Pediatric Conjunctivitis: Comparison
Please note this is a comparison between Version 1 by Emily Borman-Shoap and Version 3 by Peter Tang.

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. 

  • pediatric conjunctivitis
  • pink eye
  • pediatric ophthalmology
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References

  1. Kaufman, H.E. Adenovirus Advances: New Diagnostic and Therapeutic Options. Curr. Opin. Ophthalmol. 2011, 22, 290–293. References
  2. Sebastian, T.; Frost, H.M. A Qualitative Evaluation of Pediatric Conjunctivitis Medical Decision Making and Opportunities to Improve Care. J. Am. Assoc. Pediatr. Ophthalmol. Strabismus 2022, 26, 113.e1–113.e6. Kaufman, H.E. Adenovirus Advances: New Diagnostic and Therapeutic Options. Current Opinion in Ophthalmology 2011, 22, 290–293, doi:10.1097/ICU.0b013e3283477cb5.
  3. Rietveld, R.P. Diagnostic Impact of Signs and Symptoms in Acute Infectious Conjunctivitis: Systematic Literature Search. BMJ 2003, 327, 789. Sebastian, T.; Frost, H.M. A Qualitative Evaluation of Pediatric Conjunctivitis Medical Decision Making and Opportunities to Improve Care. Journal of American Association for Pediatric Ophthalmology and Strabismus 2022, 26, 113.e1-113.e6, doi:10.1016/j.jaapos.2021.12.008.
  4. Johnson, D.; Liu, D.; Simel, D. Does This Patient With Acute Infectious Conjunctivitis Have a Bacterial Infection?: The Rational Clinical Examination Systematic Review. JAMA 2022, 327, 2231. Rietveld, R.P. Diagnostic Impact of Signs and Symptoms in Acute Infectious Conjunctivitis: Systematic Literature Search. BMJ 2003, 327, 789–789, doi:10.1136/bmj.327.7418.789.
  5. Rietveld, R.P.; Riet, G.T.; Bindels, P.J.E.; Sloos, J.H.; Van Weert, H.C.P.M. Predicting Bacterial Cause in Infectious Conjunctivitis: Cohort Study on Informativeness of Combinations of Signs and Symptoms. BMJ 2004, 329, 206–210. Johnson, D.; Liu, D.; Simel, D. Does This Patient With Acute Infectious Conjunctivitis Have a Bacterial Infection?: The Rational Clinical Examination Systematic Review. JAMA 2022, 327, 2231, doi:10.1001/jama.2022.7687.
  6. Sheikh, A.; Hurwitz, B.; Van Schayck, C.P.; McLean, S.; Nurmatov, U. Antibiotics versus Placebo for Acute Bacterial Conjunctivitis. Cochrane Database Syst. Rev. 2012. Rietveld, R.P.; Riet, G.T.; Bindels, P.J.E.; Sloos, J.H.; Van Weert, H.C.P.M. Predicting Bacterial Cause in Infectious Conjunctivitis: Cohort Study on Informativeness of Combinations of Signs and Symptoms. BMJ 2004, 329, 206–210, doi:10.1136/bmj.38128.631319.AE.
  7. Honkila, M.; Koskela, U.; Kontiokari, T.; Mattila, M.-L.; Kristo, A.; Valtonen, R.; Sarlin, S.; Paalanne, N.; Ikäheimo, I.; Pokka, T.; et al. Effect of Topical Antibiotics on Duration of Acute Infective Conjunctivitis in Children: A Randomized Clinical Trial and a Systematic Review and Meta-Analysis. JAMA Netw. Open 2022, 5, e2234459. Buznach, N.; Dagan, R.; Greenberg, D. Clinical and Bacterial Characteristics of Acute Bacterial Conjunctivitis in Children in the Antibiotic Resistance Era: The Pediatric Infectious Disease Journal 2005, 24, 823–828, doi:10.1097/01.inf.0000178066.24569.98.
