Materiały źródłowe

• #1 Conjunctivitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK541034/

  Conjunctivitis refers to the inflammation or infection of the conjunctiva. Conjunctivitis, the inflammation or infection of the conjunctiva, represents the most prevalent cause of eye redness in both primary care and the emergency department. This condition places a substantial burden on the healthcare system. Conjunctivitis is the most prevalent etiology of eye redness and discharge. The etiology of this condition could be infectious or noninfectious; the most common is viral conjunctivitis, followed by bacterial conjunctivitis, and among noninfectious etiologies, the most common etiologies are allergic and toxin-induced conjunctivitis. […] This activity provides the learner with valuable information regarding the etiology, pathophysiology, clinical presentation, evaluation, and management of conjunctivitis. This activity also reviews the role of the interprofessional team in improving the care of patients with conjunctivitis and preventing transmission.

• #2 Conjunctivitis: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2024/0800/conjunctivitis.html

  Conjunctivitis caused by viruses, bacteria, or allergies is one of the most common eye conditions in primary care. […] There is no single sign or symptom that accurately differentiates viral from bacterial conjunctivitis. A comprehensive history and physical examination can guide diagnosis. […] Bacterial conjunctivitis is more common in children and typically presents as mucopurulent discharge with the eyelids matted shut. […] Delayed antibiotic prescribing has been found to have similar symptom control as immediate prescribing. […] Ophthalmology referral is indicated for conjunctivitis in a neonate or patients with severe pain, decreased vision, recent ocular surgery, vesicular rash on the eyelids or nose, history of rheumatologic disease, or immunocompromised state. […] This article discusses the three most common causes of conjunctivitis, clinical features that can be used to differentiate them, and recommendations for treatment.

• #3 Diagnosing Conjunctivitis | NYU Langone Health

  https://nyulangone.org/conditions/conjunctivitis/diagnosis

  Conjunctivitis can affect people of any age. It tends to spread easily among people who work or live together. […] If you have any symptoms, see your ophthalmologist as soon as possible. […] Symptoms include redness in the eye, itching, and clear, watery discharge. […] Bacterial conjunctivitis can cause vision loss if it is not treated immediately and aggressively with prescription antibiotics. […] Your ophthalmologist can rule out many causes of conjunctivitis simply by asking about your symptoms and how they came about. […] Most of the time, your doctor can diagnose conjunctivitis by using a slit lamp—an instrument that consists of a microscope and a high-energy beam of light. […] Doctors also check to see if conjunctivitis has affected your vision by conducting a visual acuity test. […] If you have had conjunctivitis for more than two or three weeks and it has not gone away on its own or with the help of home treatments, your doctor may want to perform an eye culture.

• #4 Acute conjunctivitis – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/68

  Symptoms of acute conjunctivitis include an irritated red eye with a watery or purulent discharge. […] There are a range of causes of acute conjunctivitis, including allergy, bacterial or viral infection, mechanical stress, and irritation by toxic chemicals or medication. […] Treatment for allergic conjunctivitis includes topical mast cell stabilizers and antihistamines; bacterial conjunctivitis treatment includes topical antibiotics; viral conjunctivitis requires symptomatic treatment. […] Bacterial and viral conjunctivitis is highly contagious; measures to prevent spread of infection should be considered. […] Conjunctivitis is the inflammation of the lining of the eyelids and eyeball caused by bacteria, viruses, allergic or immunologic reactions, mechanical irritation, or medications.

• #5 Acute conjunctivitis – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/68

  Key diagnostic factors include watery discharge, ropy, mucoid discharge, purulent discharge, itching predominant symptom, red eye, eyelids stuck together in morning, and tender, preauricular lymphadenopathy. […] Other diagnostic factors include conjunctival follicles, chemosis, swollen eyelids, superficial punctate keratopathy, unilateral symptoms and signs, use of medications that may lead to eye irritation, contact lens use, corneal subepithelial infiltrates, corneal pannus, vesicular skin rash, and symptoms and signs of related systemic disease. […] 1st tests to order include rapid adenovirus immunoassay. […] Tests to consider include cell culture, special stains (Gram, Giemsa), polymerase chain reaction, ocular pH, allergy skin testing, and tear immunoglobulin E level.

• #6 Clinical Overview of Pink Eye (Conjunctivitis) | Conjunctivitis (Pink Eye) | CDC

  https://www.cdc.gov/conjunctivitis/hcp/clinical-overview/index.html

  Conjunctivitis is caused by viruses, bacteria, allergens, contact lens use, chemicals, fungi, and certain diseases. […] Advise patients to remain home if they have viral or bacterial conjunctivitis with systemic signs of illness. […] Bacterial conjunctivitis is very contagious and can spread from person to person in many ways. These include from: Hand-to-eye contact, Contact of eye with contaminated objects, Sexual encounters with eye to genital contact, or vertically from mother to baby, Large respiratory tract droplets. […] Signs and symptoms of bacterial conjunctivitis overlap with other causes of conjunctivitis, including viral and allergic conjunctivitis, which can make diagnosis difficult. […] Typical signs and symptoms include: Red eye, Purulent discharge that causes eyelids to be matted together, Chemosis, Decreased vision, Eyelid swelling and pain.

• #7 Pink eye (conjunctivitis) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pink-eye/diagnosis-treatment/drc-20376360

  In most cases, your healthcare professional can diagnose pink eye by asking about your recent health history and symptoms and examining your eyes. […] Rarely, your care professional may take a sample of the liquid that drains from your eye for laboratory analysis, called a culture. A culture may be needed if your symptoms are severe or if your care professional suspects a high-risk cause, such as: […] A serious bacterial infection. […] Your healthcare professional is likely to ask you a number of questions. Being ready to answer them may allow time later to cover points you want to address. You may be asked: […] What kinds of tests do I need? […] What treatments are available? […] How long will I be contagious after starting treatment? […] Your time with your healthcare professional is limited, so preparing a list of questions can help you make the most of your time together.

• #8 Overview of conjunctivitis – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/overview-of-conjunctivitis/

  Conjunctivitis is usually a clinical diagnosis. Consider diagnostic studies if there is diagnostic uncertainty or suspicion for a serious infection. […] Obtain a full medical history including comorbidities, medications, and history of eye conditions. […] Perform eye examination, including: Visual acuity, Slit-lamp examination. […] Routine studies: conjunctival swabs for infectious etiologies (e.g., smear, culture, PCR). […] Additional studies to consider: Tear osmolarity and Schirmer test: to evaluate for dry eye syndrome, Tear IgE and conjunctival allergen challenge: to evaluate for allergic conjunctivitis, Autoantibody testing: for diagnosing autoimmune conditions, Conjunctival biopsy (rarely necessary): for diagnosing ocular cicatricial pemphigoid. […] Conjunctivitis is the most common cause of red eye and is usually a clinical diagnosis.

• #9 Pink Eye (Conjunctivitis): Symptoms, Causes, Treatment

  https://www.webmd.com/eye-health/eye-health-conjunctivitis

  Pink Eye Diagnosis […] Your eye doctor will ask you questions about your symptoms, such as: […] They may also give you an eye exam and use a cotton swab to remove fluid from your eyelid to test in a lab. Test results will show bacteria or viruses that may have caused conjunctivitis, including those that can cause an STD. Then, your doctor can prescribe the right treatment. […] What is commonly misdiagnosed as pink eye? […] These conditions aren’t contagious.

• #10 Conjunctivitis Diagnosis: When to See a Doctor and What to Expect

  https://www.healthline.com/health/conjunctivitis-diagnosis

  It might be tempting to self-diagnose, but the symptoms of pink eye are associated with several conditions. Its best to consult a healthcare professional who can determine the exact cause and prescribe the appropriate course of treatment. […] A healthcare professional will ask you questions about when your symptoms started, how severe they are, and if youve been exposed to any allergens or irritants recently. […] After reviewing your medical history, your healthcare professional will visually inspect your eyes to look for typical signs of conjunctivitis, such as redness, swelling, or discharge. […] Your healthcare professional may use a swab to gently collect a sample of the discharge and send it to a lab. This will help determine the specific bacteria or virus causing the infection. […] If you think you have conjunctivitis, its a good idea to consult a doctor, especially in the following cases: […] Consulting with a healthcare professional will ensure that you get the correct diagnosis and the best treatment for your symptoms.

