Pediatric emergency medicine trisk 0576 0576
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an ophthalmologist can help ensure that a corneal ulcer is not missed by ascribing
the red eye to one of these other etiologies. It is therefore recommended that all
contact lens wearers with a red eye be seen by an ophthalmologist.
Numerous systemic diseases may be associated with ocular inflammation.
Select examples can be found in Table 27.3 . In some systemic diseases, the
associated ocular abnormality involves intraocular inflammation (iritis, vitritis),
which can then cause secondary conjunctival infection or inflammation. Patients
with these diseases may also have coincidental ocular inflammation unrelated to
their underlying conditions. Ophthalmology consultation may be helpful in
making this distinction. For example, in Kawasaki disease, the inflammation of
the conjunctiva may be associated with mild iritis. More often, the conjunctiva is
inflamed in isolation as part of the systemic mucous membrane involvement. The
conjunctivitis of Kawasaki disease is usually confined to the bulbar conjunctiva,
often with limbal sparing ( Fig. 27.4 ), with little or no discharge. In contrast, the
bulbar and palpebral conjunctivae are inflamed in infectious conjunctivitis (Fig.
123.7 ).