  8. Silverstein, B.E.; Allaire, C.; Bateman, K.M.; Gearinger, L.S.; Morris, T.W.; Comstock, T.L. Efficacy and Tolerability of Besifloxacin Ophthalmic Suspension 0.6% Administered Twice Daily for 3 Days in the Treatment of Bacterial Conjunctivitis: A Multicenter, Randomized, Double-Masked, Vehicle-Controlled, Parallel-Group Study in Adults and Children. Clin. Ther. 2011, 33, 13–26. Gigliotti, F.; Williams, W.T.; Hayden, F.G.; Hendley, J.O.; Benjamin, J.; Dickens, M.; Ford, R.; Gleason, C.; Perriello, V.A.; Wood, J. Etiology of Acute Conjunctivitis in Children. The Journal of Pediatrics 1981, 98, 531–536, doi:10.1016/S0022-3476(81)80754-8.
  9. Buznach, N.; Dagan, R.; Greenberg, D. Clinical and Bacterial Characteristics of Acute Bacterial Conjunctivitis in Children in the Antibiotic Resistance Era: Pediatr. Infect. Dis. J. 2005, 24, 823–828. Hu, Y.-L.; Lee, P.-I.; Hsueh, P.-R.; Lu, C.-Y.; Chang, L.-Y.; Huang, L.-M.; Chang, T.-H.; Chen, J.-M. Predominant Role of Haemoph-ilus Influenzae in the Association of Conjunctivitis, Acute Otitis Media and Acute Bacterial Paranasal Sinusitis in Children. Sci Rep 2021, 11, 11, doi:10.1038/s41598-020-79680-6.
  10. Asbell, P.A.; Colby, K.A.; Deng, S.; McDonnell, P.; Meisler, D.M.; Raizman, M.B.; Sheppard, J.D.; Sahm, D.F. Ocular TRUST: Nationwide Antimicrobial Susceptibility Patterns in Ocular Isolates. Am. J. Ophthalmol. 2008, 145, 951–958. Esra, N.; Hollhumer, R. Herpes Simplex Virus–Related Conjunctivitis Resistant to Aciclovir: A Case Report and Review of the Literature. Cornea 2021, 40, 1055–1058, doi:10.1097/ICO.0000000000002613.
  11. Varu, D.M.; Rhee, M.K.; Akpek, E.K.; Amescua, G.; Farid, M.; Garcia-Ferrer, F.J.; Lin, A.; Musch, D.C.; Mah, F.S.; Dunn, S.P. Conjunctivitis Preferred Practice Pattern®. Ophthalmology 2019, 126, P94–P169. Richards, A.; Guzman-Cottrill, J.A. Conjunctivitis. Pediatrics In Review 2010, 31, 196–208, doi:10.1542/pir.31.5.196.
  12. Frost, H.M.; Sebastian, T.; Durfee, J.; Jenkins, T.C. Ophthalmic Antibiotic Use for Acute Infectious Conjunctivitis in Children. J. Am. Assoc. Pediatr. Ophthalmol. Strabismus 2021, 25, 350.e1–350.e7. Sheng, J.; Joshi, M.; Williams, K.J.; Herce, H.H.; Allen, R.C. Epidemiologic Differences and Management of Eyelid Lesions in the Pediatric Population. J Pediatr Ophthalmol Strabismus 2022, 59, 405–409, doi:10.3928/01913913-20220210-02.
  13. Lee, T.; Kuo, I.C. Survey of State Conjunctivitis Policies for School-Age Students. J. Am. Assoc. Pediatr. Ophthalmol. Strabismus 2022, 26, 115.e1–115.e5. Chen, P.; Lin, X.-J.; Ji, F.; Li, Y.; Wang, S.-T.; Liu, Y.; Tao, Z.-X.; Xu, A.-Q. Evolutionary Phylogeography Reveals Novel Geno-types of Coxsackievirus A24 Variant and Updates the Spatiotemporal Dynamics in the Population with Acute Hemorrhagic Conjunctivitis. International Journal of Infectious Diseases 2022, 124, 227–239, doi:10.1016/j.ijid.2022.10.007.
  14. Than, T.; Morettin, C.E.; Harthan, J.S.; Hartwick, A.T.E.; Huecker, J.B.; Johnson, S.D.; Migneco, M.K.; Shorter, E.; Whiteside, M.; Olson, C.K.; et al. Efficacy of a Single Administration of 5% Povidone-Iodine in the Treatment of Adenoviral Conjunctivitis. Am. J. Ophthalmol. 2021, 231, 28–38. Nasiri, N.; Sharifi, H.; Bazrafshan, A.; Noori, A.; Karamouzian, M.; Sharifi, A. Ocular Manifestations of COVID-19: A Sys-tematic Review and Meta-Analysis. JOVR 2021, doi:10.18502/jovr.v16i1.8256.
