Conjunctivitis, Bacterial

Bacterial Conjunctivitis
-History of eye morning matting present.
-No red flags such photophobia (elicited via pupillary constriction) and anisocoria (greater than 1mm).
-No vision loss (indication for prompt referral to ophthalmology).
-Don’t wear contact lenses while symptomatic.
-Good hand hygiene to decrease transmission.
-Consider cool compresses and artificial tears prn.
-Rx: Moxifloxacin ophthalmic 0.5% (Vigamox) 1gtt TID for 7 days OR ofloxacin ophthalmic 0.3% sol 1-2 gtt in eye(s) q2-4h x 2 days, then 1-2 gtt QID x 5 days.
If insurance doesn’t cover Vigamox, will use Polytrim (Polymyxin B / Trimethoprim ophthalmic ) 1 gtt in eye(s) q3h x 7-10 days; Max 6 doses per day.
-May return to school after 3 days.

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See Medications for conjunctivitis here >>

 Note: “Eliciting photophobia via pupillary constriction and the presence of anisocoria (greater than 1 mm) in patients with an acute red eye are the best predictors of serious eye disease (e.g., uveitis, keratitis, corneal abrasion, scleritis) requiring a prompt referral.” AFP Journal, 2016

*Reduced visual acuity could be a symptom of acute angle closure glaucoma and requires immediate referral to the ophthalmologist.

References