Early detection and treatment for pediatric eye conditions highlighted at Optometry’s Meeting 2024

Early detection, prompt and appropriate treatment, and careful monitoring of pediatric anterior segment eye conditions, such as infections and allergies, are crucial to prevent complications and ensure optimal health outcomes for children, according to a presentation by Dr Amy Waters, OD, FAAO at Optometry’s Meeting 2024.

During the presentation, Dr Waters covered eye infections and allergies in children, including specific characteristics and treatment protocols for a range of conditions including periorbital and orbital cellulitis, allergic conjunctivitis, and keratoconjunctivitis.

Periorbital and Orbital Cellulitis
Periorbital cellulitis, an infection of the soft tissues surrounding the eye, can arise from sinusitis, trauma, or unknown causes. It’s crucial to treat this condition promptly with oral antibiotics to prevent progression to the more severe orbital cellulitis, which involves deeper infection within the eye orbit. Orbital cellulitis is often linked to sinus infections and requires hospitalization, imaging, and intravenous antibiotics due to its severity.

Allergic Conjunctivitis
Allergic conjunctivitis, affecting a significant portion of the population, manifests as itching and redness of the eyes without corneal involvement. The condition is often seasonal and can be managed with topical antihistamines like olopatadine (Pataday) and ketotifen (Zaditor).

Vernal and Atopic Keratoconjunctivitis
Vernal keratoconjunctivitis (VKC), primarily affecting boys in their first decade of life, often resolves by adolescence but can cause complications such as corneal scarring. Treatment includes topical steroids and immunomodulators like cyclosporine (Verkazia). Atopic keratoconjunctivitis, though less common in young children, requires similar management strategies and is associated with atopic dermatitis.

Herpes Simplex Virus Infections
Herpes Simplex Virus (HSV) dermatitis and keratitis, caused by HSV-1, present significant risks for children, especially infants, due to their higher recurrence rates and potential for vision loss. Treatments include oral antivirals like acyclovir and valacyclovir. Prompt diagnosis and management are crucial, particularly in severe cases that may require hospitalization.

Dr Waters’ presentation also highlighted the importance of considering trauma in the context of potential child abuse. When evaluating cases of periorbital cellulitis with a history of trauma, healthcare providers are advised to assess for signs that could suggest physical abuse carefully. Key indicators include inconsistent histories, the pattern and nature of injuries, and the presence of multiple injuries at different stages of healing. It is essential for clinicians to maintain a high index of suspicion and to document findings thoroughly, ensuring that any concerns are reported to the appropriate authorities to protect the child’s safety and well-being.

Reference
Waters A. Common Pediatric Anterior Segment Conditions. Presented at: Optometry’s Meeting 2024; June 19-22: Nashville.