  15. Azar, M.J.; Dhaliwal, D.K.; Bower, K.S.; Kowalski, R.P.; Gordon, Y.J. Possible Consequences of Shaking Hands With Your Patients With Epidemic Keratoconjunctivitis. Am. J. Ophthalmol. 1996, 121, 711–712. Pérez-Chimal, L.G.; Cuevas, G.G.; Di-Luciano, A.; Chamartín, P.; Amadeo, G.; Martínez-Castellanos, M.A. Ophthalmic Man-ifestations Associated with SARS-CoV-2 in Newborn Infants: A Preliminary Report. Journal of American Association for Pe-diatric Ophthalmology and Strabismus 2021, 25, 102–104, doi:10.1016/j.jaapos.2020.11.007.
  16. Castillo, M.; Scott, N.W.; Mustafa, M.Z.; Mustafa, M.S.; Azuara-Blanco, A. Topical Antihistamines and Mast Cell Stabilisers for Treating Seasonal and Perennial Allergic Conjunctivitis. Cochrane Database Syst. Rev. 2015. Bielory, L.; Delgado, L.; Katelaris, C.H.; Leonardi, A.; Rosario, N.; Vichyanoud, P. ICON:Diagnosis and Management of Allergic Conjunctivitis. Annals of Allergy, Asthma & Immunology 2020, 124, 118–134, doi:10.1016/j.anai.2019.11.014.
  17. Berger, W.E.; Granet, D.B.; Kabat, A.G. Diagnosis and Management of Allergic Conjunctivitis in Pediatric Patients. Allergy Asthma Proc. 2017, 38, 16–27. La Rosa, M.; Lionetti, E.; Reibaldi, M.; Russo, A.; Longo, A.; Leonardi, S.; Tomarchio, S.; Avitabile, T.; Reibaldi, A. Allergic Conjunctivitis: A Comprehensive Review of the Literature. Ital J Pediatr 2013, 39, 18, doi:10.1186/1824-7288-39-18.
  18. Heath Jeffery, R.C.; Dobes, J.; Chen, F.K. Eye Injuries: Understanding Ocular Trauma. Aust. J. Gen. Pract. 2022, 51, 476–482. Berger, W.E.; Granet, D.B.; Kabat, A.G. Diagnosis and Management of Allergic Conjunctivitis in Pediatric Patients. allergy asthma proc 2017, 38, 16–27, doi:10.2500/aap.2017.38.4003.
  19. Algarni, A.M.; Guyatt, G.H.; Turner, A.; Alamri, S. Antibiotic Prophylaxis for Corneal Abrasion. Cochrane Database Syst. Rev. 2022, 2022. Lindsley, K.; Matsumura, S.; Hatef, E.; Akpek, E.K. Interventions for Chronic Blepharitis. Cochrane Database of Systematic Reviews 2012, doi:10.1002/14651858.CD005556.pub2.
  20. US Preventive Services Task Force; Curry, S.J.; Krist, A.H.; Owens, D.K.; Barry, M.J.; Caughey, A.B.; Davidson, K.W.; Doubeni, C.A.; Epling, J.W.; Kemper, A.R.; et al. Ocular Prophylaxis for Gonococcal Ophthalmia Neonatorum: US Preventive Services Task Force Reaffirmation Recommendation Statement. JAMA 2019, 321, 394. Smadar, L.; Dotan, G.; Abumanhal, M.; Achiron, A.; Spierer, O. Demographic, Clinical Features, and Outcomes of Pediatric Non-Penetrating Ocular Foreign Bodies. Graefes Arch Clin Exp Ophthalmol 2020, 258, 1469–1474, doi:10.1007/s00417-020-04688-7.
  21. Franco, S.; Hammerschlag, M.R. Neonatal Ocular Prophylaxis in the United States: Is It Still Necessary? Expert Rev. Anti-Infect. Ther. 2023, 1–9. Loporchio, D.; Mukkamala, L.; Gorukanti, K.; Zarbin, M.; Langer, P.; Bhagat, N. Intraocular Foreign Bodies: A Review. Sur-vey of Ophthalmology 2016, 61, 582–596, doi:10.1016/j.survophthal.2016.03.005.
