1 Has your child had an injury causing obvious damage to the eye?

2 Is there a foreign body, such as a piece of grit or sand, in the eye?

3 Does the white of the eye look bloodshot?

4 Is there a sticky, pus-like discharge from the eye?

5 Is vision in the affected eye as good as normal?

6 Are the eyelids red and itchy?

7 Is there a tender red lump on one eyelid?

8 Do one or both eyes water continuously?

9 Is your child less than 1 year old?

10 Emergency! Call an ambulance

Possible cause and action An eye injury always requires immediate medical attention because there is a risk of permanent damage. While waiting for the ambulance, carry out self-help measures (see Treating eye injuries). Once in hospital, the injury will be assessed. In some cases, surgery will be needed.

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Possible cause and action A foreign body, such as a piece of grit, in the eye, may cause pain, redness, and watering. Try to stop your child rubbing the eye, and carry out self-help measures for treating eye injuries. If these measures are not possible, are unsuccessful, or if the eye remains sore for more than an hour after removing the foreign body, you should seek medical help immediately.

12 See your doctor within 24 hours

Possible cause Bacterial conjunctivitis is likely. This is inflammation of the membrane covering the white of the eye and the inside of the eyelids due to infection by bacteria.

Action Your doctor will probably prescribe antibiotic eye drops or ointment. He or she may also advise you on self-help measures for coping with conjunctivitis. To prevent your child spreading conjunctivitis, keep him or her away from other children and do not let him or her share face cloths or towels until the symptoms have cleared up.

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Possible cause Nonbacterial conjunctivitis is likely. This is inflammation of the membrane covering the white of the eye and the inside of the eyelids due to allergy, chemical irritation, or a viral infection.

Action The inflammation will usually clear up on its own. However, if you are not sure that conjunctivitis is the cause or if your child's symptoms persist for more than 48 hours, you should consult your doctor.

14 Call your doctor now

Possible cause Iritis, inflammation of the coloured part of the eye, is a possibility.

Action Your doctor may refer your child to a specialist for a detailed eye examination and for other tests to look for disorders that sometimes occur with iritis, such as arthritis. Iritis needs immediate treatment with corticosteroid eye drops or tablets to prevent permanent damage to vision.

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Possible cause Blepharitis, inflammation of the lid margins, is the most likely cause of itchy, scaly eyelids. This condition is often associated with dandruff. Consult your doctor.

Action Your doctor will probably prescribe an ointment to apply to the eyelids. Treating the scalp with an over-the-counter anti-dandruff shampoo may also result in an improvement in the eyelids.

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Possible cause A stye, a boil-like infection at the root of an eyelash, is likely.

Action A stye will usually clear up within a week without special treatment. It will either burst, releasing pus, or gradually disappear. If pus is released, use a clean piece of cotton wool moistened with warm water to clear away the discharge, wiping towards the outer side of the eye. To prevent infection spreading, try to discourage your child from touching the affected eye. Consult your doctor if a stye fails to heal within a week or if styes recur often.

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Possible cause A blocked tear duct may be causing your baby's symptoms. This condition is common in babies and usually corrects itself without treatment by the end of the first year.

Action You may be able to open a blocked duct by gentle massage (see Blocked tear duct). In rare cases, the duct does not open and a minor procedure is needed.

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Consult your doctor if you are unable to make a diagnosis from this chart.

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Consult your doctor if you are unable to make a diagnosis from this chart.