• #11 Diagnosing Conjunctivitis | NYU Langone Health

  https://nyulangone.org/conditions/conjunctivitis/diagnosis

  Conjunctivitis can affect people of any age. It tends to spread easily among people who work or live together. […] If you have any symptoms, see your ophthalmologist as soon as possible. […] Symptoms include redness in the eye, itching, and clear, watery discharge. […] Bacterial conjunctivitis can cause vision loss if it is not treated immediately and aggressively with prescription antibiotics. […] Your ophthalmologist can rule out many causes of conjunctivitis simply by asking about your symptoms and how they came about. […] Most of the time, your doctor can diagnose conjunctivitis by using a slit lamp—an instrument that consists of a microscope and a high-energy beam of light. […] Doctors also check to see if conjunctivitis has affected your vision by conducting a visual acuity test. […] If you have had conjunctivitis for more than two or three weeks and it has not gone away on its own or with the help of home treatments, your doctor may want to perform an eye culture.

• #12 Conjunctivitis – Diagnosis and Treatment : Emergency Care BC

  https://emergencycarebc.ca/clinical_resource/clinical-summary/conjunctivitis-diagnosis-and-treatment/

  Conjunctivitis, aka “Pinkeye”, can affect people of all ages, and higher incidence in those who wear contact lenses, children, and those who are immuno-compromised. […] It is an inflammation of the conjunctiva (the thin, clear tissue that lines the inside of the eyelid and that covers the white part of the eye). […] Symptoms may include redness, itching, and discharge in the affected eye(s). […] Common symptoms include: Redness and swelling of the conjunctiva (the clear membrane that covers the white part of the eye and the inner surface of the eyelid). […] This is primarily a clinical diagnosis and tests are not routine unless other diagnoses are suspected. […] To differentiate between the different etiologies, consider: […] This is primarily a clinical diagnosis and tests are not routine unless other diagnoses are suspected.

• #13 Conjunctivitis – Diagnosis and Treatment : Emergency Care BC

  https://emergencycarebc.ca/clinical_resource/clinical-summary/conjunctivitis-diagnosis-and-treatment/

  Examine the eye and eyelids for swelling, conjunctival injection, discharge. […] Consider slit lamp exam +/- fluorescein for foreign bodies or trauma, signs of ulceration. […] Consider visual acuity exam, pupils, confrontational visual fields, intraocular pressure with tonometer, extraocular movements. […] There have been extensive studies performed for diagnostic and treatment purposes in this field, that have been validated with no major limitations.

• #14 Bacterial Conjunctivitis (Pink Eye) Differential Diagnoses

  https://emedicine.medscape.com/article/1191730-differential

  Diagnostic Considerations […] Medicolegal concerns do arise in connection with bacterial conjunctivitis. As with all medical practice, careful discussion and documentation is paramount. A few general guidelines are helpful, as follows: […] Know the differential diagnosis. […] Perform an eye examination and, in particular, document that keratitis, iritis, and acute glaucoma have been ruled out. […] Always document the best corrected visual acuity in each eye. […] Ascertain the absence of glaucoma on every visit or the inability to safely do so. A simple ballpark bidigital applanation of each globe through the closed upper lid provides a useful and legally protective assessment of intraocular pressure (IOP). This assessment can be performed in immediate proximity to the digital assessment for preauricular lymphadenopathy, accompanied by thorough physician handwashing thereafter.

• #15 A Review of the Differential Diagnosis of Acute Infectious Conjunctivi | OPTH

  https://www.dovepress.com/a-review-of-the-differential-diagnosis-of-acute-infectious-conjunctivi-peer-reviewed-fulltext-article-OPTH

  The diagnosis of acute infectious conjunctivitis can be difficult. Clinical ambiguity exists between the acute viral and bacterial as well as the allergic forms, which can confound diagnosis. […] Therefore, in order to effectively treat acute infectious conjunctivitis, physicians must be aware of the clinical signs and symptoms and available diagnostic tests that can provide a more accurate differential diagnosis. […] Misdiagnoses expose patients to unnecessary and ineffective antibiotic treatment. […] There are several challenges to accurately diagnosing acute infectious conjunctivitis. First, clinical ambiguity exists between the acute viral and bacterial as well as the allergic forms, which can confound diagnosis. […] Guidelines and criteria for diagnosing and treating acute infectious conjunctivitis based on natural history and etiology are available.

• #16 Pediatric Conjunctivitis: A Review of Clinical Manifestations, Diagnosis, and Management

  https://www.mdpi.com/2227-9067/10/5/808

  Pediatric conjunctivitis is a common pediatric problem and is broadly divided into infectious and non-infectious etiologies. […] The classification of pediatric conjunctivitis is typically by etiology, broadly categorized into infectious and non-infectious causes. Most cases of pediatric conjunctivitis are infectious, either bacterial or viral. […] The majority of cases of pediatric conjunctivitis are managed by primary care providers rather than eye-specific providers. […] The goal of this literature review is to summarize the current evidence on the clinical manifestations, diagnosis, and management of conjunctivitis for primary care providers. […] When a child presents with “pink eye”, the evaluation should first start with a review of the history, signs, and symptoms to determine the etiology.

• #17 The Ultimate Guide to Conjunctivitis Differential Diagnosis

  https://eyesoneyecare.com/resources/the-ultimate-guide-to-conjunctivitis-differential-diagnosis/

  Conjunctivitis specifically refers to the inflammation of the bulbar and palpebral conjunctiva of the eye. This inflammation results in varying degrees of injection and edema, which gives pink eye its classic reddish-pink, swollen appearance and is often accompanied by some form of discharge. The underlying causes of conjunctivitis vary and include infectious etiologies such as bacterial, viral, fungal, and parasitic infections as well as noninfectious causes like allergies, inflammatory conditions, and mechanical irritation. Accurately diagnosing the specific cause of conjunctivitis has been shown to be a challenge for providers, as 80% of cases of infectious conjunctivitis are treated with antibiotics, while only 30% of cases are truly bacterial in nature. However, while the different forms of conjunctivitis may present in similar fashions, there are key differences, although sometimes subtle, that help differentiate them. It is critical for eyecare providers (ECPs) to identify these differences quickly and accurately, as the treatments for the various forms of conjunctivitis can differ significantly.

• #18 The Ultimate Guide to Conjunctivitis Differential Diagnosis

  https://eyesoneyecare.com/resources/the-ultimate-guide-to-conjunctivitis-differential-diagnosis/

  Although all forms of conjunctivitis may appear similar at a superficial level, a careful history and thorough examination will often be all that is needed to determine the exact underlying cause. […] These two pieces of information—the quality of discharge and type of palpebral reaction present—will allow providers to broadly categorize the conjunctivitis as bacterial, viral, or allergic in nature, and by adding a few additional pieces of information an even more specific diagnosis can be made. […] If the discharge is mucoid and a creamy-white or yellow-green to brown color, and papillae are present, then the source is likely bacterial. If the discharge is watery and clear in the presence of a follicular reaction, then the condition is likely viral. […] If the discharge happens to be ropey or stringy with a papillary reaction, then it is likely allergic conjunctivitis which is confirmed by the presence of itching. These two pieces of information alone can aid tremendously in determining the overarching nature of the condition.

