FREE subscriptions for doctors and students... click here
You have 3 more open access pages.
Inflammation of the conjunctiva is commonly infective or allergic. It is usually
- it is the commonest cause of red eye (1)
in children is predominantly bacterial, with nontypeable H. influenzae being the
most common organism (2)
Clinical features depend on the underlying
- however, the eyes often feel gritty or in allergic conjunctivitis,
- discharge is a constant finding and may be purulent, mucoid or watery;
typically, the eyelashes are stuck together on waking
- may be transient
blurring as a consequence of discharge smearing the cornea but this is easily
cleared by blinking
- photophobia and pain indicate corneal involvement
- keratoconjunctivitis - which is not infrequent
- diffuse hyperaemia overlying
the sclera and the inner surface of the eyelids.
- viral infection is associated
with follicles; allergies, with chemosis.
Itching suggests an allergic
Infective conjunctivitis is treated with topical antibiotics; non-infective
with anti-inflammatory agents.
- a meta-analysis concluded that '..acute conjunctivitis seen in primary care
can be thought of as a self-limiting condition, with most patients getting
better regardless of antibiotic therapy. Patients with purulent discharge
or a mild severity of red eye may have a small benefit from antibiotics...'
- Leibowitz HM. The Red Eye Leibowitz HM. NEJM 2000; 343:345.
- Patel PB et al. Clinical features of bacterial conjunctivitis in children.
Acad Emerg Med. 2007 Jan;14(1):1-5.
- Rietveld RP et al. Predicting bacterial cause in infectious conjunctivitis:
cohort study on informativeness of combinations of signs and symptoms. BMJ
2004 329: 206-210.
Jet al. Acute infective conjunctivitis in primary care: who needs antibiotics?
An individual patient data meta-analysis. Br J Gen Pract. 2011 Sep;61(590):e542-8.
Last reviewed 03/2021