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Pediatric Conjunctivitis

Pediatric Conjunctivitis. VIRAL EPIDEMIC KERATOCONJUNCTIVITIS. Starts in one eye and the effects the other one Swollen lids Bulbar conjunctivitis injection Subconjunctival hemorrhage. KERATOCONJUNCTIVITIS (cont). Epithelial keratitis Last 3 weeks Positive - subepithelial infiltrates

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Pediatric Conjunctivitis

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  1. Pediatric Conjunctivitis

  2. VIRAL EPIDEMIC KERATOCONJUNCTIVITIS • Starts in one eye and the effects the other one • Swollen lids • Bulbar conjunctivitis injection • Subconjunctival hemorrhage

  3. KERATOCONJUNCTIVITIS (cont) • Epithelial keratitis • Last 3 weeks • Positive - subepithelial infiltrates • Adenovirus serotypes 8 and 19

  4. ALLERGIC CONJUNCTIVITIS • Immediate hypersensitivity type I reaction due to degranulation of mast cells. • Degranulation of mast cells  release of histamine, leukotrienes • Hyperemia, vasodilation, itching and chemosis

  5. TREATMENT • Mast cells stabilizers (Livostin, Opticrom) • Inhibit mast cell degranulation and inhibit release of histamine eosinophil • Corticosteroids act on acute inflammation and hyperemia

  6. VERNAL CONJUNCTIVITIS • Upper tarsus involvedwith giant papillae that resemble cobblestones • Photophobia • Keratitis

  7. VERNAL CONJUNCTIVITIS (cont) • Onset 3-5 years until 10 years • Two types < limbal palpebral

  8. COMPLICATIONS • Keratopathy • Corneal ulcer • Shield ulcer

  9. TREATMENT • Opticrom • Livostin • Local steroids • Systemic steroids

  10. BLEPHARITIS Staphylococcal Blepharitis • Chronic bilateral irritation, burning and conjunctival injection • Secondary corneal involvement with subepithelial infiltrates or punctate erosions

  11. TREATMENT • Lid hygiene • Topical antibiotics

  12. CONJUNCTIVITIS AND SYSTEMIC DISEASE Steven Johnson Syndrome • Hypersensitivity reaction to drugs, or micro-organism • Immune complex vasculitis • Conjunctival scarring  destruction of goblet cells and obstruction of lacrimal gland ducts  mucous tear deficiency

  13. TREATMENT • Topical steroids • Topical antibiotics • Removal of symblepharon

  14. JRA - UVEITIS • 2% - 21% develop uveitis • Bilateral, chronic • Keratic precipitates • Post-synechial

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