• #19 Conjunctivitis: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2024/0800/conjunctivitis.html

  Conjunctivitis caused by viruses, bacteria, or allergies is one of the most common eye conditions in primary care. […] There is no single sign or symptom that accurately differentiates viral from bacterial conjunctivitis. A comprehensive history and physical examination can guide diagnosis. […] Bacterial conjunctivitis is more common in children and typically presents as mucopurulent discharge with the eyelids matted shut. […] Delayed antibiotic prescribing has been found to have similar symptom control as immediate prescribing. […] Ophthalmology referral is indicated for conjunctivitis in a neonate or patients with severe pain, decreased vision, recent ocular surgery, vesicular rash on the eyelids or nose, history of rheumatologic disease, or immunocompromised state. […] This article discusses the three most common causes of conjunctivitis, clinical features that can be used to differentiate them, and recommendations for treatment.

• #20 Conjunctivitis: Diagnosis and Management – PubMed

  https://pubmed.ncbi.nlm.nih.gov/39172671/

  Conjunctivitis caused by viruses, bacteria, or allergies is one of the most common eye conditions in primary care. There is no single sign or symptom that accurately differentiates viral from bacterial conjunctivitis. A comprehensive history and physical examination can guide diagnosis. […] Viral and allergic conjunctivitis are more common in adults and typically present with watery discharge. Supportive care options for viral conjunctivitis include artificial tears, cold compresses, and antihistamine eye drops. […] Bacterial conjunctivitis is more common in children and typically presents as mucopurulent discharge with the eyelids matted shut. […] Ophthalmology referral is indicated for conjunctivitis in a neonate or patients with severe pain, decreased vision, recent ocular surgery, vesicular rash on the eyelids or nose, history of rheumatologic disease, or immunocompromised state.

• #21 Evaluation of Infectious Conjunctivitis by Clinical Evaluation and Novel Diagnostics – Journal of Urgent Care Medicine

  https://www.jucm.com/evaluation-of-infectious-conjunctivitis-by-clinical-evaluation-and-novel-diagnostics/

  Urgent care is often the first stop for patients experiencing acute eye complaints, including conjunctivitis. The capability to accurately distinguish between infectious conjunctivitis of a viral nature vs that of a bacterial nature is essential to administering appropriate treatment and avoiding inappropriate use of antibiotics. […] It is important to differentiate between conjunctivitis of bacterial versus viral vs other etiology in order to manage these conditions correctly and reduce the overuse of antibiotics. […] Narrowing the list of red eye differentials solely on presentation without the use of diagnostics is a daunting task. […] When assessing a patient with acute conjunctivitis, it is important to keep in mind that adenovirus makes up the majority of cases of viral conjunctivitis. Currently, most diagnoses of adenoviral conjunctivitis are made clinically. It is estimated that clinical diagnoses have only 40%72% accuracy when compared to traditional laboratory diagnostics.

• #22 Conjunctivitis differential diagnosis – wikidoc

  https://www.wikidoc.org/index.php/Conjunctivitis_differential_diagnosis

  Conjunctivitis must be differentiated from blepharitis, keratitis, and scleritis. Conjunctivitis symptoms and signs are relatively non-specific. Even after eye examination, laboratory tests are often necessary to determine the underlying pathophysiology with certainty. […] A mucopurulent discharge strongly suggests bacterial cause, unless there is known exposure to toxins. Infection with Neisseria gonorrhoeae and Chlamydia trachomatis should be suspected if the discharge is particularly thick and copious. Bacterial conjunctivitis must be differentiated from: […] A diffuse, highly contagious, characterized by watery discharge, less injected conjunctivitis (looking pink rather than red) suggests a viral cause. Viral conjunctivitis must be differentiated from: […] Neonatal conjunctivitis must be differentiated from:

• #23 Bacterial Conjunctivitis (Pink Eye) Differential Diagnoses

  https://emedicine.medscape.com/article/1191730-differential

  Diagnostic Considerations […] Medicolegal concerns do arise in connection with bacterial conjunctivitis. As with all medical practice, careful discussion and documentation is paramount. A few general guidelines are helpful, as follows: […] Know the differential diagnosis. […] Perform an eye examination and, in particular, document that keratitis, iritis, and acute glaucoma have been ruled out. […] Always document the best corrected visual acuity in each eye. […] Ascertain the absence of glaucoma on every visit or the inability to safely do so. A simple ballpark bidigital applanation of each globe through the closed upper lid provides a useful and legally protective assessment of intraocular pressure (IOP). This assessment can be performed in immediate proximity to the digital assessment for preauricular lymphadenopathy, accompanied by thorough physician handwashing thereafter.

• #24 Conjunctivitis differential diagnosis – wikidoc

  https://www.wikidoc.org/index.php/Conjunctivitis_differential_diagnosis

  Allergic conjunctivitis has a protracted course, with the severity of symptoms waxing and waning throughout the allergy season. It is characterized by itchy eyes, tearing, bilateral eye redness, and watery discharge. Allergic conjunctivitis must be differentiated from: […] Keratoconjunctivitis sicca (dry eye syndrome) must be differentiated from: […] Superior limbic keratoconjunctivitis (SLK) is chronic condition with remission and exacerbations, and it must be differentiated from:

• #25 Bacterial Conjunctivitis (Pink Eye) Differential Diagnoses

  https://emedicine.medscape.com/article/1191730-differential

  Be aware of more unusual conditions, such as carotid-cavernous fistula. […] Always consider Chlamydia or N gonorrhoeae in the differential diagnosis. Be sure to treat systemically and ask for advice from other specialists when needed. […] Given the increasing popularity of telemedicine and the increased quality of phone camera capabilities, many more patients are being diagnosed and treated via telemedicine. With a good health history and quality images, simple and straightforward conjunctivitis not involving the cornea may be treated remotely, though caution should be taken not to overprescribe antibiotics. Cases of conjunctivitis that do not resolve quickly or that are deemed more complicated should be referred to be seen by an eye care professional immediately. […] […] […] Differential Diagnoses

• #26 Overview of Conjunctivitis – Eye Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/eye-disorders/conjunctival-and-scleral-disorders/overview-of-conjunctivitis

  Conjunctivitis is typically acute, but both infectious and allergic conditions can be chronic. […] Diagnosis is clinical; sometimes cultures are indicated. […] Usually, diagnosis of conjunctivitis is made by history and ocular examination, usually including slit-lamp examination with fluorescein staining of the cornea. […] The cause of conjunctivitis is suggested by clinical findings. However, cultures are indicated for patients with severe symptoms, immunocompromise, a vulnerable eye, or poor response to initial therapy. […] Clinical differentiation between viral and bacterial infectious conjunctivitis is not highly accurate. However, if the history and examination strongly suggest viral conjunctivitis, withholding antibiotics initially is appropriate. […] Diagnosis is usually clinical.

• #27 Conjunctivitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK541034/

  In cases of conjunctivitis, the redness typically affects the entire surface of the conjunctiva, including both the bulbar and tarsal conjunctiva. […] When identifying the cause of conjunctivitis, the type of discharge is a crucial factor. […] Determining the cause of conjunctivitis can be challenging as its symptoms are not specific. […] While conjunctivitis often presents similarly, a thorough systematic history and physical exam can safely rule out any acute sight-threatening diagnoses and elucidate the likely cause of conjunctivitis. […] Labs and cultures are rarely indicated to confirm conjunctivitis diagnosis. […] Eyelid cultures and cytology are usually reserved for recurrent conjunctivitis, those resistant to treatment, suspected gonococcal or chlamydial infection, suspected infectious neonatal conjunctivitis, and adults presenting with severe purulent discharge.

