Infants with conjunctivitis rarely develop vision-threatening infections

While infantile conjunctivitis can affect up to 10% of children in the first year of life, vision-threatening infections are very uncommon.

Study design

Investigators performed a retrospective analysis of a population-based cohort of infants (aged <12 months) diagnosed with conjunctivitis between 2005 and 2014 who were included in the Rochester Epidemiology Project (Olmstead County, MN) database. The incidence, clinical features, and treatments of conjunctivitis were reviewed, including cultures for infectious agents.

Outcomes

In total, 2175 infants were diagnosed with conjunctivitis, for a mean incidence rate of 10,422 per 100,000; 3% were diagnosed with conjunctivitis by age 30 days. The mean age at diagnosis was 4.9 months, and 54.3% had bilateral conjunctivitis. Sight-threatening infectious agents were rare; only 3 infants aged ≤30 days tested positive for Chlamydia, while 40.5% of infants in this age group had a completely negative culture for all infectious agents. Ninety-one percent of those with positive cultures were treated with topical antibiotics.

Limitations

Limitations of this study included the use of retrospective non-standardized data and that 82.1% of the conjunctivitis diagnoses were made by a primary care provider rather than an ophthalmologist or optometrist. Also, this cohort population data represents only one county in the United States, with a reported population that is 82% non-Hispanic White.

Clinical significance

Results from this study indicate that the rate of vision-threatening infectious agents from infantile conjunctivitis is very low. Moreover, treatment is generally straightforward, consisting primarily of topical antibiotics.