Question about pink eye

[ro2878, ADN, BSN]

My school has been slammed with pink eye this past week. We are a district school but an early childhood campus with infants through preK. Given the age of our students, pink eye is even more contagious than it normally is.

My question is: can you have pink eye with just the crusty eyelashes but without the pink/red conjunctiva?

I know the different types of pink eye and typical sxs (viral, bacteria, allergic) but had 1 kiddo with just the crust (and not just the normal "sleep crust"). I asked a mom to pick him up because his little sister was dx'd by their physician with an URI & viral conjunctiva. I know because I had to administer her gtts (and yes it was viral & the dr rx'd the antibacterial gtts as a lot of doctors will). Anyway, the kiddo came back to school the next day with his dr note stating that he had an ear infection but not pink eye and that the crust was from fluid from the ears coming out of his eyes.

Anyone ever hear of this? Also, do you send kids home with just the crust or do they need the red eyes to be sent home? What is your policy?

Thanks for your input!

[Jolie, BSN]

I suppose it might be possible for someone to have an eye infection without obvious redness, for example someone with immune suppression who is unable to mount an inflammatory response.

If I understand correctly, this child was seen by a doctor who ruled out an eye infection, so unless you have some very clear-cut evidence otherwise, there is probably no reason to exclude him from school.

I wonder if the note was written by a ma or unlicensed staff member who didn't understand the provider's explanation. It sounds to me like perhaps he had a blocked tear duct.

[chrisrn24]

I had pink eye last month, and my eye just hurt terribly, but the conjunctiva wasn't red at all. The reason I knew I had pink eye is when I woke up, my eye was really crusted shut. So I do think it's possible.

[Nurse ABC]

It is possible but not usual. You were right to send the kid to the dr considering their sibling had it and they had a sign of it. Our job is to not diagnose-just refer for treatment and let the dr diagnose. There was obviously something wrong since the student had an ear infection!