• #28 Conjunctivitis | Johns Hopkins ABX Guide

  https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540141/all/Conjunctivitis

  Conjunctival scrapings or cultures (bacterial/viral) are generally not needed except in resistant cases as cases diagnosed clinically, also obtain in hyperpurulent, severe, visually impairing or recurrent disease. […] Specific testing: […] Bacterial: […] Swabs for Gram stain and aerobic culture will capture most standard, non-fastidious bacteria. […] Gram stain and culture […] Gonococcal disease is most commonly diagnosed by Gram stain, which shows characteristic Gram-negative intracellular diplococci. […] Chlamydia is most commonly diagnosed by DFA (Direct Fluorescent Antibody) staining of conjunctival smears or Giemsa stain looking for epithelial cell basophilic cytoplasmic inclusion bodies. […] Molecular: no tests are FDA-approved for GC or CT. […] Viral: not frequently needed but may help distinguish from other causes. […] Viral culture […] Viral PCR […] Adenovirus conjunctivitis can be diagnosed by a rapid, 10-min office test (AdenpPlus); immunohistochemical stains are available at some centers.

• #29 Bacterial Conjunctivitis – EyeWiki

  https://eyewiki.org/Bacterial_Conjunctivitis

  In the majority of cases it is a clinical diagnosis and does not require Gram stain or cultures. […] Gram stain and cultures in chocolate and blood agar are primarily used in cases of atypical conjunctivitis, such as hyperacute or chronic/nonresponding, as well as in neonatal conjunctivitis. […] Viral culture or polymerase chain reaction (PCR) can help differentiate viral versus bacterial conjunctivitis if the clinical diagnosis is unclear. […] Almost all cases of acute bacterial conjunctivitis are self-limited and will clear within 10 days without treatment. […] Furthermore, antibiotic treatment has been shown to decrease the duration of symptoms and speed the eradication of microorganisms from the conjunctival surface. […] Bacterial conjunctivitis is a contagious condition, so patients are instructed in proper hygiene and hand washing.

• #30 How is conjunctivitis diagnosed?

  https://www.mymed.com/diseases-conditions/conjunctivitis-pink-eye/how-is-conjunctivitis-diagnosed

  Bacterial: Eye-related symptoms often occur alongside sinus or ear infections. Discharge that indicates a bacterial infection will be thick (not watery or clear) mucous or pus. […] Allergic: A doctor will take into account possible seasonal influences (i.e. does the consultation coincide with a time of year that has a high pollen count spring or summer?). […] An examination may also involve an evaluation of external eye tissue and the conjunctiva (using magnification and bright light tools), as well as visual acuity measurements (to check for any possible visual impairments). […] Tear or fluid samples (conjunctival scrapings) from the affected conjunctiva may only be necessary for laboratory analysis should the symptoms present be severe, or if a high-risk cause is suspected (such as a bacterial or specific sexually transmitted infection).

• #31 How is conjunctivitis diagnosed?

  https://www.mymed.com/diseases-conditions/conjunctivitis-pink-eye/how-is-conjunctivitis-diagnosed

  If an underlying cause is tricky to diagnose using a medical review and physical examination alone, a doctor may send a sample for analysis, even if symptoms are not severe, in order to rule out or help diagnose the cause of infection. […] Should a patient be diagnosed with chronic conjunctivitis or return to the doctors office if symptoms are not improving after the recommended period of time, cultures or smears of fluid substances may be taken and sent for further supplemental laboratory testing, in order to determine an underlying cause. […] A severe set of symptoms may prompt a doctor to refer a patient to an ophthalmologist (a specialist in medical and surgical eye conditions or diseases) for further, more comprehensive evaluation.

• #32 Conjunctivitis | Johns Hopkins ABX Guide

  https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540141/all/Conjunctivitis

  Conjunctival scrapings or cultures (bacterial/viral) are generally not needed except in resistant cases as cases diagnosed clinically, also obtain in hyperpurulent, severe, visually impairing or recurrent disease. […] Specific testing: […] Bacterial: […] Swabs for Gram stain and aerobic culture will capture most standard, non-fastidious bacteria. […] Gram stain and culture […] Gonococcal disease is most commonly diagnosed by Gram stain, which shows characteristic Gram-negative intracellular diplococci. […] Chlamydia is most commonly diagnosed by DFA (Direct Fluorescent Antibody) staining of conjunctival smears or Giemsa stain looking for epithelial cell basophilic cytoplasmic inclusion bodies. […] Molecular: no tests are FDA-approved for GC or CT. […] Viral: not frequently needed but may help distinguish from other causes. […] Viral culture […] Viral PCR […] Adenovirus conjunctivitis can be diagnosed by a rapid, 10-min office test (AdenpPlus); immunohistochemical stains are available at some centers.

• #33 Acute conjunctivitis – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/68

  Key diagnostic factors include watery discharge, ropy, mucoid discharge, purulent discharge, itching predominant symptom, red eye, eyelids stuck together in morning, and tender, preauricular lymphadenopathy. […] Other diagnostic factors include conjunctival follicles, chemosis, swollen eyelids, superficial punctate keratopathy, unilateral symptoms and signs, use of medications that may lead to eye irritation, contact lens use, corneal subepithelial infiltrates, corneal pannus, vesicular skin rash, and symptoms and signs of related systemic disease. […] 1st tests to order include rapid adenovirus immunoassay. […] Tests to consider include cell culture, special stains (Gram, Giemsa), polymerase chain reaction, ocular pH, allergy skin testing, and tear immunoglobulin E level.

• #34 Evaluation of Infectious Conjunctivitis by Clinical Evaluation and Novel Diagnostics – Journal of Urgent Care Medicine

  https://www.jucm.com/evaluation-of-infectious-conjunctivitis-by-clinical-evaluation-and-novel-diagnostics/

  Rapid diagnostic tests and culture are among the most common procedures in urgent care centers, done at 49.2% of patient visits with a total of 87.1 million performed in 2018. […] The most recent such test, QuickVue Adenoviral Conjunctivitis Test (Quidel), formerly RPS AdenoPlus, is a second generation test built upon the RPOS Adeno Detector, with enhanced sensitivity and specificity. […] A recent prospective study of 128 patients with clinical diagnosis of acute viral conjunctivitis has demonstrated high sensitivity (85%-90%) and specificity (96%-98%) when compared to current standard diagnostic methods of cell culture and PCR. […] Advancements in rapid diagnostic testing further assist with making early diagnosis of adenoviral conjunctivitis, saving patients from ocular surface toxicity and the financial burden of unwarranted antibiotic treatment.

• #35

  https://www.healio.com/news/ophthalmology/20120331/acute-pediatric-conjunctivitis

  The University of Washington investigators also looked at the diagnostic value of staining material from conjunctival scrapings with Gram’s and Giemsa stains. […] They found that in 51 of 52 cases, the observed Gram’s stain agreed with the known staining properties of the cultured pathogen. […] Gram’s staining, therefore, offers a rapid, sensitive means of identifying pathogens in bacterial conjunctivitis. […] It often is difficult to distinguish bacterial from viral conjunctivitis on clinical grounds alone, but the child’s age can offer a significant guideline. […] Because acute conjunctivitis is not routinely cultured, knowledge of the most common pathogens generally provides the basis for therapeutic decisions. […] When a child has conjunctival hyperemia with a purulent exudate in both eyes, the infection is most likely bacterial.

• #36 Evaluation of Infectious Conjunctivitis by Clinical Evaluation and Novel Diagnostics – Journal of Urgent Care Medicine

  https://www.jucm.com/evaluation-of-infectious-conjunctivitis-by-clinical-evaluation-and-novel-diagnostics/

  Rapid diagnostic tests and culture are among the most common procedures in urgent care centers, done at 49.2% of patient visits with a total of 87.1 million performed in 2018. […] The most recent such test, QuickVue Adenoviral Conjunctivitis Test (Quidel), formerly RPS AdenoPlus, is a second generation test built upon the RPOS Adeno Detector, with enhanced sensitivity and specificity. […] A recent prospective study of 128 patients with clinical diagnosis of acute viral conjunctivitis has demonstrated high sensitivity (85%-90%) and specificity (96%-98%) when compared to current standard diagnostic methods of cell culture and PCR. […] Advancements in rapid diagnostic testing further assist with making early diagnosis of adenoviral conjunctivitis, saving patients from ocular surface toxicity and the financial burden of unwarranted antibiotic treatment.

