Dangerous conjunctivitis

Gonococcal conjunctivitis usually develops anywhere from day 2 to 4, and presents with a hyperpurulent severe conjunctivitis.

Chlamydial conjunctivitis usually manifests from around day 4 to 5 up to day 7 to 8. It has a less purulent discharge and is a bilateral disease.

Unilateral conjunctivitis should make any practitioner -- pediatrician, primary care doctor, emergency department doctor, nurse -- stop, pause, and think, because bacterial conjunctivitis and viral conjunctivitis present in a bilateral fashion.

The second warning sign the child had was pain. Conjunctivitis itself is not a painful disease. With pain, you should start worrying about foreign bodies, trauma, and corneal epithelial breakdown.

Then, we get to the photophobia, or light sensitivity. Although you can get some photophobia with conjunctivitis, the severe photophobia in this case should, again, make you stop, pause, and think.

The final 2 warning signs in this case were poor vision and the lack of discharge at presentation. Visual loss does not occur from bacterial conjunctivitis. And finally, if this was bacterial conjunctivitis there would have been purulent discharge on presentation.

5 warning sign of a severe conjunctivis:
Pain
Unilateral
Worsening vision
Poor eye movement
Photophobia

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