Bacterial Conjunctivitis Management (064)


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A guideline is intended to assist healthcare professionals in the choice of disease-specific treatments.

Clinical judgement should be exercised on the applicability of any guideline, influenced by individual patient characteristics. Clinicians should be mindful of the potential for harmful polypharmacy and increased susceptibility to adverse drug reactions in patients with multiple morbidities or frailty.

If, after discussion with the patient or carer, there are good reasons for not following a guideline, it is good practice to record these and communicate them to others involved in the care of the patient.



Commonly irritated red eye with mainly normal vision

  Bacterial Viral Allergic Toxic
Main Symptom Sticky Watery Itchy Photophobic
Laterality Unilateral Starts in one, spreads to other Bilateral Depends on use of multiple drops
Swabs? If purulent Unnecessary in acute phase No No
Treatment Topical antibiotics Cool compresses


Strict hygiene

Cool compresses


Sodium Cromoglycate

Stop all drops


Eye Swabs

  • Don’t use routinely (likely to be negative), and unnecessary in obvious pathology e.g. dendrite
  • Useful in chronic cases to identify chlamydial or adenoviral conjunctivitis
  • Ensure patient is informed re possible outcome of swabs and given information leaflet
  • Check correct phone number to contact patient if positive result
  • If positive Chlamydia result, phone Sandyford health advisor for treatment advice and follow up appointment. Then phone patient and ask them to come into Casualty for results.
  • Do not leave results as an answer phone message!

Last reviewed: 14 June 2022

Next review: 14 June 2025

Author(s): David Lockington

Version: 6

Author Email(s): [email protected]

Approved By: Ophthalmology Clinical Governance Subcommittee

Document Id: 64