• Allergic Conjunctivitis

• Amblyopia: The Lazy Eye

• Antibiotics

• Blocked tear ducts

• Conjunctivitis: Red Eye or Pink Eye

• Contact Lenses

• Convergence Insufficiency Therapy

• Eyeglasses in Children

• Headaches in Children

• Infants and Children with crossed eyes

• Juvenile Arthritis and associated eye problems

• Learning Disabilities and the eyes

• Nearsightedness, Farsightedness and Astigmatism

• Pediatric cataracts

• Ptosis

 

 

 

 


Antibiotics

Many antibiotics are effective when placed topically in the eye even though susceptibility studies might show resistance. The concentration of antibiotics placed topically in the eye is very large compared to blood levels. At this time, tobramycin can be purchased generically at very low cost and is a good first line agent as is polytrim. Antibiotics containing neomycin should generally be avoided due to the very high rate of allergic reaction, as high as 10-15%. There has been an alarming trend of the use of combined antibiotic-steroid eyedrops among pediatricians. We have seen 2 cases in which infantile glaucoma was induced in two different infants treated with topical steroids: children develop intraocular pressure elevation very commonly after treatment with topical steroids in as little as two weeks. Also, topical steroids will worsen herpes simplex keratitis, which is a very common cause of red eye in children (We often see 3-5 new cases weekly). One child treated with topical steroids for a red eye developed a large corneal scar due to worsening of the herpes infection in the cornea while on topical steroids. We strongly advise against the use of topical steroids by any primary care physician: you must be certain the child does not have herpes simplex and you must be capable of measuring intraocular pressure or the child can have significant ocular damage and the primary care physician will have significant liability.

With an acute red eye without injury, inspect the cornea carefully with a hand light for a foreign body. If a child has redness with significant pain and or photophobia, suspect iritis or corneal problem such as herpes simplex, corneal abrasion or foreign body. If the cornea is clear and no pain or photophobia is present, treat with a topical antibiotics QID. If no improvement occurs within 3-5 days, referral to an ophthalmologist is recommended.

 

 

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