Allergies vs Pink Eye

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Hello,

I'm fairly new to school nursing (just switched out of the hospital at the end of last semester) so there are some things I'm still learning to judge appropriately. Several of our students have confirmed cases of both bacterial and viral pink eye. The pollen here in Texas also recently started raging and allergy season is in full effect but teachers are concerned that every student with itchy, watery, and/or pink eyes are actually infected and filling my clinic with these students. How do you tell the difference?

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Specializes in Pediatrics Retired.

I hear ya about the pollen...I have a white truck and every morning its yellow from the oak trees this time of year.

The only time I "do" anything about red eyes is when there is colored drainage, matting between the eyelashes, or that little dollop of green goo at the inner canthus. Otherwise I don't worry about it. If the teachers want to worry about it, that's OK.

Welcome to the farm!!

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Specializes in School Nurse, past Med Surge.

Within this really good thread, there is a link to another really good thread with pink eye charts.

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@JenTheSchoolRN has a great conjunctivitis chart with differentials

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Specializes in School Nursing.

The chair that is being referenced above is taped next to my desk. I LOVE it!

Also, Welcome!! ONE OF US! ONE OF US!

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Specializes in school nursing.

I have high schoolers, so they are more apt to keep the discharge from their eyes "clean"ish, so I question them about the color, texture, etc., and if their eye was matted when they woke up. Also, if it is only one eye, it is likely not allergies since it would affect both eyes.

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Specializes in ICU/community health/school nursing.

Does it feel better when they rinse their eyes? Does it itch or does it hurt? What did it look like this AM? Does a cool compress help?

Yes, itch, not goopy or "sealed shut," and yes...probably allergies. I say probably. If the kid continues to bounce back in , I'd send out for r/o conjunctivitis, just in case.

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On 3/28/2019 at 9:05 AM, OldDude said:

I hear ya about the pollen...I have a white truck and every morning its yellow from the oak trees this time of year.

The only time I "do" anything about red eyes is when there is colored drainage, matting between the eyelashes, or that little dollop of green goo at the inner canthus. Otherwise I don't worry about it. If the teachers want to worry about it, that's OK.

Welcome to the farm!!

Thank you! Those are the things I had been looking for but I had a couple of teachers send the kids right back and say that they felt like it wasn't just allergies. Thankfully, I have administration that trusts my judgement and allows me to make the final call.

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On 4/4/2019 at 9:44 AM, sweetsadie said:

Thank you! Those are the things I had been looking for but I had a couple of teachers send the kids right back and say that they felt like it wasn't just allergies. Thankfully, I have administration that trusts my judgement and allows me to make the final call.

I had the same issue with some teachers too!! I went ahead and sent them for medical advice and GUESS WHAT!!!! The one I thought was allergies....IS!! AND the one I thought was pink eye....IS!!! GO FIGURE!!! :):):)

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