Referral criteria from primary care - conjunctivitis

The majority of cases of conjunctivitis do not require investigation or referral. The following cases should be referred to an ophthalmologist:

• neonatal conjunctivitis
• chronic conjunctivitis
• if the conjunctivitis does not respond to the initial treatment (if there is no improvement in 7 to 10 days) (1)
• if there are corneal changes associated with the conjunctivitis
• conjunctivitis with blurring of vision or pain as opposed to discomfort, and
• sicca (i.e. dry eye syndromes)

If the conjunctivitis is a case of sexually-associated infection then it is essential to refer the patient and contacts to the genitourinary medicine department.

References:

1. Leibowitz HM. The Red eye. NEJM 2000; 343:345.
2. American Academy of Ophthalmology. Conjunctivitis preferred practice pattern. Nov 2018 [internet publication]