Lima Memorial Health System Logo
Approximate ER WAIT TIME

Health Library

Parinaud oculoglandular syndrome

Parinaud oculoglandular syndrome

Cat scratch disease; Oculoglandular syndrome


Parinaud oculoglandular syndrome is an eye problem that is similar to conjunctivitis ("pink eye"). It most often affects only one eye. It occurs with swollen lymph nodes and an illness with a fever.

Note: Parinaud syndrome (also called upgaze paresis) is a different disorder in which you have trouble looking upward. The latter can be caused by a brain tumor, and requires an immediate evaluation by your health care provider.



Parinaud oculoglandular syndrome (POS) is caused by an infection with bacteria, a virus, fungus, or parasite.

The most common causes are cat scratch disease and tularemia (rabbit fever). The bacteria that cause either condition can infect the eye. The bacteria can directly enter the eye (on a finger or other object), or air droplets that carry the bacteria can land on the eye.

Other infectious diseases may spread the same way, or through the bloodstream to the eye.




Symptoms include:

  • Red, irritated, and painful eye (looks like "pink eye")
  • Fever
  • General ill feeling
  • Increased tearing (possible)
  • Swelling of nearby lymph glands (often in front of the ear)


Exams and Tests


An exam shows:

  • Fever and other signs of illness
  • Red, tender, inflamed eye
  • Tender lymph nodes may be present in front of the ear
  • There may be growths (conjunctival nodules) on the inside of the eyelid or the white of the eye

Blood tests will be done to check for infection. The white blood cell count may be high or low, depending on the cause of the infection.

A blood test to check antibody levels is the main method used to diagnose many of the infections that cause POS. Other tests may include:

  • Biopsy of the lymph node
  • Laboratory culture of eye fluids, lymph node tissue, or blood




Depending on the cause of the infection, antibiotics may be helpful. Surgery may be needed in rare cases to clean away the infected tissues.


Outlook (Prognosis)


The outlook depends on the cause of the infection. In general, if the diagnosis is made early and treatment starts right away, the outcome of POS can be very good.


Possible Complications


Serious complications are rare.

The conjunctival nodules can sometimes form sores (ulcers) during the healing process. The infection can spread to nearby tissues or into the bloodstream.


When to Contact a Medical Professional


You should contact your provider if you develop a red, irritated, painful eye.




Frequent hand washing can reduce the likelihood of getting POS. Avoid being scratched by a cat, even a healthy cat. You can avoid tularemia by not having contact with wild rabbits, squirrels, or ticks.




Gruzensky WD. Parinaud oculoglandular syndrome. In: Mannis MJ, Holland EJ, eds. Cornea. 5th ed. Philadelphia, PA: Elsevier; 2022:chap 41.

Pecora N, Milner DA. New technologies for the diagnosis of infection, In: Kradin RL, ed. Diagnostic Pathology of Infectious Disease. 2nd ed. Philadelphia, PA: Elsevier; 2018:chap 6.

Rubenstein JB, Spektor T. Conjunctivitis: infectious and noninfectious. In: Yanoff M, Duker JS, eds. Ophthalmology. 5th ed. Philadelphia, PA: Elsevier; 2019:chap 4.6.

Salmon JF. Conjunctiva. In: Salmon JF, ed. Kanski's Clinical Ophthalmology. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 6.

BACK TO TOPText only

  • Swollen lymph node

    Swollen lymph node


    • Swollen lymph node

      Swollen lymph node


    A Closer Look


      Talking to your MD


        Self Care


          Tests for Parinaud oculoglandular syndrome


            Review Date: 8/22/2022

            Reviewed By: Franklin W. Lusby, MD, Ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

            The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
            © 1997- adam.comAll rights reserved.