Haze days and little red eyes

Key takeaways

Haze eyes in children are surface irritation from smoke particles, not an infection, and they usually settle within an hour or two indoors.
The first hour is unglamorous: windows shut, a cool damp cloth over closed eyes, plain lubricating drops to rinse, and no rubbing.
Rubbing is what turns an irritated eye into a swollen one, so give her hands something else to do.
The Department of Environment names children as an affected group from API 101 upward, and schools stop outdoor activities above 100.
Pain rather than itch, light that hurts, changed sight, thick discharge, or an eye still angry the next morning means it is not the haze.

The week the sky turns the colour of weak tea, my clinic list changes shape. Parents arrive with children whose eyes are pink and streaming, and with the same sentence, usually before we have sat down: she has never had an eye infection, why now?

Most of the time it is not an infection. Haze is smoke, and smoke lands on the eye's surface the way dust and wind do. The eye answers the only way it knows how, with tears and redness and an itch. Miserable for an afternoon, and not damage. What follows is what settles it in the next hour, and the short list of things that mean it was never just irritation.

Why do my child's eyes go red and watery when the haze comes?

Because the front of the eye is exposed all day and fine smoke particles settle on it. The tears and the redness are the eye washing itself and complaining. That is irritation, not infection.

The Department of Environment says that during a Malaysian haze the reading is usually driven by particulate matter, the fine solid specks rather than the gases. Those specks are what your child blinks against between the car park and the school gate. In surveys during bad episodes here, eye discomfort sits near the top of what people report, behind throat and nose. In one questionnaire of just under three hundred adults in Singapore during the 2013 episode, roughly six in ten described it. Adults, online, one country, so treat it as a shape rather than a number about your child.

What helps in the next hour?

Bring her indoors, shut the windows, put a cool damp cloth over her closed eyes for a few minutes, rinse with plain lubricating drops, and stop the rubbing. That is the whole first-hour list, and it is deliberately unglamorous.

Order matters more than effort. Getting the smoke away from the eye does most of the work, so windows closed and air conditioning set to recirculate rather than drawing outdoor air in. A flannel wrung out in cool water, laid over closed lids while she watches something, calms the itch faster than anything you can buy. Ordinary artificial tears, the plain lubricating kind, rinse the particles off, and a bottle kept in the fridge feels better going in. Wash her face and hair afterwards, or the smoke sitting in her fringe keeps arriving at her eyes all evening.

Rubbing is the one thing that turns an irritated eye into a swollen one.

The rubbing is where a haze week goes wrong. An eye that itches gets rubbed, rubbing releases more of what causes the itch, the lids puff, and by bedtime you have a child who looks far worse than the air ever justified. Why children rub their eyes covers that loop properly. Give her hands something else to do, and keep the drops within reach so the reflex has an alternative.

Two honest caveats. Air conditioning keeps the smoke out and dries the eye, which is why the drops earn their place indoors as well. And a mask, whichever kind, covers the nose and mouth and does nothing for the eyes. Skin is in the same position, exposed and complaining, and Dr Ong Jin Khang, who practises skin medicine at The Retreat Clinic, sets out what haze does to skin and what actually needs a doctor.

Is it the haze, or is it an eye infection?

Irritation is usually both eyes together, watery and gritty, and it eases within an hour or two of coming indoors. Infection more often starts in one eye, glues the lashes shut overnight with yellow or green discharge, and carries on regardless of where the child is sitting.

Haze causing pink eye is a claim that does not hold up well. One study of the 1997 episode found no significant rise in conjunctivitis cases during the exposure period. Haze makes eyes sore; it does not appear to hand out infections. So if your child has thick sticky discharge in one angry eye, do not file it under haze and wait for the wind to change. Read it as its own problem, and pink eye in children will help you tell which kind it is.

At what API number should I keep her indoors?

There is no paediatric number, and anyone who gives you one has invented it. What exists is the Department of Environment's health table, and children are named in it from 101 upward, not from 200. That is the line I work to.

The bands, in the Department's own words:

0 to 50 is good and 51 to 100 is moderate. At both, the advice is no restriction on outdoor activities.
101 to 200 is unhealthy for sensitive groups. This band, the Department states, worsens the health of the elderly, pregnant women, children, and people with heart and lung complications, and it advises limited outdoor activity for high risk people.
201 to 300 is very unhealthy. Older and high risk people are advised to stay indoors and reduce physical activity, and people with health complications are advised to see a doctor.
Above 300 is hazardous, and the public is advised to avoid outdoor activities.

Read that as a description of risk, not a permission slip. The band below 101 is no guarantee your child is comfortable, and a child whose eyes are already streaming has given you better information than the index has.

Will the school close today?

Probably not, and closure is not the first thing that happens. The rule, as stated by the Deputy Education Minister in August 2026, is that once the reading passes 100 schools stop outdoor activities involving pupils, and outdoor gatherings and sport are postponed. Only above 200 may a school close, and even then it is a decision, not an automatic trigger.

That decision sits with the headmaster or principal, advised by the state and district education offices, who track the readings and pass them on. Johor stated exactly this in September 2026: schools there close only above 200, in line with the state education department's procedures.

What this means at 7am is that assembly, physical education and sports practice go first, long before anyone talks about closing. A child can come home from a normal school day with sore eyes and nobody has done anything wrong. Keeping your own child home is still a decision you are allowed to make on what you can see of her.

He has asthma. Does the haze do something different to his eyes?

