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I'm a GP and my 3 yr old daughter is day 5 into chickenpox

Hi, I'm a GP and...
Hi, I'm a GP and my 3 yr old daughter is day 5 into chickenpox and has developed unilateral episcleritis. PERLA and not c/o any discomfort, no discharge from the eye. Do I need to do anything?
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Answered in 3 hours by:
5/9/2011
Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11,654
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
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Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

It is more common for chicken pox to cause a conjunctivitis, with vessicles present on the limbus or the conjunctiva, then an episcleritis.

Dr. Rick :

In episcleritis the injection is due to engorgement of the episcleral vessels. These vessels run radially and can be seen underneath the conjunctiva. There can, at times, be concurrent conjuctivitis overlying the episcleral involvement.

Dr. Rick :

Treatment for mild episcleritis is artificial tears QID. If it is more severe, with pain, then a mild steroid, such as FML, QID will help. However, before using steroids I'd have an ophthalmologist have a look at her.

Dr. Rick :

If you think it could be more of a conjunctival issue, with periorbital or conjuctival vesicles or papules present, even without the 'usual' discharge of conjunctivitis, then I suggest erythromycin ointment TID and cool compresses.

Dr. Rick :

I am glad to hear that your daughter is not having any discomfort and (since you didn't mention it) her vision seems OK. Other structures of the eye can also be involved, such as the cornea, uvea (with uveitis, both anterior and posterior) and retina. It is uncommon, however, for this to occur during a primary outbreak in children.

Dr. Rick :

Does this make sense to you?

Dr. Rick :

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Dr. Rick
Dr. Rick, Board Certified MD
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Experience: Ophthalmology since 1994 with Retina sub-specialty interest
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Let me know if there is anything else you would like to discuss pertaining to this issue. It is always a pleasure to help my colleagues from "across the pond". ;o)
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My pleasure. I hope your daughter feels better soon. If you have any further questions, just post them to this thread or ask for me and I'll be happy to do what I can.
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Dr. Rick
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Experience: Ophthalmology since 1994 with Retina sub-specialty interest

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