Head to Toes, Part 2: The Eyes in the Pink
Not wanting to hone in on Dr. Lloyd's eye board, but various eye complaints are commonplace on a primary care office and also frequent questions on the General Health Board. Since my blog description mentions that I will discuss pinkeye at some point, I might as well do it.
In pediatrics, conjunctivitis (pink eye) tops the list. The eyes are quite sensitive to a variety of biological and environmental insults, from colds and allergies to bacterial infections and plain 'ol smog. For parents, anything that makes the eyes red is cause for concern. Schools and day-care facilities seem to consider pink eye in the same serious category as Ebola virus or meningitis. No sooner than a red eye is spotted, the child is isolated and the parent is called...for good reason. Depending on the cause, conjunctivitis can spread like bad rumor.
Viral conjunctivitis is probably the most common cause of pink eye and is highly contagious. It can be very difficult to distinguish conjunctivitis caused by a virus, or one caused by bacteria. Typically, the discharge of bacterial conjunctivitis is more purulent (pus-like, green, yucky). Most of the time, people are prescribed antibiotic eye solutions or ointments, even though the exact cause may not be clear. If it is bacterial, the medication will help. If it is viral, the parents will have something to do while God gets them better.
Putting eye medication in children is often a challenge. In the past, we would routinely prescribe sulfacetamide which burn like Hell. Most of the eye medications we use now do not burn very much, but for an irritated eye even water burns. One helpful way to administer eye medication to reluctant children is to allow them to close their eyes. Put a drop or two of the antibiotic eye solution in the corner of each eye. As soon as that eye opens, the drops will slide home. If the child refuses to open the eyes, you can just pull down gently on the lower lid and the drops should fall in place. The eye does not store more than a drop, so if you have to use several drops to get one in there, you will not have an overdose. The extra eye drops will just run down the cheek or go into the nose.
Several years ago, my PA wife and I went on a one week sea kayaking trip on the Sea of Cortez. As the only medical people on the trip, we were responsible for providing the first aid supplies. My wife took this job quite seriously and put together enough medical supplies for an army unit. We had suture sets, splints, and virtually every drug you could name, including some sulfacetamide solution for pinkeye.
The kayak has very limited storage space, and I was more concerned with the amount of food we were packing, not the medication. As I started to whittle down her pharmacy, I spotted the eye medication. "We do not need pink eye medication. We are all adults. When was the last time you had pink eye?" Her response was that the bottle was small and we are taking it.
Two days into the trip, I had to eat my words (instead of all of the food I packed), for all eight of us had red, oozing eyes. Apparently, after a few days of camping in Mexico, adults take on the hygiene levels of a two-year-old. We had to share that one bottle of sulfacetamide...the only first aid item that we used for the entire trip. And, yes, it burned like Hell. I stopped using it in kids from that moment on. However, I still use it from time to time for very annoying adult patients.
Most of the time, children can return to school or day-care a day or so after treatment, assuming they are improving. It is better if the facilities will allow the medication to be administered during the day.
Hand-washing is the most important preventative method in preventing the spread of infectious conjunctivitis. If the child does not touch or rub the eyes (difficult to prevent), the microorganisms will not jump off of one person's eye onto another. The spread is primarily by hands, or hands to objects, such as towels.
Medical providers certainly have the opportunity, but do not have the time to experience all the diseases that they treat. In spite of our challenged immune systems, we do get sick occasionally. All of us learn from those experiences.
Related Topics: Eye Health, Which Hand Washing Cleansers Fight Germs Best?
Technorati Tags: eyeinfection, pinkeye, conjunctivitis, daycare,
In pediatrics, conjunctivitis (pink eye) tops the list. The eyes are quite sensitive to a variety of biological and environmental insults, from colds and allergies to bacterial infections and plain 'ol smog. For parents, anything that makes the eyes red is cause for concern. Schools and day-care facilities seem to consider pink eye in the same serious category as Ebola virus or meningitis. No sooner than a red eye is spotted, the child is isolated and the parent is called...for good reason. Depending on the cause, conjunctivitis can spread like bad rumor.
