Red Eye in Children Diagnosis and Management Ronit Friling M.D. SCHNEIDER MEDICAL CENTER ילדים.
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Transcript of Red Eye in Children Diagnosis and Management Ronit Friling M.D. SCHNEIDER MEDICAL CENTER ילדים.
![Page 1: Red Eye in Children Diagnosis and Management Ronit Friling M.D. SCHNEIDER MEDICAL CENTER ילדים.](https://reader030.fdocuments.in/reader030/viewer/2022032722/56649cda5503460f949a4cf5/html5/thumbnails/1.jpg)
Red Eye in ChildrenRed Eye in Children
Diagnosis and Diagnosis and ManagementManagement
Ronit Friling M.D.
SCHNEIDER MEDICAL CENTER
ילדים
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Red Eye Disorders: Non-Vision -Threatening
Conjunctivitis
Subconjunctival hemorrhage
Chalasion
Blepharitis
Dry eyes
Corneal abrasions (most)
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Red Eye Disorders: Vision -Threatening
Corneal infection
Scleritis
Hyphema
Iritis
Acute glaucoma
Foreign body
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• How long has the eye been red?
• Does the vision seem to be okay?
• Do the eyes move normally?
• Is the infection in both eyes?
Anamnesis:
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• Does the child wear contact lenses?
• Is there a history of trauma?
• How long has the eye been red?
• Is the pupil round ?
Anamnesis:
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DacryocystitisNaso Lacrimal Duct Obstruction
Signs:Red painful swelling above lacrimal sacHistory of chronic eye watering
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Dacryocystitis
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Dacryocystitis
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Dacryocystitis
Pathogens:Staphylococcus aureus, Strep pneumonia
Treatment:Treatment:
conservative until 1 yr conservative until 1 yr
(antibiotics after culture, hygiene, massage?)(antibiotics after culture, hygiene, massage?)
Surgery at 1 yr - probing, silicone tubes, Surgery at 1 yr - probing, silicone tubes, rarely DCRrarely DCR
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Conjunctivitis
Bacterial
Chlamydia
Viral
Allergic
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Conjunctivitis:symptoms & signs
Symptoms:Sore, red, sticky eyes.
Signs:Red conjunctiva, discharge.
Viral & Chlamydial: Follicles, swollen lids,enlarged preauricular node.
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Conjunctivitis
Bacterial Strep pneumonia Haemophilus Staph. aureus Neisseria gonorrhea
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Conjunctivitis
Chlamydia
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Any conjunctivitis during the first month of lifeAny conjunctivitis during the first month of life
Ophthalmia Neonatorum
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Ophthalmia Neonatorum
Etiology thought to have been acquired Etiology thought to have been acquired in birth canal: chlamydia, gonococcus, in birth canal: chlamydia, gonococcus, other bacteriaother bacteria
Regard chlamydia and gonococcus as Regard chlamydia and gonococcus as systemic disease and treat systemicallysystemic disease and treat systemically
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Corneal ulcer : symptoms
• Pain
• Watering
• Photophobia
• Blurring of vision
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Corneal ulcer : signs
• Red eye• Epithelial defect -
fluorescein staining
• Corneal infiltrate
• A/C inflammation, Hypopyon
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Corneal ulcer : risk factors
• Contact lens wear
• Dry eye • Insesitive eye
• Blepharitis
• Herpes virus- zoster, simplex
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Corneal ulcer : risk factors
• Ectropion
• Bell’s palsy
• Corneal surgery, injury, foreign body
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Corneal ulcer : pathogens
• Bacterial
Pseudomonas
Staphylococcus
Streptococcus
• Viral
Herpes simplex
• Fungal
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Corneal ulcer : treatment
Referral to hospital - cultureAdmission
Urgent topical antibiotic treatment:Cefazolin - Gentamicin dropsFluoroquinolon (ciloxan, oflox) drops
q 1h - q 1/2h
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Conjunctivitis
Viral Adenovirus Herpes simplex virus
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Herpes simplex keratitis
Primary infection during childhood
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Herpes simplex keratitis
Usually unilateral
Dendritic pattern
Often recurrent
Corneal sensation reduced.
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Conjunctivitis: treatment
Bacterial ChloramphenicolPhenymixin (Chloramphenicol + polymixin B)GentamicinBamyxin
Chlamydia Topical Tetracycline 3 weeks Systemic Tetracycline 2 weeks
Viral As bacterial or topical steroids
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Conjunctivitis: treatment
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Herpes simplex keratitis : treatment
Topical Acyclovir 3% ointment 5 times / day
Systemic Acyclovir 400 mg x 5/day in immunesupressed or severe infection.
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Herpes zoster ophthalmicus
Usually above age 50
Immune supressed - HIV
Rx: PO zovirax 800 mg X 5
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Orbital & periorbital celullitis
Signs :periorbital swelling and redness fever
lethargy
proptosis
decreased eye motility
abnormal pupillary reaction
optic nerve swelling or pallor
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Orbital & periorbital celullitis
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Orbital & periorbital celullitis
Signs:
Limitation of abduction of involved eye
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Orbital & periorbital celullitis
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Orbital & periorbital celullitis
Etiology:
Sinusitis
Trauma
URI
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Orbital & periorbital celullitis
Treatment :Periorbital PO antibiotics
Orbital – Hospitalization
– CT – IV antibiotics
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Blunt Ocular Trauma: Blunt Ocular Trauma: Anterior segment Anterior segment
IrisIris
-- hyphemahyphema
- - mydriasismydriasis
- - iridodialysisiridodialysis
- - angle recessangle recess
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VERNAL KERATOCONJUCTIVITIS(VERNALIS)
Usually bilateral
Seasonal
Atopic history:
Asthma, rhinitis,
atopic dermatitis
Palpebral : cobble stones
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VERNAL KERATOCONJUCTIVITIS(VERNALIS)
Treatment of exacerbations
Topical steroids
Systemic steroids
Lubricants
Mast cell stabilizers:
Sodium chromoglycate
Alomide Zaditen Livostin
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Red Eye in ChildrenRed Eye in Children