Preventive Therapy

1. Good hand washing to decrease transmission.

2. Avoidance of allergen or irritant if allergic.

3. Neonatal prophylaxis with 1% silver nitrate, 0.5% erythromycin, or 1% tetracycline.

Problem Case Diagnosis. On examination, the 10-year-old girl had clear drainage involving both eyes, but no pruritus or pain. She complained of sore throat. Conjunctivae were injected in both eyes. No foreign body was visible. Eyelids were not edematous, and extraocular muscles and vision were intact. Preauricular adenopathy was noted bilaterally, and the oropharynx was injected without exudate. Clinical diagnosis is viral conjunctivitis (probably adenovirus). Patient's mother was counseled about use of cool compresses for comfort and importance of washing hands to prevent transmission. Family was asked to follow up in 3 days, and to call back sooner if worrisome features develop or symptoms worsen.

Teaching Pearl: Question. What is a common cause of mucopurulent eye discharge in neonates that is noninfectious in etiology?

Teaching Pearl: Answer. Neonates with malformation or incomplete canalization of a nasolacrimal tear duct can present with excessive tearing or mucopurulent discharge days or weeks after birth. The condition usually resolves with conservative treatment by 1 year of age.

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