• #37 Diagnosis and treatment of hyperacute bacterial conjunctivitis – EyeWorld

  https://www.eyeworld.org/2018/diagnosis-and-treatment-of-hyperacute-bacterial-conjunctivitis/

  Hyperacute bacterial conjunctivitis requires prompt diagnosis and treatment because some types, specifically conjunctivitis caused by Neisseria gonorrhoeae or Neisseria meningitides, can cause corneal ulceration, corneal opacification, corneal perforation, and panophthalmitis. […] According to Francis Mah, MD, La Jolla, California, Hyperacute bacterial conjunctivitis is accompanied by a copious amount of green or gray mucus. If you take a tissue and wipe some of it away, it is back immediately. It is typically unilateral, although it can be bilateral. There can also be significant eyelid edema and redness of the eye. […] According to Dr. de Luise, this condition is so dramatic that it cant be mistaken for another condition. Its an explosive, rapid onset, severely purulent, pussy conjunctivitis. The patient comes to you and is weeping yellow discharge.

• #38 Diagnosis and treatment of hyperacute bacterial conjunctivitis – EyeWorld

  https://www.eyeworld.org/2018/diagnosis-and-treatment-of-hyperacute-bacterial-conjunctivitis/

  The causes of hyperacute bacterial conjunctivitis are almost always bacteria in the genus Neisseria. Neisseria gonorrhoeae or its cousin Neisseria meningitidis are often responsible, Dr. de Luise said. […] Dr. Mah added that Neisseria gonococcus is one of the rare pathogens that can penetrate a normal, intact corneal epithelium. […] If the physician diagnoses hyperacute bacterial conjunctivitis, this can be a sexually transmitted disease by Neisseria gonorrhoeae bacteria, Dr. de Luise said. One should be worried about Neisseria gonorrhoeae, which is the gonococcus, or rarely Neisseria meningitidis, which is the meningococcus that causes meningitis. […] He noted that the cornea is involved in almost half of the cases of hyperacute bacterial conjunctivitis. About 40% of the time, there is an ulceration or a perforation, which is a sight-threatening and life-threatening emergency.

• #39 Types of Bacterial Conjunctivitis | Conjunctivitis (Pink Eye) | CDC

  https://www.cdc.gov/conjunctivitis/hcp/clinical-overview/bacterial-types.html

  Bacterial conjunctivitis (pink eye) is very contagious and caused by many types of bacteria, including staph and strep. […] Signs and symptoms of bacterial conjunctivitis overlap with other causes of conjunctivitis, which can make diagnosis difficult. […] Most common form of bacterial conjunctivitis. […] Typically self-limited within 1 to 2 weeks, but topical antibiotic therapy may reduce the duration of disease. […] A very rare and severe type of conjunctivitis with rapid onset and progression. […] Can progress to corneal infiltrates, melting and perforation, and vision loss if not treated promptly by an ophthalmologist. […] Requires both parenteral and topical antibiotic therapy. […] Defined as symptoms lasting for at least 4 weeks. People with this condition should see an ophthalmologist.

• #40 Diagnosis and treatment of hyperacute bacterial conjunctivitis – EyeWorld

  https://www.eyeworld.org/2018/diagnosis-and-treatment-of-hyperacute-bacterial-conjunctivitis/

  Hyperacute bacterial conjunctivitis requires prompt diagnosis and treatment because some types, specifically conjunctivitis caused by Neisseria gonorrhoeae or Neisseria meningitides, can cause corneal ulceration, corneal opacification, corneal perforation, and panophthalmitis. […] According to Francis Mah, MD, La Jolla, California, Hyperacute bacterial conjunctivitis is accompanied by a copious amount of green or gray mucus. If you take a tissue and wipe some of it away, it is back immediately. It is typically unilateral, although it can be bilateral. There can also be significant eyelid edema and redness of the eye. […] According to Dr. de Luise, this condition is so dramatic that it cant be mistaken for another condition. Its an explosive, rapid onset, severely purulent, pussy conjunctivitis. The patient comes to you and is weeping yellow discharge.

• #41 Diagnosis and treatment of hyperacute bacterial conjunctivitis – EyeWorld

  https://www.eyeworld.org/2018/diagnosis-and-treatment-of-hyperacute-bacterial-conjunctivitis/

  The causes of hyperacute bacterial conjunctivitis are almost always bacteria in the genus Neisseria. Neisseria gonorrhoeae or its cousin Neisseria meningitidis are often responsible, Dr. de Luise said. […] Dr. Mah added that Neisseria gonococcus is one of the rare pathogens that can penetrate a normal, intact corneal epithelium. […] If the physician diagnoses hyperacute bacterial conjunctivitis, this can be a sexually transmitted disease by Neisseria gonorrhoeae bacteria, Dr. de Luise said. One should be worried about Neisseria gonorrhoeae, which is the gonococcus, or rarely Neisseria meningitidis, which is the meningococcus that causes meningitis. […] He noted that the cornea is involved in almost half of the cases of hyperacute bacterial conjunctivitis. About 40% of the time, there is an ulceration or a perforation, which is a sight-threatening and life-threatening emergency.

• #42 Diagnosis and treatment of hyperacute bacterial conjunctivitis – EyeWorld

  https://www.eyeworld.org/2018/diagnosis-and-treatment-of-hyperacute-bacterial-conjunctivitis/

  The causes of hyperacute bacterial conjunctivitis are almost always bacteria in the genus Neisseria. Neisseria gonorrhoeae or its cousin Neisseria meningitidis are often responsible, Dr. de Luise said. […] Dr. Mah added that Neisseria gonococcus is one of the rare pathogens that can penetrate a normal, intact corneal epithelium. […] If the physician diagnoses hyperacute bacterial conjunctivitis, this can be a sexually transmitted disease by Neisseria gonorrhoeae bacteria, Dr. de Luise said. One should be worried about Neisseria gonorrhoeae, which is the gonococcus, or rarely Neisseria meningitidis, which is the meningococcus that causes meningitis. […] He noted that the cornea is involved in almost half of the cases of hyperacute bacterial conjunctivitis. About 40% of the time, there is an ulceration or a perforation, which is a sight-threatening and life-threatening emergency.

• #43

  https://www.healio.com/news/ophthalmology/20120331/acute-pediatric-conjunctivitis

  The usual treatment is systemic erythromycin, which covers both the conjunctivitis and the pneumonitis that often accompany neonatal conjunctivitis. […] The most common infectious cause of neonatal conjunctivitis is Chlamydia trachomatis, which the infant acquires from the mother during birth. […] The clinical spectrum varied from eyes with mild conjunctival vascular injection to some with a profuse mucopurulent discharge, making the clinical diagnosis (viral versus bacterial) difficult.

• #44

  https://www.healio.com/news/ophthalmology/20120331/acute-pediatric-conjunctivitis

  A topical anti-infective known to be effective against the suspected or culture-proven pathogen should be selected for treatment. […] Many other topical products are available. […] Available topical antibiotics include ofloxacin (Ocuflox, Allergan), ciprofloxacin (Ciloxan, Alcon), norfloxacin (Chibroxin, Merck Co Co) and levofloxacin (Quixen, Santen). […] Ophthalmologists have become comfortable with the use of topical fluoroquinolones, which have supplanted other antibiotics as first line therapy for pediatric bacterial conjunctivitis in most cases. […] The need for systemic antibiotic treatment depends on the severity of the child’s symptoms and associated problems, such as development of conjunctivitis-otitis syndrome. […] Direct culture of the conjunctiva is the most sensitive method to diagnose chlamydial conjunctivitis.

