Bacterial Conjunctivitis
Ophthalmology: Acute Ocular Surface Infection
1. Clinical Presentation
Bacterial conjunctivitis is characterized by an acute onset of redness and discharge. Key clinical identifiers include:
- Discharge: Purulent or mucopurulent (yellow/green), often causing “matted” eyelashes upon waking.
- Symptoms: Grittiness, burning, or foreign body sensation; usually minimal pain and preserved visual acuity.
- Physical Exam: Diffuse conjunctival injection (hyperemia) and papillary reaction.
2. Common Pathogens
| Pathogen | Key Characteristics |
|---|---|
| Staphylococcus aureus | Common in adults; often associated with blepharitis. |
| Streptococcus pneumoniae | Frequent in pediatric populations; it can be associated with otitis media. |
| Haemophilus influenzae | Common cause in children; may present with systemic symptoms. |
3. Management & High-Yield Pearls
- Self-Limiting: Many cases are self-limiting; however, topical antibiotics (e.g., erythromycin ointment, trimethoprim-polymyxin B drops) accelerate resolution and reduce transmission.
- Hygiene: Crucial to prevent spread. Advise patients on frequent hand washing and avoiding sharing towels/pillows.
- Differentiating Diagnosis: Always rule out hyperacute bacterial conjunctivitis (e.g., Neisseria gonorrhoeae), which presents with massive purulent discharge and requires urgent systemic treatment to prevent corneal perforation.
- Educational Resource: For management flowcharts, antibiotic selection guides, and practice questions, visit mymedschool.org.