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 | | Drug Therapy | |
- Recognize that topical antibacterial antibiotics are ineffective in acute viral conjunctivitis.
- Consider conferring with an ophthalmologist about judicious use of topical steroids for some of the complications of viral conjunctivitis.
- Consider topical antibiotics only if there is clear evidence of bacterial superinfection.
- Consider antihistamines, nonsteroidal agents, and mast-cell stabilizers when allergic forms of conjunctivitis are suspected.
| | Drug Treatment for Conjunctivitis (table)
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Recognize that topical antibacterial antibiotics are ineffective in acute viral conjunctivitis.  |
- Do not prescribe prophylactic use of antibiotics to prevent secondary bacterial infections in patients with known viral conjunctivitis.
| Background | Back to top
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Consider conferring with an ophthalmologist about judicious use of topical steroids for some of the complications of viral conjunctivitis.  |
- Avoid topical steroids for treating acute diseases
- Consider the following indications for topical steroids for the associated inflammatory phases of adenoviral conjunctivitis:
- Corneal infiltrates associated with epidemic keratoconjunctivitis that can cause severe photophobia and blurred vision
- Pseudomembranes, which are dense exudates firmly adherent to the palpebral conjunctiva
- Be aware that topical steroids are associated with serious and blinding ocular complications, including cataracts and glaucoma, and their use should be restricted to an ophthalmologist.
- See table Drug Treatment for Conjunctivitis.
| Background | Back to top
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Consider topical antibiotics only if there is clear evidence of bacterial superinfection.  |
- Use topical broad spectrum antibiotics, such as fluoroquinolones, when:
- Purulent discharge signifies bacterial infection is present
- Conjunctival culture results of purulent discharge are positive
- Patients have concurrent contact lens use
- See table Drug Treatment for Conjunctivitis.
| Background | Back to top
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Consider antihistamines, nonsteroidal agents, and mast-cell stabilizers when allergic forms of conjunctivitis are suspected. |
- Consider antihistamines and vasoconstrictors, such as naphazoline and naphazoline pheniramine, in mild allergic conjunctivitis.
- Consider nonsteroidal drugs such as diclofenac and ketorolac in more severe cases of conjunctivitis.
- Note that mast-cell stabilizers such as cromolyn sodium, lodoxamide, and olopatadine can also be used in allergic forms of conjunctivitis.
- See table Drug Treatment for Conjunctivitis.
| Background | Back to top
| | | FAQs |
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| Robert Sambursky, MD, editorial consultant, Chief Medical Officer for Rapid Pathogen Screening, Inc.;served as consultant for Rapid Pathogen Screening, Inc.;received an honoraria for Rapid Pathogen Screening, Inc.;serves as consultant for Rapid Pathogen Screening, Inc; owns stock options in Rapid Pathogen Screening, Inc.;served as board member or director for Rapid Pathogen Screening, Inc.;received grants and has grants pending from Rapid Pathogen Screening, Inc.;and has received patents and has patents pending for Rapid Pathogen Screening, Inc. Stephen Orlin, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Steven E. Weinberger, MD, FACP, Acting Editor, PIER, has stock holdings in Glaxosmithkline and Abbott. |
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Acute Viral Conjunctivitis
