Family Nurse Practitioner Exam

Which condition is most likely indicated by a 4-year-old child experiencing burning and itching in both eyes, along with a runny nose and injected bilaterally bloodshot eyes?

1. Herpes keratitis

2. Corneal ulcer

3. Viral conjunctivitis

4. Bacterial conjunctivitis

The correct answer is: Viral conjunctivitis

The symptoms described in the scenario—burning and itching in both eyes, a runny nose, and injected bilaterally bloodshot eyes—are characteristic of viral conjunctivitis. This condition is commonly associated with viral infections, particularly adenoviral infections, which often lead to conjunctival inflammation. The itching and burning sensation, along with clear watery discharge and nasal symptoms, further supports this diagnosis, as viral conjunctivitis frequently occurs in conjunction with upper respiratory infections. In children, viral conjunctivitis can also be spread easily and is often accompanied by symptoms such as a runny nose, reinforcing the likelihood of a viral etiology. The bilateral involvement (both eyes affected) is typical for viral infections, contrasting with other conditions that may present unilaterally. Understanding these clinical features helps differentiate viral conjunctivitis from other eye conditions that could present with redness and discomfort, such as bacterial conjunctivitis, which typically results in purulent discharge, or herpes keratitis and corneal ulcers, which may have more specific and severe symptoms related to the cornea itself.