  22. Kapoor, V.S.; Evans, J.R.; Vedula, S.S. Interventions for Preventing Ophthalmia Neonatorum. Cochrane Database Syst. Rev. 2020, 2020, CD001862. Upshaw, J.E.; Brenkert, T.E.; Losek, J.D. Ocular Foreign Bodies in Children: Pediatric Emergency Care 2008, 24, 409–414, doi:10.1097/PEC.0b013e318177a806.
  23. Kates, M.M.; Tuli, S. Complications of Contact Lenses. JAMA 2021, 325, 1912, doi:10.1001/jama.2020.20328.
  24. Nucci, P.; Sacchi, M.; Pichi, F.; Allegri, P.; Serafino, M.; Dello Strologo, M.; De Cillà, S.; Villani, E. Pediatric Conjunctivitis and Air Pollution Exposure: A Prospective Observational Study. Seminars in Ophthalmology 2017, 32, 407–411, doi:10.3109/08820538.2015.1115088.
  25. Chang, C.-J.; Yang, H.-H.; Chang, C.-A.; Tsai, H.-Y. Relationship between Air Pollution and Outpatient Visits for Nonspecific Conjunctivitis. Invest. Ophthalmol. Vis. Sci. 2012, 53, 429, doi:10.1167/iovs.11-8253.
  26. Khan, A.; Anders, A.; Cardonell, M. Neonatal Conjunctivitis. NeoReviews 2022, 23, e603–e612, doi:10.1542/neo.23-9-e603.
  27. Manasseh, G.S.L.; Amarakoon, S.; Photiou, V.; Arruti, N.; Borman, A.D. Approach to Conjunctivitis in Newborns. BMJ 2022, e068023, doi:10.1136/bmj-2021-068023.
  28. Bothun, C.E.; Mansukhani, S.A.; Xu, T.T.; Hendricks, T.M.; Hodge, D.O.; Mohney, B.G. Incidence and Clinical Characteristics of Infantile Conjunctivitis in a Western Population. American Journal of Ophthalmology 2022, 241, 145–148, doi:10.1016/j.ajo.2022.04.008.
  29. Boffa, M.M.; Spiteri, A. Haemolacria: A Case of Pseudomembranous Conjunctivitis in a Neonate. BMJ Case Rep 2020, 13, e235110, doi:10.1136/bcr-2020-235110.
  30. Maqsood, N.; Mahmood, U. Herpes Simplex Ophthalmia Neonatorum: A Sight-Threatening Diagnosis. Br J Gen Pract 2020, 70, 513–514, doi:10.3399/bjgp20X712973.
  31. Kapoor, V.S.; Evans, J.R.; Vedula, S.S. Interventions for Preventing Ophthalmia Neonatorum. Cochrane Database of Systematic Reviews 2020, 2020, doi:10.1002/14651858.CD001862.pub4.
  32. Franco, S.; Hammerschlag, M.R. Neonatal Ocular Prophylaxis in the United States: Is It Still Necessary? Expert Review of Anti-infective Therapy 2023, 1–9, doi:10.1080/14787210.2023.2172401.
  33. Weatherby, T. Relative Frequencies of Ophthalmia Neonatorum and Congenital Nasolacrimal Duct Obstruction. Br J Gen Pract 2021, 71, 59.1-59, doi:10.3399/bjgp21X714905.
  34. Sheikh, A.; Hurwitz, B.; Van Schayck, C.P.; McLean, S.; Nurmatov, U. Antibiotics versus Placebo for Acute Bacterial Con-junctivitis. Cochrane Database of Systematic Reviews 2012, doi:10.1002/14651858.CD001211.pub3.
  35. Honkila, M.; Koskela, U.; Kontiokari, T.; Mattila, M.-L.; Kristo, A.; Valtonen, R.; Sarlin, S.; Paalanne, N.; Ikäheimo, I.; Pokka, T.; et al. Effect of Topical Antibiotics on Duration of Acute Infective Conjunctivitis in Children: A Randomized Clinical Trial and a Systematic Review and Meta-Analysis. JAMA Netw Open 2022, 5, e2234459, doi:10.1001/jamanetworkopen.2022.34459.