His eyes behave like any other child's. He does not, and that is the part I care about. A child whose asthma is flaring in a hazy week is one I want seen sooner, because sore eyes are the least of what the smoke is doing to him.

Children sit in the group the Department of Environment names as affected from 101 upward, alongside people with heart and lung problems, and a child who is both is in that group twice. The respiratory literature is blunt about why: lung development in childhood is held back by exposure to air pollutants. Singapore's health ministry advisory says anyone unwell, especially children and those with chronic heart or lung conditions, should seek medical attention, and that cutting outdoor time and exertion limits the effects.

There is an eye link too, running sideways. Children with asthma or eczema are more prone to allergic eye disease in the first place, so the hazy weeks and the itchy weeks arrive together. Manage the chest with the doctor who looks after his asthma. I will look after the eyes.

When is it more than irritation?

When it hurts rather than itches, when light is genuinely painful, when sight changes in any way, when there is thick discharge, or when the eye is still angry the next morning after a night indoors. Any one of those, and the haze has stopped being the explanation.

The thresholds worth memorising are not haze-specific. Sudden changes to sight, wavy lines or flashes, an eye that is very dark red, one pupil larger than the other, or a chemical or object in the eye are same-day problems for an emergency department. A baby under a month old with red eyes needs advice today, and a very painful red eye at any age needs an urgent appointment.

Everything else is what it looks like. A child who spent a smoky afternoon outside, whose eyes are pink and watery, and who is comfortable an hour after a cool cloth and a rinse, has had an unpleasant day and no more. The hat and sunglasses still matter through all of it, because ultraviolet light passes straight through haze and a grey sky is not shade, which is the argument of sun protection for children's eyes. Bring her to me if the list above says so. If it does not, close the windows, cool the cloth, and wait for the wind.

See a doctor today if…

The eye is painful rather than itchy, or bright light is genuinely painful to look at.
Your child's sight has changed in any way, including wavy lines or flashes.
One eye is very dark red, or one pupil is larger than the other.
There is thick yellow or green discharge, or the eye is still angry the next morning after a night indoors.
Your baby is under a month old and has a red eye, or your child's asthma is flaring alongside it.

Common questions

The haze is back and my child's eyes are red and watery, what do I do now?

Bring her indoors, close the windows, and put a cool damp cloth over her closed eyes for a few minutes. Rinse the surface with plain lubricating drops, which feel better if the bottle has been in the fridge. Then stop the rubbing, because that is what turns an irritated eye into a puffy one. Most children are comfortable again within an hour or two.

Is it the haze or is it an eye infection?

Haze irritation is usually both eyes, watery and gritty, and it eases once the child is indoors. An infection more often starts in one eye, produces thick yellow or green discharge that glues the lashes overnight, and carries on wherever the child is sitting. If you are seeing sticky discharge in one angry eye, treat it as its own problem rather than blaming the air.

At what API number should I keep my child indoors?

There is no paediatric threshold published, so nobody can honestly give you a single number. The Department of Environment's own health table names children among the groups affected from 101 upward and advises limiting outdoor activity for high risk people from that band. Below that, use your child rather than the index: streaming eyes are better information than a digit.

Will the school close because of the haze?

Usually not. The stated rule is that schools stop outdoor activities involving pupils once the reading passes 100, and that a school may be closed above 200 on the decision of the head, advised by the state and district education offices. Closure is discretionary rather than automatic. Assembly, physical education and sports practice are what go first.

Can I give my child eye drops from the pharmacy for haze eyes?

Plain lubricating drops, the ordinary artificial tears, are the sensible thing to reach for, and they work by rinsing and diluting what has landed on the eye. Ask the pharmacist for a lubricant rather than anything that promises to take redness away. Medicated drops, including anything with a steroid, are not a pharmacy decision for a child.

Does a mask protect my child's eyes on a hazy day?

No. A mask covers the nose and mouth and does nothing for the eyes, which stay exposed the whole time. That is not an argument against masks, which are about the airway, only a reminder that the eyes need their own plan: indoors, a cool cloth, lubricating drops, and no rubbing.

My child has asthma. Does the haze affect his eyes differently?

His eyes behave like any other child's, but he does not. Children with asthma sit in the group that health advice singles out during haze, and a flare matters far more than sore eyes do. Keep the eye care simple and speak to the doctor who manages his asthma about the chest. If he is unwell rather than just uncomfortable, he should be seen.

References

Department of Environment Malaysia · Air Pollutant Index calculation and health impact bands · www.doe.gov.my
Bernama · Jerebu: Sekolah boleh ditutup jika IPU lebih 200, 14 August 2026 · www.bernama.com
Bernama · Haze: Johor schools to close if API reading exceeds 200, 7 September 2026 · www.bernama.com
Acute health impacts of the Southeast Asian transboundary haze problem, a review, Int J Environ Res Public Health 2019 · pmc.ncbi.nlm.nih.gov
Air pollution and noncommunicable diseases, Forum of International Respiratory Societies review part 2, Chest 2019 · pubmed.ncbi.nlm.nih.gov
Ministry of Health Singapore · Haze health advisory for the public · www.moh.gov.sg
AAPOS · Allergic conjunctivitis (artificial tears, cold compresses and why rubbing makes it worse) · aapos.org
NHS · Dry eyes · www.nhs.uk
NHS · Red eye · www.nhs.uk

By Dr Chan Li Yen. General information only. It does not replace a consultation. If you are worried about your child's eyes or vision, please see an eye doctor.