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Conjunctivitis (often referred to as red eye)

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Describe the common signs and symptoms of conjunctivitis
Describe the aetiology of conjunctivitis
Describe when conjunctivitis should be referred
List OTC products to treat conjunctivitis and:
a) List their active ingredients
b) Explain the pharmacological basis of action of each of the ingredients
c) Detail the evidence base for each of the preparations and define the most effective product,
in accordance with that evidence base
d) List potential side effects of these products
e) State patient groups for whom these products are contra-indicated
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The three most common causes of this inflammation are: infection (infective conjunctivitis),
an allergic reaction (allergic conjunctivitis) or something irritating the conjunctiva, such as a
loose eyelash (irritant conjunctivitis)
Common signs and symptoms of conjunctivitis: symptoms involve the cause but generally
include: itchiness, watering of the eye, eye redness (note: although it only affects one eye at
first, symptoms usually affect both eyes within a few hours
If you have infective conjunctivitis you may also have:
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a burning sensation in your eyes

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a feeling of grit in your eyes

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a sticky coating on the eyelashes – usually when you first wake in the
morning

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an enlarged lymph node in front of the ear

If you have allergic conjunctivitis then itchy eyes is common
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Allergies to pollen (hay fever) occur during certain parts of the year
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When a topical ocular antibiotic is prescribed because of the person's preference for
treatment, consider advising them to delay starting treatment for 7 days to see if the
condition will resolve spontaneously
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Prescribe chloramphenicol first-line for empirical treatment of infective conjunctivitis when
a topical ocular antibiotic is considered necessary
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It is preferred for people who:
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Are pregnant
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Are intolerant of chloramphenicol
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Self-care advice
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To remove contact lenses, if worn, until all symptoms and signs of infection have
completely resolved and any treatment has been completed for 24 hours
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To clean away infected secretions from eyelids and lashes with cotton wool soaked in
water
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Self-care advice for seasonal or perennial allergic conjunctivitis?
Remove contact lenses, if these are worn, until symptoms and signs resolve
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Avoid exposure to the allergen when practical
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Drug treatment for allergic conjunctivitis
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When rapid relief of symptoms is required, prescribe an oral or topical
ocular antihistamine, depending on the person's preference and previous response
to treatment
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When a topical ocular mast cell stabilizer is prescribed long term, also prescribe
an oral antihistamine, or a topical ocular antihistamine if:
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Symptom control is needed in the first few weeks while waiting for the mast
cell stabilizer to take effect

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