Pediatric Conjunctivitis: A Review of Clinical Manifestations, Diagnosis, and Management

Abstract

Conjunctivitis is a common pediatric problem and is broadly divided into infectious and non-infectious etiologies. Bacterial conjunctivitis makes up the majority of cases in children and often presents with purulent discharge and mattering of the eyelids. Treatment is supportive with an individual approach to antibiotic use in uncomplicated cases since it may shorten symptom duration, but is not without risks. Viral conjunctivitis is the other infectious cause and is primarily caused by adenovirus, with a burning, gritty feeling and watery discharge. Treatment is supportive. Allergic conjunctivitis is largely seasonal and presents with bilateral itching and watery discharge. Treatment can include topical lubricants, topical antihistamine agents, or systemic antihistamines. Other causes of conjunctivitis include foreign bodies and non-allergic environmental causes. Contact lens wearers should always be treated for bacterial conjunctivitis and referred to evaluate for corneal ulcers. Neonatal conjunctivitis requires special care with unique pathogens and considerations. This review covers essential information for the primary care pediatric provider as they assess cases of conjunctivitis.

Pakistan’s battle against adenoviral conjunctivitis and its economic implications

“…Being more prevalent among all conjunctivitis, a significant rise in viral conjunctivitis had been observed, particularly in summers from July to August, while bacterial incidence was high in winter from December to April 1 . Matted eyelids due to purulent discharge and lack of itching in bacterial conjunctivitis are labeled as differentiating symptoms from viral conjunctivitis 2 . Manifestations of viral conjunctivitis include red or pink eye, watery discharge, irritation, lid swelling, and punctate keratopathy, progressing to corneal scarring and visual loss 3 .…”

“…Usually, supportive care with artificial lubricants, topical steroids, and repeated cold washings are advised by clinicians for symptomatic relief, but oral or topical antiviral drugs (i.e. acyclovir and ganciclovir) could be used to limit the duration of active infection 2 .…”