Bacterial conjunctivitis

Background

Causes

1. gram-positives
   1. Streptococcus pneumoniae
   2. Staphylococcus aureus
2. gram-negatives
   1. Haemophilus influenzae

Diagnosis

1. More abrupt onset (than viral)
2. Normally spreads bilateral within 48hrs
3. Morning crusting

DDx

Eye Algorithm (Main)

Treatment

1. Topical ophthalmi antibiotic
   1. Erythromycin, OR
   2. Bacitracin/Polymyxin B
      1. If contact lens wearer, cover for pseudomonas
         1. discontinue lens wearing
         2. Topical fluoroquinolone
         3. Eg: Cipro drops 10D OU
2. Follow-up (if no improvement) 3-4 days
   1. Closer follow-up in young children and the debilitated (obtain cultures)

• Ointment for children
• Drops for adolescents/adults

See Also

• Conjunctivitis

Source

• Mahmood AR, Narang AT. Diagnosis and management of the acute red eye. Emerg Med Clin N Am. 2008;26:35-55.