If symptoms worsen or persist beyond ten days, stop all drops and seek an Ophthalmology opinion. Infective conjunctivitis is a common self-limiting condition and does not routinely require antibiotics
- Ask about contact lens usage
- Conjunctiva:thin layer of tissue that covers the front of the eye
- Adenovirus, enterovirus, occasionally herpes simplex)
- Bacterial:Streptococcus pneumoniae, staphylococcus aureus and Haemophilus influenzae.
- Allergic: Hayfever, allergy to chloramphenicol
- Rare: membrane (cicatricial) pemphigoid or Stevens–Johnson syndrome
- Trachoma can cause scarring
- Usually self limiting in 7-10 days
- Severe case "Red eye" Pink eyes, sticky, discharge
- Bacterial - glued lids on waking
- Viral - usually a history of previous episodes
- Allergic - itching is common due to hay fever or allergy to chloramphenicol, which is commonly used to treat conjunctivitis
- Severe conjunctivitis with STD: gonorrhoea. If prolonged mucopurulent discharge (chlamydia) and require swabs, contact tracing and treatment
- Culture swabs if persists
- Usually no treatment required at least for first 3 days in adults; viral cause most likely (adenovirus, enterovirus, occasionally herpes simplex).
- Infective conjunctivitis is best treated by bathing eyes with cool clean water, using lubricating drops, using moist cotton wool to clean the lids, and abstain from contact lens use.
- Purulent conjunctivitis: Chloramphenicol 0.5% eye drops every 2 hours for 2 days and then 4 hourly for 48 hours after resolution of symptoms
- Consider ophthalmia neonatorum in a neonate; this does not refer to a simple sticky eye in a neonate and requires urgent review in the hospital.
- Persisting symptoms consider Chloramphenicol eye drops 0.5% and Chloramphenicol eye ointment 1%.
Continue until 2 days after symptoms resolve.
- Red flag: Contact lens wearer (always ask) If suspected refer urgently to Ophthalmology if suspected corneal ulcer, and do not give antibiotics in the interim as this may interfere with a subsequent corneal culture. Have a low threshold for referral