Conjunctivitis

Hyperemia throughout entire globe

Conjunctivitis should NOT have: *Photophobia or Ciliary flush -> think uveitis, acute angle glaucoma, keratitis

Allergic
Symptoms:
- Bilateral eye itching
- Watery discharge
- Concomitant rhinorrhea
Treatment:
- Pain management with NSAIDs
- Antihistamines
Viral
Symptoms: Clear discharge
Treatment:
- Pain management with NSAIDs
- Very contagious! Encourage hand hygiene
- Adenovirus, enterovirus, HSV
Bacterial
Symptoms: Purulent discharge

Treatment: See choices for antibiotic treatment below
- Pain management with NSAIDs
- Do patients with bacterial conjunctivitis need cultures? Only if immunocompromised or patients are post-surgery
- Staph, Strep, Chlamydia, Gonorrhea
Treatment Bacterial Conjunctivitis: topical antibiotics
- Moxifloxacin 0.5% drops 2-4 X daily for 7-10 days
- Fluoroquinolone or trimethoprim/polymyxin B 2-4 X daily
Treatment Conjunctivitis due to Chlamydia or gonorrhea:
- Ceftriaxone 1g IM + 1g azithromycin once / 100 mg doxycycline BID for 7 days
- Bacitracin 500 U/g or gentamicin 0.3% ointment
- Treat sex partners as well