• #45

  https://www.healio.com/news/ophthalmology/20120331/acute-pediatric-conjunctivitis

  The usual treatment is systemic erythromycin, which covers both the conjunctivitis and the pneumonitis that often accompany neonatal conjunctivitis. […] The most common infectious cause of neonatal conjunctivitis is Chlamydia trachomatis, which the infant acquires from the mother during birth. […] The clinical spectrum varied from eyes with mild conjunctival vascular injection to some with a profuse mucopurulent discharge, making the clinical diagnosis (viral versus bacterial) difficult.

• #46 Pediatric Conjunctivitis: A Review of Clinical Manifestations, Diagnosis, and Management

  https://www.mdpi.com/2227-9067/10/5/808

  While antibiotics have been shown to decrease the duration of symptoms, no differences in sight threatening outcomes have been observed between treatment and non-treatment groups. […] Treatment of viral conjunctivitis, including COVID-19 conjunctivitis, is primarily symptomatic through the use of cool compresses and lubricating artificial tears. […] Treatment of allergic conjunctivitis consists of minimizing exposure to the allergen and controlling symptoms. […] Many foreign bodies are superficial and benign, yet cause significant pain. […] In the United States, ocular prophylaxis against neonatal conjunctivitis with 0.5% erythromycin ophthalmic ointment is the common practice. […] Although certain symptoms and clinical exam findings tend to correspond with specific causes of pink eye, it must be emphasized that clinical manifestations are non-specific and that considerable overlap exists in actual clinical practice.

• #47 Clinical Overview of Pink Eye (Conjunctivitis) | Conjunctivitis (Pink Eye) | CDC

  https://www.cdc.gov/conjunctivitis/hcp/clinical-overview/index.html

  Most cases of acute, infectious conjunctivitis in adults are viral and self-limited; these cases do not require antimicrobial treatment. Antiviral medication may be used to treat more serious forms of conjunctivitis. […] Contact lens wearers with bacterial conjunctivitis are at higher risk of bacterial keratitis. They should be asked to remove their contact lenses; treated with topical antibiotics; and promptly evaluated by an ophthalmologist. […] Advise patients to remain home if they have viral or bacterial conjunctivitis with systemic signs of illness, especially if they cannot avoid close contact with others. Patients may return to work or school if they receive clinician approval and after any indicated therapy is implemented.

• #48 Conjunctivitis – EyeWiki

  https://eyewiki.org/Conjunctivitis

  All clinical forms of allergic conjunctivitis present with symptoms such as redness, watering, discharge, and discomfort or eye pain, and most importantly, ocular itching which is unusual in non-allergic eye conditions. Visual disturbance is usually minimal except in the more severe disorders and patients may also complain of swelling of the lids. […] Signs and symptoms include red eye, purulent or mucopurulent discharge, and chemosis and presents with severe copious purulent discharge and decreased vision. There is often accompanying eyelid swelling and eye pain on palpation. When conjunctivitis is caused by Neisseria gonorrhoeae, it carries a high risk for keratitis, endophthalmitis, corneal perforation, and systemic infection. […] The course of the disease usually lasts 7-10 days. […] The possibility of bacterial keratitis is high in contact lens wearers, who should be treated with topical antibiotics and referred to an ophthalmologist. A patient wearing contact lenses should be asked to immediately remove them. […] The treatment consists of allergen avoidance.

• #49 Pink eye (conjunctivitis) – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pink-eye/symptoms-causes/syc-20376355

  Pink eye (conjunctivitis) is the inflammation or infection of the transparent membrane that lines your eyelid and eyeball. […] Treatments can help ease the discomfort of pink eye. Because pink eye can be contagious, getting an early diagnosis and taking certain precautions can help limit its spread. […] If your symptoms don’t start to get better within 12 to 24 hours, make an appointment with your eye healthcare professional to make sure you don’t have a more serious eye infection related to contact lens use. […] Prompt evaluation and treatment by your healthcare professional can reduce the risk of complications.

• #50 Clinical Overview of Pink Eye (Conjunctivitis) | Conjunctivitis (Pink Eye) | CDC

  https://www.cdc.gov/conjunctivitis/hcp/clinical-overview/index.html

  Most cases of acute, infectious conjunctivitis in adults are viral and self-limited; these cases do not require antimicrobial treatment. Antiviral medication may be used to treat more serious forms of conjunctivitis. […] Contact lens wearers with bacterial conjunctivitis are at higher risk of bacterial keratitis. They should be asked to remove their contact lenses; treated with topical antibiotics; and promptly evaluated by an ophthalmologist. […] Advise patients to remain home if they have viral or bacterial conjunctivitis with systemic signs of illness, especially if they cannot avoid close contact with others. Patients may return to work or school if they receive clinician approval and after any indicated therapy is implemented.

• #51 Conjunctivitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK541034/

  When treating viral or bacterial conjunctivitis, educating the patient to reduce the spread of the infection is important. […] Bacterial conjunctivitis, while typically self-limiting, can be treated to help reduce the duration of symptoms. […] The recommended treatment for gonococcal conjunctivitis is ceftriaxone 1 gm intramuscular (IM); the recommendation is to treat concurrent chlamydial infection with 1 gm azithromycin by mouth (PO). […] Patients with moderate to severe pain, vision loss, corneal involvement, severe purulent discharge, conjunctival scarring, recurrent episodes, lack of response to therapy, or herpes simplex virus keratitis should receive a prompt referral to an ophthalmologist.

• #52 Conjunctivitis: Diagnosis and Management – PubMed

  https://pubmed.ncbi.nlm.nih.gov/39172671/

  Conjunctivitis caused by viruses, bacteria, or allergies is one of the most common eye conditions in primary care. There is no single sign or symptom that accurately differentiates viral from bacterial conjunctivitis. A comprehensive history and physical examination can guide diagnosis. […] Viral and allergic conjunctivitis are more common in adults and typically present with watery discharge. Supportive care options for viral conjunctivitis include artificial tears, cold compresses, and antihistamine eye drops. […] Bacterial conjunctivitis is more common in children and typically presents as mucopurulent discharge with the eyelids matted shut. […] Ophthalmology referral is indicated for conjunctivitis in a neonate or patients with severe pain, decreased vision, recent ocular surgery, vesicular rash on the eyelids or nose, history of rheumatologic disease, or immunocompromised state.

• #53 Conjunctivitis: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2024/0800/conjunctivitis.html

  Conjunctivitis caused by viruses, bacteria, or allergies is one of the most common eye conditions in primary care. […] There is no single sign or symptom that accurately differentiates viral from bacterial conjunctivitis. A comprehensive history and physical examination can guide diagnosis. […] Bacterial conjunctivitis is more common in children and typically presents as mucopurulent discharge with the eyelids matted shut. […] Delayed antibiotic prescribing has been found to have similar symptom control as immediate prescribing. […] Ophthalmology referral is indicated for conjunctivitis in a neonate or patients with severe pain, decreased vision, recent ocular surgery, vesicular rash on the eyelids or nose, history of rheumatologic disease, or immunocompromised state. […] This article discusses the three most common causes of conjunctivitis, clinical features that can be used to differentiate them, and recommendations for treatment.

• #54 Bacterial conjunctivitis: diagnosis and management – The Pharmaceutical Journal

  https://pharmaceutical-journal.com/article/ld/bacterial-conjunctivitis-diagnosis-and-management

  Bacterial conjunctivitis is a common presentation in community pharmacy so it is important to be able to recognise signs and symptoms, as well as identify causes and risk factors for all types of infection. […] After reading this learning article, you should be able to: […] Identify the symptoms of bacterial conjunctivitis and know how to conduct an appropriate diagnostic examination; […] A basic examination and a focused ocular history is usually all that is required to diagnose bacterial conjunctivitis. […] A combination of bilateral sticking of the eyelids on waking, absence of itching and no prior conjunctivitis is suggestive of bacterial conjunctivitis. […] Conjunctival swabs for culture and/or polymerase chain reaction are reserved for recurrent, treatment resistant, severely purulent or otherwise suspected STI origin. […] Patients who do not respond to treatment within 48 hours and/or who have worsening symptoms should be referred to an ophthalmologist for investigation.

