Kawasaki disease is an acute illness that primarily affects young children, characterized by inflammation of blood vessels throughout the body. While it is widely recognized for its potential impact on the heart, this condition can also significantly affect other organs, including the eyes. It is the most common cause of acquired heart disease in children in developed countries.
Common Eye Manifestations
Children with Kawasaki disease exhibit specific eye symptoms. The most common manifestation is bilateral conjunctivitis, which is redness of both eyes. This redness is non-purulent, meaning it occurs without discharge or pus. This symptom appears within a few days of fever onset.
Parents or caregivers may also observe periorbital edema, swelling around the eyes. Uveitis, an inflammation of the middle layer of the eye, can be present. Uveitis arises within a week of fever onset and can cause light sensitivity. These eye symptoms are not painful for the child.
Understanding Eye Involvement
The eye involvement in Kawasaki disease stems from vasculitis, the inflammation of blood vessels. Kawasaki disease is a form of medium vessel vasculitis, where the body’s immune system mistakenly attacks healthy blood vessel tissue. This inflammatory process can affect the blood vessels supplying various parts of the eye.
Inflammation of the small blood vessels in the conjunctiva, the clear membrane covering the white part of the eye, leads to the characteristic redness. If the inflammation impacts the uvea, the middle layer of the eye containing many blood vessels, it can result in uveitis.
Diagnosis and Management of Eye Symptoms
Diagnosing eye involvement is part of the broader assessment for Kawasaki disease, which is a clinical diagnosis based on symptoms. A child must have a fever lasting five or more days, along with at least four of five criteria, including conjunctivitis. A thorough clinical examination by a healthcare professional is performed, and an ophthalmological consultation may be conducted to confirm eye findings like anterior uveitis.
The management of eye symptoms is integrated into the overall treatment for Kawasaki disease. Standard treatments involve intravenous immunoglobulin (IVIG) and aspirin. IVIG is administered to reduce fever and the risk of heart problems, and it effectively relieves acute symptoms, including those affecting the eyes.
Aspirin is also prescribed, initially at a high dose to reduce inflammation and fever, and then at a lower dose to prevent blood clots, particularly in the coronary arteries. Eye symptoms resolve without specific therapy or lasting issues, but follow-up is still important.
Importance of Early Detection and Treatment
Early diagnosis and prompt initiation of treatment are important when Kawasaki disease is suspected, particularly if eye symptoms are present. Early intervention with IVIG can reduce the occurrence of coronary artery abnormalities, lowering the risk from 25% to 3-5%. This is important for preventing more severe complications.
Seeking immediate medical attention upon observing signs such as prolonged fever and unexplained eye redness in a child ensures better resolution of eye symptoms and the overall prognosis. Timely treatment not only addresses the immediate symptoms but also minimizes the risk of long-term cardiac damage.