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Conjunctivitis - infective - Management
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Definition
- For the purposes of this CKS topic, persistent infective conjunctivitis is defined as infective conjunctivitis lasting longer than 2 weeks.
What self-care advice should I give someone with infective conjunctivitis that lasts longer than 2 weeks?
- Urgently seek medical attention if marked eye pain or photophobia, loss of visual acuity or marked redness of the eye develop.
- Remove contact lenses, if worn, until all symptoms and signs of infection have completely resolved and any treatment has been completed for 24 hours.
- Lubricant eye drops may reduce eye discomfort; these are available over the counter, as well as on prescription.
- Clean away infected secretions from eyelids and lashes with cotton wool soaked in water.
- Wash hands regularly, particularly after touching infected secretions, and to avoid sharing pillows and towels to avoid spreading infection.
In depth
How do I determine the cause of infective conjunctivitis that persists longer than 2 weeks?
- Reassess the diagnosis — see Diagnosing infective conjunctivitis.
- Assess features suggestive of blepharitis. If present, see the CKS topic on Blepharitis. Features include:
- Swollen eyelids: the defining sign of staphylococcal blepharitis, but unusual when it is less severe.
- Inflamed lid margins: usually present.
- Altered eyelash appearance: including misdirection, crusting, and eyelash loss.
- Altered eyelid surfaces: may be scaly, oily, or greasy. Ulceration of the anterior lid indicates infection.
- Take swabs for bacteria and chlamydia.
- Consider prescribing a topical ocular antibiotic while awaiting results of swabs.
In depth
How do I manage the cause of persistent infective conjunctivitis?
For people with:
- Blepharitis associated with chronic conjunctivitis — see the CKS topic on Blepharitis.
- A positive bacterial culture — prescribe a topical ocular antibiotic directed by sensitivity results if they are still symptomatic.
- A positive chlamydial culture — refer for testing of sexual contacts and systemic treatment.
- A negative bacterial and chlamydial culture — consider repeating the test if symptoms persist for longer than 3 weeks.
In depth
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