Thick, purulent, ropy disharge
Usually starts unilaterally
Eyelids may be “crusted shut” in a.m.
+/- preauricular lymphadenopahty
Clinical px of what condition?
Cause of Bacterial conjunctivitis
S. pneumoniae, H. influenza, M. cattarhalis, S. aureus
Newborns: Chlamydia trachomatis #1
Tx of bacterial conjunctivitis
Antibiotic drops- older children
**treat both eyes!!
Cause of viral conjunctivitis
adenovirus: one of the primary causes of ‘colds’ (URI)
conjunctival injection of one or both eyes
watery ocular discharge, some crusting in a.m.
May be accompanied by URI sx, feels “gritty”
Clinical Px of what?
Viral conjunctivitis Tx
bilateral itchy, watery, red eyes
“Bumpiness” of tarsal conjunctivae
Accompanied by sx of allergic rhinitis
Sneezing, dry cough, atopic dermatitis
Clinical Px of what?
Allergic conjunctivitis Tx
olopatadine in children > 2 years
Cause of Periorbital cellulitis (preseptal)
(Infection ANTERIOR to orbital septum)
exogenous source ( eyelid abrasion, horedolum, chalazion, dacrocystitis, insect bite)
MC pathogen = Staph aureus & S. pyogenes
2 MC pathogens of peri-orbital cellulitis
Staph aureus & S. pyogenes
Periorbital cellulitis/orbital cellulitis infections arise POSTERIOR to the orbital septum
False, Periorbital cellulitis/orbital cellulitis infections arise ANTERIOR to the orbital septum
Periorbital cellulitis has mild, minimal complications
Periorbital Cellulitis Tx
infection POSTERIOR to the orbital serum
may cause serious complications- such as an acute ischemic optic neuropathy or cerebral abscess
This describes which condition?
Cause of Orbital cellulitis
(2 MC pathogens?)
Staph or Strep (S. aureus)
Orbital cellullitis is almost always associated w rhinosinusitis or sinus infection
+/- fever (if present, it is high)
lid swelling & erythema
vision disturbances/decreased vision
Pain w EOMs, proptosis (protruding eye)
Clinical px of which condition?
Dx of orbital cellulitis
CT or MRI
Tx of orbital cellulitis
Emergent Opthalmology Consult; IV abx
+/- surgical drainage
Widespread inflammation of medium and small arteries, including the coronary arteries
aka “mucocutaneous lymph node syndrome”
Dx of Kawasaki Dz
+/- anemia & thrombocytosis
no specific dx criteria
What is the leading cause of acquired heart dz in children in US?
Transmissible to household contacts; clustering
Some clinical features similar to adenovirus and scarlet fever
Seasonality (winter and spring)
80% of cases occur in children < 5 yo (median age at diagnosis is 2yo)
Epidemiology of which condition?
Dx criteria of Kawasaki Dz
- Conjunctivitis: bilateral, bright-red, non-exudative
- Mucositis: cracked lips, strawberry tongue
- Polymorphous rash & desquamation: starts in perineum, skin peels, then spreads
- Lymphadenopathy: cervical
- Extremity changes: edema, redness of palms/soles
"Can't make pain leave, eek!"
Details of Mgmt of Kawasaki Dz: IVIG
IVIG (intravenous immune globulin) + Aspirin (ASA) (80-100mg/kg/d)
IVIG reduces incidence of aneurysms
DO NOT admin live vaccines within 11 mos of IVIG
General Mgmt of Kawasaki Dz
IVIG + Aspirin
Baseline Echo + repeat @ 2 & 6 wks
Complications of Kawasaki Dz
CV: coronary artery aneurysms --> myocardial ischemia, infarction, sudden death
Highest risk: < 1yr & >9yrs
Loss of the most superficial layer of corneal cells
What is this?
Red eye, watery d/c (tearing)
blephorospasm (tight closure of eyelid)
Severe ocular pain
Fussy baby, irritable toddler
Rubbing at eye
Corneal Abrasion Dx
fluorescein stain, Wood’s lamp**
If foreign body refer to Opthalmology