What causes pediatric eye redness (conjunctival injection)?

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Differential Diagnosis for Pediatric Eye Redness

  • Single most likely diagnosis
    • Conjunctivitis (viral or bacterial): This is the most common cause of eye redness in children, often accompanied by discharge, itching, and tearing. The high prevalence of conjunctivitis in the pediatric population makes it the single most likely diagnosis.
  • Other Likely diagnoses
    • Allergic conjunctivitis: Seasonal or environmental allergies can cause eye redness, itching, and tearing in children. This condition is common, especially during peak allergy seasons.
    • Blepharitis: Inflammation of the eyelids can cause redness, itching, and crusting around the eyes. It's a common condition in children and can be associated with poor eyelid hygiene.
    • Dry eye syndrome: Although less common in children, dry eye can cause eye redness, especially if they have underlying conditions like blepharitis or use digital devices extensively.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Orbital cellulitis: A serious infection of the tissues surrounding the eye, which can lead to vision loss or more severe complications if not promptly treated. Symptoms include severe eye redness, swelling, pain, and limited eye movement.
    • Endophthalmitis: A rare but severe infection within the eye that can result from trauma, surgery, or blood-borne infection. It presents with severe eye pain, redness, and vision loss.
    • Uveitis: Inflammation of the uvea, which can be associated with systemic diseases or infections. If left untreated, it can lead to complications like cataracts, glaucoma, or vision loss.
  • Rare diagnoses
    • Kawasaki disease: A rare condition that can cause eye redness as part of its symptom complex, which includes fever, rash, and lymphadenopathy. It's essential to consider this diagnosis due to its potential for cardiac complications.
    • Sjögren's syndrome: An autoimmune disorder that can cause dry eye and other systemic symptoms. It's rare in children but should be considered in those with persistent eye symptoms and systemic complaints.
    • Stevens-Johnson syndrome: A severe skin and mucous membrane disorder, often drug-induced, which can cause eye redness and potentially lead to long-term vision problems.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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