Red eye in children

Red eye in children can result from a variety of conditions, ranging from benign to serious. Below is a comprehensive overview of the potential causes:

Infectious Causes

1. Conjunctivitis (Pink Eye):
   • Viral Conjunctivitis: Often caused by adenoviruses, highly contagious.
   • Bacterial Conjunctivitis: Commonly caused by Staphylococcus aureus, Streptococcus pneumoniae, and Haemophilus influenzae.
   • Allergic Conjunctivitis: Due to allergens like pollen, dust, or pet dander.
2. Keratitis:
   • Bacterial Keratitis: Often due to contact lens use or trauma.
   • Viral Keratitis: Commonly caused by herpes simplex virus.
3. Blepharitis:
   • Inflammation of the eyelids, often associated with bacterial infection or skin conditions like seborrheic dermatitis.

Inflammatory Causes

1. Uveitis:
   • Inflammation of the uveal tract, which can be idiopathic or associated with systemic diseases like juvenile idiopathic arthritis.
2. Episcleritis:
   • Inflammation of the episcleral tissue, usually benign and self-limiting.

Traumatic Causes

1. Foreign Body:
   • Presence of a foreign object in the eye can cause redness and irritation.
2. Corneal Abrasion:
   • Scratch on the cornea, often due to trauma or foreign bodies.
3. Chemical Exposure:
   • Exposure to irritants like chlorine in swimming pools or household cleaners.

Allergic Causes

1. Seasonal Allergies:
   • Pollen, grass, and other environmental allergens can cause red, itchy eyes.
2. Perennial Allergies:
   • Dust mites, mold, and pet dander can cause year-round symptoms.

Structural Causes

1. Chalazion:
   • A blocked meibomian gland causing a painless lump and redness.
2. Hordeolum (Stye):
   • Infection of the eyelash follicle or sebaceous gland, causing a painful red bump.

Systemic Causes

1. Kawasaki Disease:
   • A vasculitis that can cause conjunctival injection without exudate.
2. Juvenile Idiopathic Arthritis (JIA):
   • Can cause chronic uveitis, leading to red eye.

Other Causes

1. Dry Eye Syndrome:
   • Insufficient tear production or poor tear quality can cause redness and irritation.
2. Subconjunctival Hemorrhage:
   • Broken blood vessels under the conjunctiva, often due to trauma or straining.

Evaluation and Diagnosis

When evaluating red eye in children, healthcare providers consider several factors:

• Duration: Acute vs. chronic.
• Associated Symptoms: Pain, itching, discharge, vision changes, systemic symptoms.
• Examination Findings: Conjunctival injection, corneal clarity, pupil reactivity, intraocular pressure.

Diagnostic Tests:

• Slit-Lamp Examination: Detailed examination of the anterior segment of the eye.
• Fluorescein Staining: To detect corneal abrasions or ulcers.
• Conjunctival Swab: For culture and sensitivity in suspected bacterial conjunctivitis.
• Blood Tests: If systemic conditions like JIA or Kawasaki disease are suspected.

Conclusion

Red eye in children can be caused by a wide array of factors, ranging from benign to serious conditions. A thorough clinical evaluation, including history, physical examination, and appropriate diagnostic tests, is essential to determine the underlying cause and guide treatment. Parents should seek medical attention if their child has persistent or severe red eye, especially if accompanied by pain, vision changes, or systemic symptoms.

For more detailed information, consulting a healthcare provider or referring to medical literature is recommended.