Patient: My daughter is now 6 months old, she had Kawasaki disease when she was a little over 4 months old, she was admitted to the children’s hospital for 16 days has been discharged for 25 days. Now rechecking platelets 364, bilateral arterial dilatation trunk internal diameter 3.1mm, can see 9mm long. now continue to take aspirin and pentoxifylline. Except for a few days when I input immunoglobulin, my eyes have been bloodshot since I got sick, and they are especially bloodshot and red after crying and waking up. She often tries to rub her eyes with her hands, but now she is very photophobic and has a little bit of eye stool, and the sclera of her right eye has a 2mm transparent filament like eye stool 1mm away from the cornea, which cannot be rubbed and is the same color as the sclera. On the 14th, we went to Chongqing Children’s Hospital for examination, and the doctor said it was conjunctivitis. Regarding the stuff on the sclera, the doctor said she had never seen it before and told us to go home for observation. I prescribed ichthyosis, tobramycin eye drops and tetracycline eye ointment, applied eye drops without crying, the child’s eyes bloodshot a little better, but after crying or after sleeping up eyes bloodshot more, still some photophobia, rubbing eyes with hands, more frequent rubbing eyes at night when sleeping. The child usually does not cry, but after applying the eye ointment, he cries hard after a while. I see on the eye ointment instructions that “Herpes simplex virus keratitis is prohibited”, is the child suffering from other eye diseases than conjunctivitis? What should the parents do now? Doctor: Your daughter’s “eyes have been bloodshot at other times since she got sick, and her eyes are especially bloodshot and red after she cries and wakes up” is an ocular manifestation of Kawasaki disease. ”Kawasaki disease is a vasculitis syndrome, also known as “cutaneous mucosal lymph node syndrome”, which occurs in children aged 2 to 4 years old, with symptoms of conjunctival congestion in both eyes, similar to “conjunctivitis”. Conjunctivitis” is very similar, but there is a difference between the two. Conjunctivitis is usually caused by infection or allergy, often with itchy eyes, foreign body sensation and discharge, and is treated with local medication, but only in severe cases with systemic medication, mainly anti-infective (commonly known as “anti-inflammatory” drugs) or anti-allergic drugs, while “Kawasaki disease” has The conjunctiva of both eyes is congested, but there is no purulent discharge or tearing, and the conjunctival congestion lasts for the entire fever period or longer, and there is generally no manifestation of infection. Your daughter is now 6 months old and the possibility of “herpes simplex virus keratitis” is almost non-existent because infants within 6 months of age are immune and generally do not suffer from this disease, and I have not seen any reports of this disease in children within 6 months of age. However, “rubbing the eyes with your hands” can predispose you to infectious keratitis and conjunctivitis, and if there is such a “mixed infection” then it should be treated as “conjunctivitis” and “keratitis”. “It is impossible to know if your child has other eye diseases, as they are not seen in person, but if you have a close-up local photo you can help to see. According to the situation you described, the child’s current eye performance may be both “Kawasaki disease” eye performance, but also mixed infections, so to treat “conjunctivitis” to reduce symptoms, and to prevent keratitis, but note that if there is already a corneal ulcer If you have a corneal ulcer, you should not use steroid hormone type eye drops. The systemic treatment of children should follow the treatment plan of the internist, I am just explaining the eye condition you mentioned for reference (not the only one, and not comprehensive due to limited online communication). In addition, “the sclera of the right eye is a little bit like a 2 mm transparent filament like eye droppings 1 mm from the cornea, which cannot be rubbed and is born on the sclera with the same color as the sclera.” I thought, “Is it a so-called “lymphedema”? If so, there is no need to treat this symptom. Patient: My child got better after ordering eye drops a few days ago, but on the 22nd, probably because the air conditioner was turned up a bit hot, her eyes became red and she had a cough. I went to the hospital and the doctor said it was caused by the cold. I continued to treat the cold and ordered eye drops. However, 3 days later, the sclera on the nasal side of my right eye is still full of blood, and the blood on the outer side has also increased, and my entire right eye is red, and I still have a lot of eye stool, but my left eye is fine. Can you tell me if this is caused by a cold, why only the right eye is red, and if you can continue to use the eye drops after using them for 12 days, because the child cries a lot with the eye ointment, so we have not been using it. Doctor: Your child’s current symptoms may be due to a cold plus a heavy original eye disease. For treatment, antibacterial eye drops can be used, and if the symptoms of redness or itchy eyes are obvious, eye drops such as “Aveido” can be added. In addition, care should be taken to prevent cross-infection and recurrent infection (omitted). Patient: We will go to buy Aveda in a minute as you said. My child’s bloodshot eyes have cleared up and are no longer swollen, and her eye discharge has decreased significantly. It’s just that she still keeps rubbing her eyes every day when she sleeps. We went to the local hospital for a checkup and the doctor told us to continue using eye drops for a while because our child has been suffering from eye disease for a long time with eye drops, and I read the instructions that they should not be used for a long time. Please help Dr. Feng again and advise us what eye drops to use now, so that the side effects on the child are less. Doctor: Infants and children can use “Tobias” (a brand of “tobramycin eye drops”), but also “fishy herb eye drops”, which have fewer side effects, but of course any kind of eye drops Any kind of eye drops should not be used for a long time, unless they do not contain preservatives, and preservative-free eye drops are generally only used when treating dry eyes as artificial tears. Patient: We have been using “Tobias” (a brand of “Tobramycin eye drops”) according to the help you provided, and the acute conjunctivitis in her right eye has been healed, with less blood, less redness, and no eye stool. After the acute conjunctivitis was healed, she was given “Tobias” for 20 days, but she still had more fine filaments in both eyes, and three slightly larger ones on the side of her nose. She often tries to rub her eyes with her hands, both before waking up and before going to bed. I wonder if this condition of fine blood streaks has been bad for too long, if her eyes have been inflamed for too long, or if she has chronic conjunctivitis. (Another Kawasaki disease continues to take medication, coronary artery dilation has been restored, platelets are elevated to 420). Doctor: Tobramycin eye drops such as antibacterial drugs can only antibacterial anti-inflammatory, to a certain extent to reduce the symptoms of congestion due to inflammation when the blood vessels are dilated, long-term inflammation may produce neovascularization, the general drug can not reduce the blood vessels, and there is no need to cure the blood vessels. If the inflammation has completely subsided do not use this drug, use more is not good.