• #55 A Review of the Differential Diagnosis of Acute Infectious Conjunctivi | OPTH

  https://www.dovepress.com/a-review-of-the-differential-diagnosis-of-acute-infectious-conjunctivi-peer-reviewed-fulltext-article-OPTH

  The diagnosis of acute infectious conjunctivitis can be difficult. Clinical ambiguity exists between the acute viral and bacterial as well as the allergic forms, which can confound diagnosis. […] Therefore, in order to effectively treat acute infectious conjunctivitis, physicians must be aware of the clinical signs and symptoms and available diagnostic tests that can provide a more accurate differential diagnosis. […] Misdiagnoses expose patients to unnecessary and ineffective antibiotic treatment. […] There are several challenges to accurately diagnosing acute infectious conjunctivitis. First, clinical ambiguity exists between the acute viral and bacterial as well as the allergic forms, which can confound diagnosis. […] Guidelines and criteria for diagnosing and treating acute infectious conjunctivitis based on natural history and etiology are available.

• #56 A Review of the Differential Diagnosis of Acute Infectious Conjunctivi | OPTH

  https://www.dovepress.com/a-review-of-the-differential-diagnosis-of-acute-infectious-conjunctivi-peer-reviewed-fulltext-article-OPTH

  Diagnosis of acute infectious conjunctivitis is complicated because of the signs and symptoms that overlap with other inflammatory conjunctival conditions; therefore, likelihood for misdiagnosis remains high. Misdiagnosis of viral conjunctivitis as bacterial conjunctivitis may result in inappropriate use of antibiotics, which in turn contributes to increased antibiotic resistance.

• #57 Acute conjunctivitis – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/68

  Symptoms of acute conjunctivitis include an irritated red eye with a watery or purulent discharge. […] There are a range of causes of acute conjunctivitis, including allergy, bacterial or viral infection, mechanical stress, and irritation by toxic chemicals or medication. […] Treatment for allergic conjunctivitis includes topical mast cell stabilizers and antihistamines; bacterial conjunctivitis treatment includes topical antibiotics; viral conjunctivitis requires symptomatic treatment. […] Bacterial and viral conjunctivitis is highly contagious; measures to prevent spread of infection should be considered. […] Conjunctivitis is the inflammation of the lining of the eyelids and eyeball caused by bacteria, viruses, allergic or immunologic reactions, mechanical irritation, or medications.

• #58 Clinical Overview of Pink Eye (Conjunctivitis) | Conjunctivitis (Pink Eye) | CDC

  https://www.cdc.gov/conjunctivitis/hcp/clinical-overview/index.html

  Most cases of acute, infectious conjunctivitis in adults are viral and self-limited; these cases do not require antimicrobial treatment. Antiviral medication may be used to treat more serious forms of conjunctivitis. […] Contact lens wearers with bacterial conjunctivitis are at higher risk of bacterial keratitis. They should be asked to remove their contact lenses; treated with topical antibiotics; and promptly evaluated by an ophthalmologist. […] Advise patients to remain home if they have viral or bacterial conjunctivitis with systemic signs of illness, especially if they cannot avoid close contact with others. Patients may return to work or school if they receive clinician approval and after any indicated therapy is implemented.

• #59 Pink Eye (Conjunctivitis): Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/pink-eye-conjunctivitis

  Pink eye (conjunctivitis) is when your eyes look pink because the membrane that covers the sclera, the white of your eye, is inflamed. […] Pink eye is inflammation of the conjunctiva, a clear membrane layer that covers parts of your eyes and the inside of your eyelids. […] Pink eye can be acute (short-term), meaning it lasts under four weeks. Or it can be chronic (long-term), meaning it lasts more than four weeks. […] Eye care specialists usually arent the ones to diagnose conjunctivitis. Instead, 80% of diagnoses come from primary care providers and pediatricians. Urgent care and emergency room providers also diagnose many cases. […] Providers may also recommend taking a swab to test for bacterial infections. […] Pink eye is treatable, regardless of the cause. […] Most pink eye treatments are medications.

• #60 Pink Eye (Conjunctivitis): Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/pink-eye-conjunctivitis

  Antibiotics (eye drops, ointments or pills) treat bacterial conjunctivitis. […] Pink eye from viruses doesnt need treatment unless the virus causing it is herpes simplex, varicella-zoster (chickenpox/shingles) or an STI. […] Its important to remember that antibiotics only treat bacterial infections. […] Some forms of conjunctivitis are preventable, and you can lower your risk of developing many others. […] The outlook for pink eye is generally good, especially when treated as needed. […] If you suspect you have pink eye and it keeps worsening after a few days, its a good idea to see a primary care provider or go to urgent care. […] You dont necessarily need to see a doctor for pink eye. Most of the time, you can treat the symptoms at home until they go away on their own. […] Pink eye can come back, especially if you have allergy-related pink eye.

• #61 Conjunctivitis: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2024/0800/conjunctivitis.html

  Conjunctivitis caused by viruses, bacteria, or allergies is one of the most common eye conditions in primary care. […] There is no single sign or symptom that accurately differentiates viral from bacterial conjunctivitis. A comprehensive history and physical examination can guide diagnosis. […] Bacterial conjunctivitis is more common in children and typically presents as mucopurulent discharge with the eyelids matted shut. […] Delayed antibiotic prescribing has been found to have similar symptom control as immediate prescribing. […] Ophthalmology referral is indicated for conjunctivitis in a neonate or patients with severe pain, decreased vision, recent ocular surgery, vesicular rash on the eyelids or nose, history of rheumatologic disease, or immunocompromised state. […] This article discusses the three most common causes of conjunctivitis, clinical features that can be used to differentiate them, and recommendations for treatment.

• #62 Clinical Overview of Pink Eye (Conjunctivitis) | Conjunctivitis (Pink Eye) | CDC

  https://www.cdc.gov/conjunctivitis/hcp/clinical-overview/index.html

  Conjunctivitis is caused by viruses, bacteria, allergens, contact lens use, chemicals, fungi, and certain diseases. […] Advise patients to remain home if they have viral or bacterial conjunctivitis with systemic signs of illness. […] Bacterial conjunctivitis is very contagious and can spread from person to person in many ways. These include from: Hand-to-eye contact, Contact of eye with contaminated objects, Sexual encounters with eye to genital contact, or vertically from mother to baby, Large respiratory tract droplets. […] Signs and symptoms of bacterial conjunctivitis overlap with other causes of conjunctivitis, including viral and allergic conjunctivitis, which can make diagnosis difficult. […] Typical signs and symptoms include: Red eye, Purulent discharge that causes eyelids to be matted together, Chemosis, Decreased vision, Eyelid swelling and pain.

• #63 Clinical Overview of Pink Eye (Conjunctivitis) | Conjunctivitis (Pink Eye) | CDC

  https://www.cdc.gov/conjunctivitis/hcp/clinical-overview/index.html

  Most cases of acute, infectious conjunctivitis in adults are viral and self-limited; these cases do not require antimicrobial treatment. Antiviral medication may be used to treat more serious forms of conjunctivitis. […] Contact lens wearers with bacterial conjunctivitis are at higher risk of bacterial keratitis. They should be asked to remove their contact lenses; treated with topical antibiotics; and promptly evaluated by an ophthalmologist. […] Advise patients to remain home if they have viral or bacterial conjunctivitis with systemic signs of illness, especially if they cannot avoid close contact with others. Patients may return to work or school if they receive clinician approval and after any indicated therapy is implemented.

