What are the most common causes of conjunctivitis in childhood?

Conjunctivitis is an inflammation of the conjunctiva which is usually caused by infection or allergy.

It is frequently referred to as “pink eye” and is the most common acute eye disorder seen by primary care pediatricians and family physicians.

What are the characteristics of allergic conjunctivitis?

Allergic conjunctivitis is characterized by:

• Redness and itching around the eye
• Tearing (clear tears)
• Crusting of the eyelids
• Light-sensitivity

The condition is often recurrent and seasonal.

Children who have allergic conjunctivitis often have a history of other atopic diseases, particularly:

• Allergic rhinitis
• Eczema
• Asthma

What are the characteristics of an infectious conjunctivitis?

Infectious conjunctivitis may be bacterial or viral. Bacterial conjunctivitis is twice as common as viral conjunctivitis.

• Typically in bacterial conjunctivitis the eye is red, there is a purulent (pus) discharge, the affected child is often a preschooler and there may be an associated ear infection.
• In viral conjunctivitis, which usually occurs in older school-age children, is often associated with an upper respiratory infection, a common cold, and/or a sore throat. Its symptoms include watery discharge and variable itching in one eye, but may spread easily to the other.

What organisms are commonly involved in bacterial conjunctivitis?

The most common bacterial organisms causing conjunctivitis are Haemophilus Influenzae and Streptococcus pneumoniae.

• Haemophilus Influenzae conjunctivitis occurs in 40 percent to 50 percent of cases and is more likely to be associated with an accompanying ear infection than other organisms.
• Streptococcus Pneumoniae accounts for about 10 percent of cases and other organisms (Staphylococcus aureus, Bacteroides and Moraxella catarrhalis) account for the remainder.

What is the most common cause of viral conjunctivitis?

Adenovirus conjunctivitis is the most common cause of viral conjunctivitis and may account for up to 20 percent of infectious conjunctivitis.

Outbreaks of adenoviral conjunctivitis have been linked to contaminated equipment in ophthalmology clinics and to swimming pools.

Why is there a need to distinguish viral from bacterial conjunctivitis?

Viral and other non-purulent types of conjunctivitis do not require treatment with antibiotics. Often these children are treated mistakenly for prolonged periods of time with both topical and systemic antibiotics with persistence of the red eye.

In some situations the topical antibiotic itself may cause an allergic reaction resulting in a persistent red eye.

What is the treatment of choice for acute bacterial conjunctivitis?

Acute bacterial conjunctivitis is a self-limited condition. However, the use of antibiotic treatment is recommended because it hastens healing considerably and it eradicates the bacterial pathogen allowing children to return to daycare centers and schools within 24 hours of treatment.

What is the treatment for viral conjunctivitis?

Non-purulent viral conjunctivitis requires no treatment.

What is the treatment for allergic conjunctivitis?

Allergic conjunctivitis can be treated with a preparation for eyes containing a topical decongestant with or without antihistamine.

Where can I get more information?

Contact your doctor or the Southern Nevada Health District, Office of Epidemiology at (702) 759-1300.