Conjunctivitis in Infancy and Childhood

Abstract

Conjunctivitis is one of the most common afflictions affecting the eyes. Practically every microorganism, from viruses to bacteria have been implicated as causes of conjunctivitis. Depending upon the etiologic agent, conjunctivitis may range from a mild self-limited infection to one that can destroy vision and even be life-threatening. This review will be divided into two sections covering conjunctivitis in older infants and children and ophthalmia neonatorum, which has a different epidemiology. CONJUNCTIVITIS BEYOND THE NEONATAL PERIOD Epidemiology and Etiology Bacterial infection probably accounts for most of acute conjunctivitis in children. The organisms thought to be most common are Staphylococcus aureus, Haemophilus species including H influenzae and H aegyptius, and Streptococcus pneumoniae (Table I). Bacterial infection is frequently characterized by a purulent or mucopurulent discharge which is usually the source of transmission of infection. Towels and other commonly used articles may spread the infection from one person to another. Although Staph aureus has traditionally been assumed to be a pathogen, the organism is frequently isolated from the conjunctivae of individuals without conjunctivitis.1,2 In a recent prospective study of acute conjunctivitis in children,1 Staph aureus was isolated from 24% of the children with acute conjunctivitis and 16% of the control subjects, a nonsignificant difference. It has been hypothesized that the increased isolation rate of Staph aureus seen in conjunctivitis may be secondary to the wetter environment of the infected eye rather than a direct cause of the infection.