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Saturday, July 2, 2022

Ask the doctor: How can I erase my child’s recurrent conjunctivitis once and for all?

Question: For almost three months, my two-year-old constantly got conjunctivitis. It revolved around her crib at the end of February, and for sure, she picked it up there. She was prescribed three different antibiotic eye drops that seem to clear up after about a week, but she seems to be coming back for another week after that. I was very careful to wash her bedding every day and wash her toys as much as possible. How can I get rid of this once and for all?

Dr. Grant answers: The medical term for the white part of your eye is sclera. The sclera covers almost the entire surface of the eyeball and provides connections for the muscles that control the movement of the eyeball. On the front part of the eye, the part that we can see in the mirror, the sclera is lined with conjunctiva – a transparent thin membrane of loose connective tissue. The conjunctiva covers not only the front part of the eyeball, but also the lower surface of the eyelids. Together with the production of tears from the lacrimal glands, the conjunctiva helps to lubricate the eye and provides protection from dust, debris and infections.

Conjunctivitis (inflammation of the conjunctiva) is one of the most common causes of red eyes. The underlying cause can be infectious (bacterial or viral, both highly contagious) or non-infectious (eg caused by allergies). Itching largely indicates allergic conjunctivitis and the characteristic of infectious conjunctivitis is usually not prominent.

Most infectious cases are viral. However, bacterial conjunctivitis is more common in children than in adults. Bacterial conjunctivitis is spread by direct contact with the patient and his secretions, or with contaminated objects and surfaces. There are probably many reasons why this is so, as children’s hand hygiene is not so good and they tend to put their hands on their faces much more often than adults.

During an eye infection, the whites of the eyes usually have a red / pink color (erythema), white / green / yellow secretions or pus, especially in the morning (when the affected eye is often covered or stuck) and even mild eye pain, often described as a feeling of tingling, sand or sand, which is aggravated by blinking.

Infectious conjunctivitis tends to respond to topical antibiotic eye drops within 24 hours, certainly after 48 hours. At this point, you need to continue treatment for another 48 hours after the eye condition improves. In theory, only bacterial conjunctivitis should be prescribed antibiotic therapy. But in reality, it can be difficult to tell the difference (in terms of clinical signs and symptoms) between the two types of infection. Generally, a total of five days of treatment is enough, but sometimes you may have to go for seven days.

In my opinion, you are probably already doing your best to prevent conjunctivitis again. Young children in day care centers tend to pick up everything they visit. There is no need to change all of her bedding every day, but it seems reasonable to change her pillowcase more than once a week.

If your daughter’s eye infection recurs, you may want to consider taking her to a local optician for a slit lamp examination. This will confirm the diagnosis and guide you in the right direction regarding treatment. The optician will discuss eyelid hygiene and routine care to prevent infection.

Dr. Jennifer Grant is a general practitioner with Beacon HealthCheck

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