Everything you need to know about insect bites near the eyes in children – what to do and what not to miss
Hello.
We have a fantastic chapter on our website about insect bites in children, and it summarizes all the different types of bites and possible bodily responses.
Whoever’s read that chapter (in the link here) knows not to say “my child is allergic to insect bites” but rather “my child gets localized reactions to insect bites, which doesn’t usually mean an allergic reaction” …
That chapter has a paragraph that discusses insect bites near the eye, but there are at least two good reasons for why we should have a post dedicated entirely for those bites in children:
a. This is a common topic that concerns many parents when they wake up in the morning and find that their child has a very swollen eye. Not only that, but sometimes they end up going to the doctor’s office and receiving unnecessary antibiotics, as if there was an infection near the eye.
b. A photo I received of a stunning girl called Rio Guy, who had insect bites near both eyes, attached to this chapter. Note, however, that Rio is an exception to the story.
So, lets get started!
Everything you need to know about insect bites near the eyes in children.
Is it an allergy or a localized reaction?
Imagine a certain amount of venom enters from underneath our skin. This venom contains substances that produce a localized inflammatory reaction and therefore the area around it will be tender and swollen. However, this is not an allergic reaction, but simply a localized reaction to the venom.
Only in a small percentage of the cases, a insect bite can cause a localized allergic reaction. In a very small number of cases (especially in bee stings), it can even cause a severe systemic allergic reaction.
Therefore, despite having heard the words “my child is allergic to insect bites” hundreds of times, I hope it is now clear to everyone that your child isn’t really allergic to insect bites.
What is the usual cause of insect bites near the eyes?
Obviously, it could be any animal, but usually it is mosquito bites we are talking about.
Why do mosquitos like to bite near the eyes?
Why do they like this area? I don’t know.
Since the area is exposed, I presume it is easier to bite near the eyes than in the areas under the pyjamas.
What are the characteristics of mosquito bites near the eyes?
Typical. Swelling and redness over or under the eye, on one side.
What usually happens is that the child wakes up in the morning, and the parents notice this swelling, which is really more pronounced in the mornings.
Note that the bites are usually on one side, don’t get confused by looking at the picture attached to this post.
How dangerous are these bites, on a scale of 0 to 10?
0.
What else can be the cause of redness and swelling around one of the eyes?
Redness and swelling around one of the eyes, as seen in the image here of Emry, can also be present in an infectious process that develops around the eyeball call periorbital cellulitis.
Even though this may seem similar to bites, there are substantial differences between the two different conditions as you will learn below.
Swelling around both eyes, in the absence of redness that would usually indicate an insect bite, can also be seen in rare conditions that arise due to low protein in the bloodstream. These conditions cause swelling or edema in both eyes. Such cases must be evaluated by a physician.
How can we distinguish between an infection and an insect bite?
Try to remain focused. Notice the difference between the two photos attached (Rio with her bite and Emry with her infection), namely:
The general appearance – the redness you see around an infected eyeball, periorbital cellulitis, is a kind of “angry red”. It’s not just pink and swollen. The borders of the swelling grow fast, sometimes within hours, as common in infectious processes.
The pain – this is the most important part of the post! In insect bites, the child “enjoys it” when you touch the swollen area. It is not painful because it is simply swelling due to a localized reaction. In infections the child finds it very painful when you touch the swollen area.
Fever – bites never cause fever. Infections sometimes cause fever. What I’m trying to say is that if the child has fever then it is certainly not a bite (unless there is another coincidental cause for the fever). And what if the child doesn’t have fever? It doesn’t mean anything,
For the advanced parents – notice how Emry’s infection also started off with a small insect bite (seen in the corner of the nose), but a bacteria present on (all of our) skin penetrated and caused an unpleasant infection that needed treatment with oral antibiotics.
And for the super advanced parents – notice that Emry had another insect bite on his left cheek, and that too underwent impetiginisation, or in other words, a mild, localized infectious process.
This is proof for the presence of bacteria on the skin which must have caused the infection in the bear near the eye, as well.
In order not to miss an important infection that requires treatment with antibiotics, see your doctor whenever in doubt.
How should an insect bite near the eye be treated in children?
If anything, you can apply a topical antihistamine gel or a type of steroidal cream/ointment that can be applied to the face.
Since the localized reaction does not indicate a systemic allergic reaction, but simply a local reaction to the venom, systemic antihistamines are not usually helpful.
And whenever in doubt, consult with your pediatrician.
How long do the manifestations of an insect bite last?
Approximately two days. So do not stress out if your child wakes up with an eye that is almost entirely shut on the second day. It usually gets better within a few hours.
But again, if you are unsure whether it is a bite or an infection, it is best to get assessed by a doctor.
In summary, this is a small topic but can be the cause of distress for many parents and it has specific characteristics.
It is important not to miss the important aspects of it but at the same time it is also important to avoid overdiagnosis and unnecessary treatment.
Good luck and a big thank you to Rio and Emry.
May you always be on the ‘right’ side of the stethoscope. Amen.
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