Bacterial Conjunctivitis.

 

Definition:

Conjunctivitis is an inflammation of the conjunctiva, which is the thin membrane covering the white of the eye and inside of the eyelids. Bacterial conjunctivitis is due to an infection of the conjunctiva, and is extremely contagious.

 

 

Causes:

It is caused by the same germs which can also cause the common cold. Bacterial conjunctivitis is often caused by Staphylococcus species, Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. It is very contagious; so spreads from person to person easily.

 

 

Presentation:

Bacterial conjunctivitis will typically occur unilaterally (in one eye only), and then spread

to the other. The eye will be red, discharge will be present, and the patient is likely to

wake up with the eyelids stuck together in the morning.

 

There is a history of close contact with someone suffering from conjunctivitis.

 

 

Differential Diagnosis:

Exclude irritant dermatitis by ensuring patient hasn't had foreign bodies in the eye, or

that chemicals have entered the eye.

 

Ensure there has been no recent trauma to the eye.

 

Check whether there is associated itching- this may be a sign of allergic conjunctivitis, and that the problem may be allergy related.

 

If a patient complains of moderate to severe pain, photophobia, loss of vision or has glaucoma, they should be referred to a GP.

 

 

Treatment:

Bacterial conjunctivitis can be treated with chloramphenicol eye drops 0.5% w/v (e.g. Tubilux Infected Eyes), 

ONE drop should be instilled into the infected eye every TWO hours for the first 48 hours, and FOUR hours

thereafter. 

 

Chloramphenicol eye ointment 1% w/v may also be used in conjunction with the eye drops (e.g. Optrex Infected

Eye Ointment), a small amount should be applied to the affected eye. The ointment should be applied at night if

the eye drops are used duing the day, or THREE to FOUR times daily if the ointment is used alone.

 

If symptoms do not improve within 5 days the patient should see their GP.

 

 

Self Help Advice:

Remove contact lenses until 24 hours after symptoms subside.

 

Clean away secretions from eye with cotton wool soaked in water.

 

Wash hands regularly, especially after touching secretions from eye, and avoid sharing towels or bedding to

prevent spread of infection.

 

Place cool compresses (such as a flannel soaked in water) onto the eye to reduce symptoms.

 

 

Sample Question:

You diagnose Mrs JR with bacterial conjunctivitis. What symptom or symptoms would cause you to refer her, rather than provide OTC treatment? You may select more than one answer if applicable.

 

a) severe pain in the eyes

b) photophobia 

c) clouding of the cornea

d) associated vomiting

e) redness caused by a foreign body

 

 

Answers to all sample questions can be found by following the link under the Test Yourself tab.