Conjunctivitis

ruby_jane, BSN, RN · Dec 5, 2018

Bless that doctor's office. Really. Whatever. That's just not helpful.

Redness that seems to resolve with a cool pack, that is not itchy, crusty or matted...that can stay. Goopy conjunctival redness to the whole eye...that's gotta go. And since I can't differentiate I will be sending all of that out.

Re: the teachers - I said at the beginning of the year that I needed to ask for grace in advance because I was sure I would send a kid back to them and it would turn out that the kid was actually sick but did not have symptoms severe enough to qualify for dismissal. It will happen. Just like they will send us students who aren't really ill.... Grace, people! Grace!!

Sorry that got a little ranty. Good luck!

CanIcallmymom, BSN, RN · Dec 5, 2018

In TX, we exclude for conjunctivitis per Dept of Health. Readmission criteria: Permission and/or permit is issued by a physician or local health authority or until symptom free.

If it is just red, dry eyes, they get a cool moist cloth for a few minutes and go back to class. I ask them how their eye was when they woke up and about drainage, this usually is my determination. I don't send them home if it is just red. I do educate on proper and frequent hand washing and tell them to keep an eye out of excessive drainage and to report to me if it is during the school day or to their parents at home.

JenTheSchoolRN, BSN, RN · Dec 5, 2018

What ruby_jane said.

I work with older kids. Conjunctivitis is so very often viral and resolves on its own. When I suspect bacterial (constant crustiness that returns even after you wipe the eye, discolored discharge, severe edema, moderate to severe erythema, blurry vision that can clear with blinking but returns after) out the student goes. Warm or cool pack that helps with redness and mild symptoms, student stays put (but I will call home of course).

Now younger ones, I might do differently depending on age group and symptoms.

I have charts attached I use.

OldDude · Dec 5, 2018

I only "do" something when I see the goo stringers on the eyelashes, globules of gunch on the inner canthus, or green/brown drainage. Otherwise it's back to class and wait and see.

LikeTheDeadSea, MSN, RN · Dec 5, 2018

I have charts attached I use.

I use these charts too. Bless their existence.

BunnyBunnyBSNRN, ASN, BSN · Dec 5, 2018

I sent one home the other day that had unilateral redness, pain, and itch. She said her eye was "glued" shut when she woke up. Mom called back to say not only did she have conjunctivitis, but a URI as well and would return on Friday.

Typically if it's only one eye, I suspect pinkeye and, depending on the severity of the symptoms at the moment, will either send home or call home to let mom know to keep an eye on it.

Farawyn · Dec 5, 2018

What is your school's policy on students with "pink eye". I dread seeing kids with pink eyes because I hate making the decision to send them home. My school system is no help. Parents complain and teachers breathe down the back of my neck and say that their eye is pink and they don't want the whole class exposed (I totally understand). I got a note from a doctor's office today saying that "overreacting over a pink eye is not helpful". Basically saying I shouldn't have sent the kid to be checked out. His eye was red/pink, tearing, swollen, no crust along eyelid, and student reported pain and itching. What do you do?

First of all, doc can stuff it. If you didn't suggest a doc for those symptoms, everyone would be up in arms.

I send home for symptoms like that. If it's B/L eyes, no drainage or discomfort, I suspect allergies, keep them here, but still give a call home.