Conjunctivitis

  • All forms present with red and irritated conjunctiva. Blurry vision is common, but vision loss should not occur if disease is limited to conjunctiva. 
  • In practice it can be difficult to distinguish between the types of conjunctivitis. 
  • Consult ophthalmology if worsening despite treatment.

Allergic

Viral

Bacterial

History Atopy, seasonal nature Recent URI or exposure to illness Contact lenses & hygiene, morning crusting/discharge
Laterality Often bilateral Unilateral first, then bilateral Unilateral first, then bilateral
Signs/Symptoms Chemosis, watery/mucoid discharge, itching Itching/burning, subconjunctival petechiae, watery/mucoid discharge, tender preauricular lymph nodes Less itching. Burning, aching, stabbing discomfort. Copious mucoid/purulent discharge
Management Eliminate allergens, artificial tears, antihistamine/mast-cell stabilizer drops (olopatadine, ketotifen), oral antihistamine Artificial tears 4-8x/day, cool compresses, isolation precautions Culture/swab discharge, isolation precautions, moxifloxacin drops (Vigamox) QID or trimethoprim/polymyxin B drops/ointment 5-7 days
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