• #64 Clinical Overview of Pink Eye (Conjunctivitis) | Conjunctivitis (Pink Eye) | CDC

  https://www.cdc.gov/conjunctivitis/hcp/clinical-overview/index.html

  Most cases of acute, infectious conjunctivitis in adults are viral and self-limited; these cases do not require antimicrobial treatment. Antiviral medication may be used to treat more serious forms of conjunctivitis. […] Contact lens wearers with bacterial conjunctivitis are at higher risk of bacterial keratitis. They should be asked to remove their contact lenses; treated with topical antibiotics; and promptly evaluated by an ophthalmologist. […] Advise patients to remain home if they have viral or bacterial conjunctivitis with systemic signs of illness, especially if they cannot avoid close contact with others. Patients may return to work or school if they receive clinician approval and after any indicated therapy is implemented.

• #65 Clinical Overview of Pink Eye (Conjunctivitis) | Conjunctivitis (Pink Eye) | CDC

  https://www.cdc.gov/conjunctivitis/hcp/clinical-overview/index.html

  Most cases of acute, infectious conjunctivitis in adults are viral and self-limited; these cases do not require antimicrobial treatment. Antiviral medication may be used to treat more serious forms of conjunctivitis. […] Contact lens wearers with bacterial conjunctivitis are at higher risk of bacterial keratitis. They should be asked to remove their contact lenses; treated with topical antibiotics; and promptly evaluated by an ophthalmologist. […] Advise patients to remain home if they have viral or bacterial conjunctivitis with systemic signs of illness, especially if they cannot avoid close contact with others. Patients may return to work or school if they receive clinician approval and after any indicated therapy is implemented.

• #66 Overview of Conjunctivitis – Eye Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/eye-disorders/conjunctival-and-scleral-disorders/overview-of-conjunctivitis

  Conjunctivitis is typically acute, but both infectious and allergic conditions can be chronic. […] Diagnosis is clinical; sometimes cultures are indicated. […] Usually, diagnosis of conjunctivitis is made by history and ocular examination, usually including slit-lamp examination with fluorescein staining of the cornea. […] The cause of conjunctivitis is suggested by clinical findings. However, cultures are indicated for patients with severe symptoms, immunocompromise, a vulnerable eye, or poor response to initial therapy. […] Clinical differentiation between viral and bacterial infectious conjunctivitis is not highly accurate. However, if the history and examination strongly suggest viral conjunctivitis, withholding antibiotics initially is appropriate. […] Diagnosis is usually clinical.

• #67 Conjunctivitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK541034/

  In cases of conjunctivitis, the redness typically affects the entire surface of the conjunctiva, including both the bulbar and tarsal conjunctiva. […] When identifying the cause of conjunctivitis, the type of discharge is a crucial factor. […] Determining the cause of conjunctivitis can be challenging as its symptoms are not specific. […] While conjunctivitis often presents similarly, a thorough systematic history and physical exam can safely rule out any acute sight-threatening diagnoses and elucidate the likely cause of conjunctivitis. […] Labs and cultures are rarely indicated to confirm conjunctivitis diagnosis. […] Eyelid cultures and cytology are usually reserved for recurrent conjunctivitis, those resistant to treatment, suspected gonococcal or chlamydial infection, suspected infectious neonatal conjunctivitis, and adults presenting with severe purulent discharge.

• #68 Conjunctivitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK541034/

  Identify the characteristic clinical features of conjunctivitis to facilitate accurate diagnosis. […] Implement evidence-based management strategies for conjunctivitis, optimizing patient outcomes. […] Communicate effectively with patients about conjunctivitis, its course, treatment options, and potential complications. […] Coordinate care with interdisciplinary teams to address underlying systemic conditions associated with conjunctivitis. […] When diagnosing conjunctivitis, conducting a comprehensive history and physical examination is essential to identify the underlying cause and determine the appropriate treatment. […] The ocular exam should focus on visual acuity, extraocular motility, visual fields, discharge type, shape, size and response of pupil, the presence of proptosis, corneal opacity, foreign body assessment, tonometry, and eyelid swelling.

• #69 Bacterial Conjunctivitis (Pink Eye) Differential Diagnoses

  https://emedicine.medscape.com/article/1191730-differential

  Diagnostic Considerations […] Medicolegal concerns do arise in connection with bacterial conjunctivitis. As with all medical practice, careful discussion and documentation is paramount. A few general guidelines are helpful, as follows: […] Know the differential diagnosis. […] Perform an eye examination and, in particular, document that keratitis, iritis, and acute glaucoma have been ruled out. […] Always document the best corrected visual acuity in each eye. […] Ascertain the absence of glaucoma on every visit or the inability to safely do so. A simple ballpark bidigital applanation of each globe through the closed upper lid provides a useful and legally protective assessment of intraocular pressure (IOP). This assessment can be performed in immediate proximity to the digital assessment for preauricular lymphadenopathy, accompanied by thorough physician handwashing thereafter.

• #70 Acute conjunctivitis – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/68

  Key diagnostic factors include watery discharge, ropy, mucoid discharge, purulent discharge, itching predominant symptom, red eye, eyelids stuck together in morning, and tender, preauricular lymphadenopathy. […] Other diagnostic factors include conjunctival follicles, chemosis, swollen eyelids, superficial punctate keratopathy, unilateral symptoms and signs, use of medications that may lead to eye irritation, contact lens use, corneal subepithelial infiltrates, corneal pannus, vesicular skin rash, and symptoms and signs of related systemic disease. […] 1st tests to order include rapid adenovirus immunoassay. […] Tests to consider include cell culture, special stains (Gram, Giemsa), polymerase chain reaction, ocular pH, allergy skin testing, and tear immunoglobulin E level.

• #71 A Review of the Differential Diagnosis of Acute Infectious Conjunctivi | OPTH

  https://www.dovepress.com/a-review-of-the-differential-diagnosis-of-acute-infectious-conjunctivi-peer-reviewed-fulltext-article-OPTH

  The diagnosis of acute infectious conjunctivitis can be difficult. Clinical ambiguity exists between the acute viral and bacterial as well as the allergic forms, which can confound diagnosis. […] Therefore, in order to effectively treat acute infectious conjunctivitis, physicians must be aware of the clinical signs and symptoms and available diagnostic tests that can provide a more accurate differential diagnosis. […] Misdiagnoses expose patients to unnecessary and ineffective antibiotic treatment. […] There are several challenges to accurately diagnosing acute infectious conjunctivitis. First, clinical ambiguity exists between the acute viral and bacterial as well as the allergic forms, which can confound diagnosis. […] Guidelines and criteria for diagnosing and treating acute infectious conjunctivitis based on natural history and etiology are available.

• #72 Conjunctivitis: a systematic review of diagnosis and treatment. – Ophthalmology and Visual Sciences – UW–Madison

  https://www.ophth.wisc.edu/blog/2013/10/23/conjunctivitis-a-systematic-review-of-diagnosis-and-treatment/

  IMPORTANCE Conjunctivitis is a common problem. […] OBJECTIVE To examine the diagnosis, management, and treatment of conjunctivitis, including various antibiotics and alternatives to antibiotic use in infectious conjunctivitis and use of antihistamines and mast cell stabilizers in allergic conjunctivitis. […] FINDINGS Viral conjunctivitis is the most common overall cause of infectious conjunctivitis and usually does not require treatment; the signs and symptoms at presentation are variable. Bacterial conjunctivitis is the second most common cause of infectious conjunctivitis, with most uncomplicated cases resolving in 1 to 2 weeks. Mattering and adherence of the eyelids on waking, lack of itching, and absence of a history of conjunctivitis are the strongest factors associated with bacterial conjunctivitis. Topical antibiotics decrease the duration of bacterial conjunctivitis and allow earlier return to school or work. Conjunctivitis secondary to sexually transmitted diseases such as chlamydia and gonorrhea requires systemic treatment in addition to topical antibiotic therapy. Allergic conjunctivitis is encountered in up to 40% of the population, but only a small proportion of these individuals seek medical help; itching is the most consistent sign in allergic conjunctivitis, and treatment consists of topical antihistamines and mast cell inhibitors.

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