Eye infections

Conjunctivitis

Most infections are viral and/or self-limiting and do not require antibiotics.

Chloramphenicol is cheap to buy and is readily available for certain patients, along with advice, from pharmacies. Please click here for further information and a patient leaflet

Bacterial conjunctivitis is self-limiting and will normally settle in 5-10 days, it is characterised by red eye with mucopurulent, not watery, discharge. Therefore, avoidance of drug treatment is an option if a patient wishes, for example during pregnancy

Public Health England advises that exclusion of single cases from school / nursery is not generally necessary, but may be required if an outbreak occurs.

Chlamydia conjunctivitis in neonates: oral erythromycin 12.5mg/kg every 6 hours. Additional drops are unnecessary.

Neonates with severe conjunctivitis should be referred urgently to secondary care.

If treatment with chloramphenicol fails take swabs and consider viral cause or incorrect administration. Fusidic acid has a narrow spectrum of activity and should not be used in cases of chloramphenicol failure or for reasons of convenience. Fusidic acid drops may be used in patients with chloramphenicol intolerance.

Chloramphenicol 0.5% eye drops
  • Apply every 2 hours during day for first 48 hours, then four times a day until 48 hours after resolution
  • There are no links established between chloramphenicol eye drops and aplastic anaemia
Chloramphenicol 1% ointment
  • Apply 3-4 times daily until 48 hours after resolution

Corneal abrasion

Chloramphenicol
  • Ointment 1%
  • Treat in primary care if no stromal whitening/abscess

 

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