Pediatric emergency medicine trisk 0579 0579
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TABLE 27.3
SYSTEMIC CONDITIONS THAT MAY BE ASSOCIATED WITH RED
EYE a
Collagen vascular disorders
Juvenile idiopathic arthritis
Infectious diseases
HSV, varicella zoster, measles, otitis media
Kawasaki disease
Inflammatory bowel disease
Cystic fibrosis
Vitamin A deficiency
Cystinosis
Leukemia
Ectodermal dysplasia
Trisomy 21
Cornelia de Lange syndrome
History of radiation therapy, including ocular field
History of bone marrow transplantation or graft-versus-host disease
Stevens–Johnson syndrome
a Not
a complete list: intended to demonstrate multiorgan representation.
The position of the eyelashes should be inspected before performing lid
eversion and examining the conjunctival fornices. Eyelashes that turn against the
ocular surface (trichiasis) may cause a red eye that is accompanied by pain or
foreign body sensation in the absence of lid swelling. Corneal fluorescein staining
from the lashes abrading the corneal epithelium may be so mild that it can only be
detected by slit-lamp biomicroscopy, even in symptomatic patients. Trichiasis is
particularly common in patients who have had prior injury or surgery to the
eyelid and in patients of Asian background. In the latter case, a prominent fold of
skin (epiblepharon) may be found medially just below the eyelid margin, causing
the lower lid medial eyelashes, and less commonly the upper lid lashes, to rotate
toward the eyeball.