Viral conjunctivitis is probably the most common cause of pink eye and is highly contagious. It can be very difficult to distinguish conjunctivitis caused by a virus, or one caused by bacteria. Typically, the discharge of bacterial conjunctivitis is more purulent (pus-like, green, yucky). Most of the time, people are prescribed antibiotic eye solutions or ointments, even though the exact cause may not be clear. If it is bacterial, the medication will help. If it is viral, the parents will have something to do while God gets them better.
Putting eye medication in children is often a challenge. In the past, we would routinely prescribe sulfacetamide which burn like Hell. Most of the eye medications we use now do not burn very much, but for an irritated eye even water burns. One helpful way to administer eye medication to reluctant children is to allow them to close their eyes. Put a drop or two of the antibiotic eye solution in the corner of each eye. As soon as that eye opens, the drops will slide home. If the child refuses to open the eyes, you can just pull down gently on the lower lid and the drops should fall in place. The eye does not store more than a drop, so if you have to use several drops to get one in there, you will not have an overdose. The extra eye drops will just run down the cheek or go into the nose.Several years ago, my PA wife and I went on a one week sea kayaking trip on the Sea of Cortez. As the only medical people on the trip, we were responsible for providing the first aid supplies. My wife took this job quite seriously and put together enough medical supplies for an army unit. We had suture sets, splints, and virtually every drug you could name, including some sulfacetamide solution for pinkeye.
The kayak has very limited storage space, and I was more concerned with the amount of food we were packing, not the medication. As I started to whittle down her pharmacy, I spotted the eye medication. "We do not need pink eye medication. We are all adults. When was the last time you had pink eye?" Her response was that the bottle was small and we are taking it.
Two days into the trip, I had to eat my words (instead of all of the food I packed), for all eight of us had red, oozing eyes. Apparently, after a few days of camping in Mexico, adults take on the hygiene levels of a two-year-old. We had to share that one bottle of sulfacetamide...the only first aid item that we used for the entire trip. And, yes, it burned like Hell. I stopped using it in kids from that moment on. However, I still use it from time to time for very annoying adult patients.
Most of the time, children can return to school or day-care a day or so after treatment, assuming they are improving. It is better if the facilities will allow the medication to be administered during the day.
Hand-washing is the most important preventative method in preventing the spread of infectious conjunctivitis. If the child does not touch or rub the eyes (difficult to prevent), the microorganisms will not jump off of one person's eye onto another. The spread is primarily by hands, or hands to objects, such as towels.
Medical providers certainly have the opportunity, but do not have the time to experience all the diseases that they treat. In spite of our challenged immune systems, we do get sick occasionally. All of us learn from those experiences.
Related Topics: Eye Health, Which Hand Washing Cleansers Fight Germs Best?
Technorati Tags: eyeinfection, pinkeye, conjunctivitis, daycare,
2 Comments:
CPAC on Goldhawk tonight has the childcare issue and people are welcome to call in if your interested... www.cpac.ca
"Fund the Child" Movement
The RPS Adeno Detector provides health care professionals with a true point of care test for infectious conjunctivitis. The test requires only 10 minutes to obtain a result that can aid health care professionals to make an accurate diagnose, foster patient acceptance of more supportive therapy, and identify contagious viral conjunctivitis which does not improve with topical antibiotics and needs more time away from work, school, or daycare, and limits the spread of disease and complications while simultaneously reducing ocular antibiotic problems. The management style utilizing empiric antibiotic treatment may not only increase the risk of antibiotic resistance, side effects, allergies, and corneal toxicity, but also may lead to increased cost to the individual and society as a whole.
www.conjunctivitis.blogspot.com
www.pinkeyedetectors.blogspot.com
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