Conjunctivitis

Question 1

Symptoms?

Answer 1

Pink/red colour in whites of the eye(s)

Swelling of the conjunctiva and/or eyelids

Watering of eyes

Feeling like a foreign body is in the eye(s) or an urge to rub the eye(s)

Itching, irritation, and/or burning

Discharge (pus or mucus) - usually bacterial or viral

Crusting of eyelids/ lashes, particularly in the morning

Question 2

Questions?

Answer 2

Have you taken anything for this already?

Are you allergic to any medication?

What part of your eye do you feel discomfort?

Do you feel like your eyes are watering?

What sort of sensation are you feeling, itching or burning?

Do you get any discharge leaving the eyes, especially in the morning?

How is your vision through the affected eye?

Which one of your eyes is affected?

Question 3

Red flags?

Answer 3

• Reduced visual acuity
• Marked eye pain
• Headache
• Photophobia
• Inability to open the eye or keep it open.
• Red sticky eye in a neonate (within 30 days of birth).
• History of trauma (mechanical, chemical or ultraviolet) or possible foreign body.
• Copious rapidly progressive discharge

Question 4

Treatment?

Answer 4

Allergic:
Oral antihistamines for allergic conjunctivitis are:
- cetirizine
- fexofenadine
- loratadine. 
These are usually taken once a day. 

OR

Antihistamine eye drops include:

• Alaway
• Zaditor. . The eye drops will relieve symptoms in the eyes, but the oral dose will also help treat a runny nose and other symptoms.

Bacterical:
Topical antibiotics:
Chloramphenicol 0.5% drops — apply 1 drop 2 hourly for 2 days then 4 times daily for 5 days.

Chloramphenicol 1% ointment — apply four times daily for 2 days, then twice daily for 5 days.

Fusidic acid 1% eye drops — can be used second line. Apply twice daily for 7 days.

Viral:
Topical chloramphenicol

Topical fusidic acid