Conjunctivitis (Newborn/Childhood)
What is conjunctivitis?
Conjunctivitis, also
known as "pink eye," is an inflammation of the conjunctiva of the eye. The
conjunctiva is the membrane that lines the inside of the eye and also a thin
membrane that covers the actual eye.
What causes conjunctivitis?
There are many
different causes of conjunctivitis. The following are the most common causes:
- Bacteria, including:
- Staphylococcus aureus
- Haemophilus influenza
- Streptococcus pneumoniae
- Neisseria gonorrhea
- Chlamydia trachomatis
- Viruses, including:
- adenoviruses
- herpes virus
- chemicals (seen mostly in the newborn period after the use of medicine in
the eye to prevent other problems)
- allergies
What are the different types of conjunctivitis?
Conjunctivitis is usually divided into at least two categories, newborn
conjunctivitis and childhood conjunctivitis, with different causes and
treatments for each.
Newborn conjunctivitis The following are the most common causes and treatment
options of newborn conjunctivitis:
- Chemical conjunctivitis
Chemical conjunctivitis is
related to an irritation in the eye from the use of eye drops that are given
to the newborn to help prevent a bacterial infection. Sometimes, the newborn
reacts to the drops and may develop a chemical conjunctivitis. The eyes are
usually mildly red and inflamed, starting a few hours after the drops have
been placed in the eye, and lasts for only 24 to 36 hours. This type of
conjunctivitis usually does not require treatment and rarely occurs with
present medications.
- Gonococcal conjunctivitis
Gonococcal conjunctivitis
is caused by a bacteria called Neisseria gonorrhea. The newborn obtains this
type of conjunctivitis by the passage through the birth canal from an infected
mother. This type of conjunctivitis may be prevented with the use of eye drops
in newborns at birth. The newborn eyes usually are very red, with thick
drainage and swelling of the eyelids. This type usually starts about 2 to 4
days after birth. Treatment for gonococcal conjunctivitis usually will include
antibiotics through an intravenous (IV) catheter.
- Inclusion conjunctivitis
Inclusion conjunctivitis is
caused by an infection with chlamydia trachomatis. The symptoms include
moderate drainage from the eyes, redness of the eyes, swelling of the
conjunctiva, and some swelling of the eyelids. This type of conjunctivitis
usually starts 5 to 12 days after birth. Treatment usually will include oral
antibiotics. o other bacterial causes After the first week of life, other
bacteria may be the cause of conjunctivitis in the newborn. The eyes may be
red and swollen with some drainage. Treatment depends on the type of bacteria
that has caused the infection. Treatment usually will include antibiotic drops
or ointments to the eye, warm compresses to the eye, and proper hygiene when
touching the infected eyes.
Childhood conjunctivitis Childhood conjunctivitis is a swelling of the
conjunctiva and may also include an infection. It is a very common problem in
children. Also, large outbreaks of conjunctivitis are often seen in daycare
settings or schools. The following are the most common causes of childhood
conjunctivitis:
- bacteria
- viral
- allergies
- herpes
The following are the most common symptoms of childhood conjunctivitis.
However, each child may experience symptoms differently.
Symptoms may include:
- itchy, irritated eyes
- clear, thin drainage (usually seen with viral or allergic causes)
- sneezing and runny nose (usually see with allergic causes)
- stringy discharge from the eyes (usually seen with allergic causes)
- thick, green drainage (usually seen with bacterial causes)
- ear infection (usually seen with bacterial causes)
- lesion on eyelids with a crusty appearance (usually seen with herpes
infection)
- eyelids that are matted together in the morning
- swelling of the eyelids
- redness of the conjunctiva
- discomfort when the child looks at a light
- burning in the eyes
The symptoms of conjunctivitis may resemble other medical conditions or
problems. Always consult your child's physician for a diagnosis.
How is conjunctivitis diagnosed?
Conjunctivitis is
usually diagnosed based on a complete medical history and physical examination
of your child's eye. Cultures of the eye drainage are usually not required, but
may be done to help confirm the cause of the infection.
Treatment for conjunctivitis:
Specific
treatment for conjunctivitis will be determined by your physician based on:
- your child's age, overall health, and medical history
- extent of the condition
- your child's tolerance for specific medications, procedures, or therapies
- expectations for the course of the condition
- your opinion or preference
Specific treatment depends on the underlying cause of the conjunctivitis:
- Bacterial causes
Your child's physician may order antibiotic
drops to put in the eyes.
- Viral causes
Viral conjunctivitis usually does not require
treatment. Your child's physician may order antibiotic drops for the eyes to
help decrease the chance of a secondary infection.
- Allergic causes
Treatment for conjunctivitis caused by allergies
usually will involve treating the allergies. Your child's physician may order
oral medications or eye drops to help with the allergies.
- Herpes
If your child has an infection of the eye caused by a
herpes infection, your child's physician may refer you to an eye care
specialist. Your child may be given both oral medications and eye drops. This
is a more serious type of infection and may result in scarring of the eye and
loss of vision.
Infection can be spread from one eye to the other, or to other people, by
touching the affected eye or drainage from the eye. Proper handwashing is very
important. Drainage from the eye is contagious for 24 to 48 hours after
beginning treatment.