Conjunctivitis

Conjunctivitis, characterised by sore, red eyes associated with sticky discharge,  is the commonest eye problem presenting to primary care.

Classifications

Bacterial Conjunctivitis

  • Purulent discharge
  • Eyes may be “stuck together” in the morning

Viral Conjunctivitis

  • Serous discharge
  • Recent URTI
  • Preauricular lymph nodes

Allergic Conjunctivitis

  • Bilateral symptoms
  • Itch is most prominent
  • May be history of atopy
  • May be seasonal (pollen) or perennial (dust mights / washing powder / other allergens)

Treatment  of infective conjunctivitis

  • Normally self limiting
  • Usually settles without treatment in 1 – 2 weeks
  • Topical antibiotic therapy (chloramphenicol) is usually offered
    • Drops are 2 – 3 hourly
    • Ointment is QDS
  • Topical Fusidic acid is an alternative – and should be used for pregnant women – twice daily
  • Contact lenses shouldn’t be worn during episode

Management of Allergic Conjunctivitis

  • Topical or systemic antihistamines
  • Topical mas-cell stabilisers (eg Sodium cromoglicate and nedocromil)