Approach to the Child with a Corneal Condition

Unilateral red eye

Bilateral red eye

1. Corneal abrasion or foreign body (Gerstenblith and Rabinowitz 2012; Pavan-Langston 2008)

(May have a history of trauma, abrasion may be visible as disruption of the corneal light reflex, foreign body may be visible. Typically acute onset of symptoms. Often associated with pain, tearing and light sensitivity. Abrasions may be managed with topical ophthalmic antibiotics to prevent infection during healing, foreign bodies require referral for removal)

1. Infectious conjunctivitis (Koo and Colby 2017)

(Watery discharge, pre-auricular lymphadenopathy, concurrent URI common with adenoviral conjunctivitis. Mucopurulent discharge more commonly bacterial conjunctivitis. Can often be managed with topical antibiotics by the pediatrician. Referral indicated if lack of improvement or atypical history)

2. Contact lens keratitis (Koo and Colby 2017)

(History of contact lens use, white spot may be visible on exam. Can be acute or subacute onset. Same symptoms as abrasion/foreign body. Requires urgent referral for cultures and antimicrobial treatment)

2. Allergic eye diseases (Cruzat and Colby 2017)

(Often associated systemic atopy, symptoms typically seasonal, itching is a predominant symptom, findings on exam may be less impressive than symptoms. Mild cases can be managed with over the counter allergy drops. Referral for more serious or nonresponsive symptoms)

3. Herpetic keratitis or conjunctivitis (Koo and Colby 2017)

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Dec 19, 2017 | Posted by in OPHTHALMOLOGY | Comments Off on Approach to the Child with a Corneal Condition
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