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A. Gupta, K. Mukkamala, L. Spielberg, L. Hall; Incidence of Pediatric Conjunctivitis in the Urgent Care Setting. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1318.
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To determine epidemiologic trends among pediatric patients who are diagnosed with conjunctivitis upon presentation for an ocular emergency.
Retrospective chart review. Of 7,310 patients that presented for urgent care at a tertiary care ophthalmic referral center in 2008, 479 patients were under the age of 18. We reviewed the charts of 74 of these patients who were diagnosed with conjunctivitis.
Of the 74 patients, 26% (n=19) were allergic, 17% (n=13) were bacterial, and 57% (n=42) were viral. Mean age in years was 7.7±5.7 (all conjunctivitis), 8.2±5.1 (allergic), 5.27± 6.1 (bacterial), and 8.15±5.8 (viral). Incidence of allergic conjunctivitis has a peak between April and July with 89% of patients presenting in this period. Bacterial conjunctivitis has no clear predilection for time of year unlike viral conjunctivitis for which 45% of patients present in a peak between July and September. Of those diagnosed with viral conjunctivitis, most were given no treatment (n=25, 59%). The remaining were given antibiotic only (n=12, 29%), steroid only (n=2, 5%), or an antibiotic/steroid combination (n=3, 7%)
In the urgent care setting, differentiating allergic, bacterial, and viral conjunctivitis in the pediatric population can be difficult because clinical signs can be very similar. We analyzed data on the incidence of the three sub-groups of conjunctivitis to provide insight into frequency of presentation. Viral is the most common diagnosis followed by allergic and bacterial. Patients that present in spring to early summer (April - July) might be more likely to have allergic inflammation whereas patients that present in late summer to early fall (July - September) may be more likely to have viral conjunctivitis. We propose that when clinical signs are insufficient to provide a definitive diagnosis of the etiology of conjunctivitis in the urgent care setting, knowledge of peaks in incidence may provide a further clue needed for management.
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