?

[JohnHaganMD]

Not every treatment works every time.  After a week of therapy you would expect the eye to be more comfortable than it is now. I would suggest that you return to the pediatric ophthalmologist you feel most comfortable with for additional testing and treatment. Hopefully your daughter is cooperative so that a good exam with the biomicroscope (slit lamp) can be done.  Fluoscene drops might be used to check for small scratches. Flipping the eye lid to look under the lid for debris or lashes or other abnormalities is often very difficult at that age.  JCH MD

[Tellpriya]

My 4.5yr daughter too complained of a severe pain and we took her to a pediatric ophthalmologist who said it's an infection without red eye or crusting. When the problem did not go away with 15 days of antibiotic drops we took second opinion. This pediatric ophthalmologist prescribed an anti allergic drop once a day and lubricant drops four drops a day. Have been trying this for a week now but my daughter still keeps complaining eye pain. The eye is not red and sometimes there is a lash in the eye but most of the times its nothing. We are clueless now

[JohnHaganMD]

alphatm: Since the problem is worsening I suggest you ask your pediatrician to set us a second opinion from a different pediatric ophthalmologist. If your son is co-operative ask the pediatric ophthalmologist to evert the upper lids to be sure there is no pathology or foreign material under the eyelid.

If this is also negative  investigate if it could be something else. Is there a family history of migraine, especially childhood migraine, that can cause hard to diagnose eye pain, consider sinus pathology as the eyes are surrounded by sinuses.

JCH MD

[alphaltm]

Very similar is going on with our 9 years old son. It also started with an episode of severe night pain back in August. Since then he's been constantly complaining that his eye/eyes hurt . At first it's been happening about once a week (usually on the weekends), but now as often as almost every day. We saw our GP as well as the pediatric optalmologist and after all the test done they found nothing wrong. The pain usually starts in the evening or late afternoon and it's gets better only with a sleep. It is usually located under his upper eyelide. We tried artifitial tears, antihistamin drops, warm compress, but nothing helps. He is also very sensitive to any lights. It breaks my heart every time when he has a pain and I have no idea how to help him.

[JohnHaganMD]

If you get a Diagnosis let us know  JCH MD

[gregory777]

For sure.

[JohnHaganMD]

He really needs to see an ophthalmologist and the pain is likely corneal in origin. Ask your pediatrician to refer you. Please do this.

[gregory777]

Thank you! Will do.

[LilLidia]

My son is 4years old  he woke up today telling me his eye hurt, it looks watery too me also a little redness what can I do I hate seeing him in pain :( can I buy eye drops over the counter for him or can this be serious ?

[gregory777]

Update:
Since the original night of severe eye pain, I have limited his food intake as well as what he's exposed to environmentally to make it easier to see if there's anything in particular causing the problem (it was easy because he's been out of school for the holidays).

There seems to be no connection between food/environment and his rashes and eye pain.
However, he has had no severe eye pain episodes since the first time...but he has had nightly borderline incidents. And here's where it gets interesting.

His eyes get red and irritated, borderline painful, and hyper sensitive to light every day starting between 7-8pm.

That's normally his bedtime, and since he doesn't nap, it's also when he is physically and mentally the most worn down and tired. So it's possible it's affecting him in his worn down state...or maybe it has nothing to do with that and whatever it is just happens to have a 24 hour (or nocturnal?) cycle. Either way, nightly he begins to dig into his eyes hoping to dig something out of there and I have to keep stopping him.

Overall, his rashes have gotten much better and barely appear anymore, but the eye irritation and light sensitivity continues. Last night we were driving home at 7:30pm and just the street lights along the highway were causing him pain and he asked for a jacket to put over his head.

[JohnHaganMD]

Best of luck. JCH MD

[JohnHaganMD]

With a story like that it is far more likely that he scratched his cornea. If he is still in pain see an ophthalmologist or optometrist or your pediatrician. Benadry drys the eyes (and mouth) and also predisposes to "exposure keratitis" where the lower cornea drys out then gets a corneal abrasion or exposure keratitis.

JCH MD

[gregory777]

Thank you for the head's up! What didn't mention is, for a couple months now (I guess for about the same amount of time as the rashes) he has been complaining daily that there's something in his eye and he keeps rubbing at it, but there's never anything there. So something is causing an eye irritation for sure, and it's certainly possible it led to him scratching his cornea. He had no episode last night. Now if I can figure out what's causing the rash and psoriasis in the first place...

That was the first time I had given him benadryl btw...

[gregory777]

Hi,

I am following this thread because my 5 yr old son woke in the middle of the night (last night) absolutely and inconsolably screaming in pain (which we eventually found out was in his right eye). He was also extremely sensitive to light or opening his eyes. I noticed the whites of his eyes were very red when I got a chance to see them. Normally his pain tolerance and ability to communicate a problem is quite good so this episode really had me worried. The screaming lasted for about 35 minutes and by then I had already given him both ibuprofen and benadryl  (benadryl because I noticed a rash on his body and thought maybe the pain had to do with some form of allergic reaction/pressure).

Just now (a day later) I put him to bed and noticed a rash again, and he was rubbing his eyes. I am fearful of a night like the last. I'm wondering if anyone else noticed a rash or any psoriasis type of skin reactions during the bouts of eye pain (just wondering if it's a coincidence).

He's had rashes coming and going for a few months now, but his pediatrician said not to worry about it. The hive looking rash can appear anywhere and everywhere (arms, neck, front, back, legs etc). However, one has caught my attention...on the inside of his elbow has been a persistent patch of rash that has recently morphed into psoriasis of some sort. And that's autoimmune, so it may tie into the allergy/immune/inflammation response and thus pain in or behind the eye. Just some thoughts.

I'm about to start documenting what he eats to see if anything corresponds with the appearance of the rashes, and if the eye episodes also correspond. Will update later...

[JohnHaganMD]

Thanks for the follow up. In my practice when I did pediatrics I was impressed at the frequency of childhood migraine.
JCH MD

[StephLF]

We took my 6 year old son to the pediatrician who was super dismissive and said basically that some kids have eye pain and it eventually just goes away. No help whatsoever, needless to say I will be finding a new pediatrician. I took him to an ophthalmologist and neurologist last week. I described symptoms and showed a video of one of the attacks but didn't mention that I suspected cluster headaches yet both came to that same conclusion. The neurologist informed me that these headaches are just as frequent in young kids, but because kids have a difficult time describing the pain they are not died until they are much older.

[JohnHaganMD]

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[StephLF]

My 6 year old son started complaining of eye pain in just his left eye back in August. We could find nothing in his eye but he would insist that it hurt terribly. We would give him Motrin and after 30 min he would feel better. I took him to an eye Dr. who said his vision was 20/40, not bad enough to cause issues and nothing seemed wrong with his eye. After August he didn't seem to have issues but in the last week he's had 3 attacks. He starts out complaining that his left eye hurts. It starts to get teary and a little red. Within about 10 minutes the area around his eye starts to swell and become red and the real pain starts. He screams in agony and can't hold still. This typically lasts about 15-30 minutes. It also seems to happen in mid to late morning each time. After 3 episodes we finally got him to explain what he is feeling. He says it feels like a pinching feeling all around his eye, not in it. Pressing around his eye makes the pain much worse. I soured this internet this weekend and came across something called a "cluster headache". His symptoms match this diagnosis exactly with the exception of his age. It is very rare for children under 12 to have these types of headaches, though it's not completely unheard of. I am seeing his regular pediatrician today and will update on what we find out if anything.