Childhood Eye Problems

Abstract

The articles in this issue of Pediatric Annals focus on common ocular problems that usually present initially to the child’s primary care provider. Pediatricians and other primary care providers are typically the ones who need to recognize the child with strabismus, cataract, amblyopia, and leukocoria for referral for ophthalmologic care. In addition, acute conjunctivitis may be viral or bacterial, and there are a number of therapeutic options. These topics are all covered well in the articles in this issue. Assessment of the normal red refl ex, the normal corneal light refl ex, and normal cover tests are all important in screening for signifi cant ocular abnormalities, some with very important long-term consequences. With respect to conjunctivitis, I would be remiss if I did not take this opportunity to suggest that Kawasaki disease should be considered in the child who presents with some days of fever and bilateral injected bulbar conjunctivae without exudate or drainage from the eyes. This presentation is one of the most consistent fi ndings in Kawasaki disease and should prompt a careful search (by history and physical exam) for other classic Kawasaki disease symptoms or signs. Should there be enough other features to prompt concern about the possibly of a complete or an incomplete (or atypical) case of Kawasaki disease, laboratory studies, including C-reactive protein (CRP) and/or erythrocyte sedimentation rate (ESR), can be very valuable.