Disorders of the eye: infection and inflammatory
Eye infections are common in
childhood and largely due to bacterial or viral infections affecting the
Common in the neonatal period
starting from the 3rd or 4th day. Swabs are usually negative for significant
pathogens. Simple cleaning measures are usually sufficient. Bacterial infection
with either Staphylococcus aureus, Pseudomonas aeruginosa, or streptococcal
pathogens can occur.
Topical antibiotic ointment is indicated, e.g. neomycin.
Should be suspected if purulent
discharge with swelling of the eyelids oc-curs within the first 48hr of life.
IV antibiotics required,
Usually presents at the end of the
first week of life. Diagnosis established by specific monoclonal antibody test
performed on conjunctival secre-tions.
Two-week course of oral
erythromycin or topical tetracycline eye
ointment is required.
May be due to bacteria (e.g. Gram
+ve cocci or Haemophilus influenzae),
virus (e.g. adenovirus), or to allergic reaction.
Specific antibiotic eye drops or
ointment (e.g. fusidic acid or gentamicin)
for 5 days is required.
Acute allergic conjunctivitis can
cause rapid onset lid swelling and chemo-sis (conjunctival oedema).
Seasonal/perennial forms present with other features of atopy. Vernal
kerato-conjunctivits is a chronic allergic con-junctivitis which is painful and
can cause photosensitivity due to corneal involvement. Topical mast cell
stabilizers and antihistamines can improve symptoms. Topical steroids are
occasionally necessary, but should only be prescribed by a specialist.
Keratitis is an inflammation or
infection of the cornea, which can lead to corneal scarring and requires urgent
specialist management. Symptoms in-clude FB sensation, pain, and photophobia
with a red eye. It can occur due to viral infection, e.g. HSV or adenovirus in
conjunction with skin lesions or conjunctivitis. Bacterial keratitis can occur
secondary to corneal exposure in the hospital setting or secondary to contact
lens use. Staphylococcal hypersensitivity is a common cause of keratitis in
children with blepharitis. Keratitis can also occur as a toxic effect of
Also known as anterior uveitis.
Refers to inflammation of the uveal tract structures (i.e. iris, ciliary body,
and choroids). It is characterized by symp-toms of:
precipitates on ophthalmoscopic examination.
Long-term disease may be
complicated with the development of cataract, glaucoma, and macular eye
Local infection: e.g. herpes simplex/zoster.
positive, ankylosing spondylitis, Reiter’s
syndrome, psoriatic arthritis.
Referral to the ophthalmologists
and treatment with topical steroid
drops/ointment and mydriatic agents are required.