Bacterial conjunctivitis

Background

• Often due to staphylococcus or streptococcus

Clinical Features

• Painless, unilateral or bilateral mucopurulent discharge
  • Often causes adherence of the eyelids on awakening
• Chemosis is common

Diagnosis

• Perform fluorescein stain of cornea (especially in infants) to avoid missing corneal lesion

Differential Diagnosis

• Eye Algorithm (Main)

Treatment

Topical antibiotic

1. Adults: polymyxin-trimethoprim 1-2 drops QID x 5 - 7 days
2. Children: erythromycin ointment 1/2" QID x 5 - 7 days
3. Contact lens wearer: fluoroquinolone ophthalmic drop 1-2 drops QID x 5 - 7 days (covers pseudomonas)
4. Culture: if severe

Disposition

1. Follow-up (if no improvement) in 3 - 4 days

See Also

• Conjunctivitis

Source

• Mahmood, Narang. Diagnosis and management of acute red eye. Emerg Med Clin N Am. 2008;26
• Tintinalli