Bacterial conjunctivitis

Background

• Often due to staph and strep

Clinical Features

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

Diagnosis

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

DDx

• Eye Algorithm (Main)

Treatment

1. Topical abx
   1. Adults
      1. Polymyxin-trimethoprim 1-2 drops QID x5-7d
   2. Peds
      1. Erythromycin ointment 1/2" QID x5-7d OR
   3. Contact lens wearer
      1. Fluoroquinolone ophthalmic drops 1-2 drops QID x5-7d (covers pseudomonas)
      2. Discontinue contact lens wearing
2. Culture
   1. Consider for severe cases

Disposition

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

See Also

• Conjunctivitis

Source

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