  36. Silverstein, B.E.; Allaire, C.; Bateman, K.M.; Gearinger, L.S.; Morris, T.W.; Comstock, T.L. Efficacy and Tolerability of Be-sifloxacin Ophthalmic Suspension 0.6% Administered Twice Daily for 3 Days in the Treatment of Bacterial Conjunctivitis: A Multicenter, Randomized, Double-Masked, Vehicle-Controlled, Parallel-Group Study in Adults and Children. Clinical Therapeutics 2011, 33, 13–26, doi:10.1016/j.clinthera.2010.12.004.
  37. Asbell, P.A.; Colby, K.A.; Deng, S.; McDonnell, P.; Meisler, D.M.; Raizman, M.B.; Sheppard, J.D.; Sahm, D.F. Ocular TRUST: Nationwide Antimicrobial Susceptibility Patterns in Ocular Isolates. Am J Ophthalmol 2008, 145, 951–958, doi:10.1016/j.ajo.2008.01.025.
  38. Varu, D.M.; Rhee, M.K.; Akpek, E.K.; Amescua, G.; Farid, M.; Garcia-Ferrer, F.J.; Lin, A.; Musch, D.C.; Mah, F.S.; Dunn, S.P. Conjunctivitis Preferred Practice Pattern®. Ophthalmology 2019, 126, P94–P169, doi:10.1016/j.ophtha.2018.10.020.
  39. Frost, H.M.; Sebastian, T.; Durfee, J.; Jenkins, T.C. Ophthalmic Antibiotic Use for Acute Infectious Conjunctivitis in Children. Journal of American Association for Pediatric Ophthalmology and Strabismus 2021, 25, 350.e1-350.e7, doi:10.1016/j.jaapos.2021.06.006.
  40. Lee, T.; Kuo, I.C. Survey of State Conjunctivitis Policies for School-Age Students. Journal of American Association for Pediatric Ophthalmology and Strabismus 2022, 26, 115.e1-115.e5, doi:10.1016/j.jaapos.2022.02.002.
  41. Than, T.; Morettin, C.E.; Harthan, J.S.; Hartwick, A.T.E.; Huecker, J.B.; Johnson, S.D.; Migneco, M.K.; Shorter, E.; Whiteside, M.; Olson, C.K.; et al. Efficacy of a Single Administration of 5% Povidone-Iodine in the Treatment of Adenoviral Conjuncti-vitis. American Journal of Ophthalmology 2021, 231, 28–38, doi:10.1016/j.ajo.2021.05.018.
  42. Azar, M.J.; Dhaliwal, D.K.; Bower, K.S.; Kowalski, R.P.; Gordon, Y.J. Possible Consequences of Shaking Hands With Your Patients With Epidemic Keratoconjunctivitis. American Journal of Ophthalmology 1996, 121, 711–712, doi:10.1016/S0002-9394(14)70640-3.
  43. Castillo, M.; Scott, N.W.; Mustafa, M.Z.; Mustafa, M.S.; Azuara-Blanco, A. Topical Antihistamines and Mast Cell Stabilisers for Treating Seasonal and Perennial Allergic Conjunctivitis. Cochrane Database of Systematic Reviews 2015, doi:10.1002/14651858.CD009566.pub2.
  44. Heath Jeffery, R.C.; Dobes, J.; Chen, F.K. Eye Injuries: Understanding Ocular Trauma. Aust J Gen Pract 2022, 51, 476–482, doi:10.31128/AJGP-03-21-5921.
  45. Algarni, A.M.; Guyatt, G.H.; Turner, A.; Alamri, S. Antibiotic Prophylaxis for Corneal Abrasion. Cochrane Database of Sys-tematic Reviews 2022, 2022, doi:10.1002/14651858.CD014617.pub2.
  46. US Preventive Services Task Force; Curry, S.J.; Krist, A.H.; Owens, D.K.; Barry, M.J.; Caughey, A.B.; Davidson, K.W.; Doubeni, C.A.; Epling, J.W.; Kemper, A.R.; et al. Ocular Prophylaxis for Gonococcal Ophthalmia Neonatorum: US Preventive Services Task Force Reaffirmation Recommendation Statement. JAMA 2019, 321, 394, doi:10.1001/jama.2018.21367.
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