Conjunctivitis

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AntibioticChoose one

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Counseling

Redness and discharge should improve within a few days. Recommended supportive care with an emphasis on wiping discharge from the inner corner of the eye outward with a clean cloth, washing hands often, and not sharing towels or pillows. Return precautions given including eye pain, vision changes, light sensitivity, eyelid swelling or redness around the eye, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

CounselingNot in the note with these choices

Viral conjunctivitis usually improves along with the cold over 1-2 weeks, and antibiotic drops will not help it. It is contagious for up to 10-14 days from onset, so wash hands often, avoid close contact, and avoid sharing towels and pillows. Recommended supportive care with an emphasis on cool compresses and artificial tears. Return precautions given including eye pain, vision changes, light sensitivity, eyelid swelling or redness around the eye, thick discharge, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

CounselingNot in the note with these choices

Allergic conjunctivitis is not contagious. Recommended supportive care with an emphasis on cool compresses, avoiding eye rubbing, and washing the face and hands after outdoor play. Return precautions given including eye pain, vision changes, light sensitivity, thick discharge, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

Note when inserted as is

Conjunctivitis
Bacterial
• No vision change, photophobia, or significant eye pain
• Ofloxacin eye drops
• Follow up if worsening or not improving as expected

Redness and discharge should improve within a few days. Recommended supportive care with an emphasis on wiping discharge from the inner corner of the eye outward with a clean cloth, washing hands often, and not sharing towels or pillows. Return precautions given including eye pain, vision changes, light sensitivity, eyelid swelling or redness around the eye, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

What the sources cover

Bacterial or viral or allergic
No vision change, photophobia or pain
Contact lens wear
Topical antibiotic, no agent superior
Mild bacterial is self-limited; avoid indiscriminate antibiotics
No antibiotics or steroids for viral
Adenovirus hygiene, contagious 10-14 days
School: no automatic exclusion or tomorrow or fever-free
Urgent ophthalmology for red flags
Chronic or recalcitrant conjunctivitis

Return precautions in the template

eye painvision changeslight sensitivityeyelid swelling or redness around the eye

Sources

American Academy of Ophthalmology Cornea/External Disease Committee. Conjunctivitis Preferred Practice Pattern 2023. Ophthalmology 2024
AAP. Managing Infectious Diseases in Child Care and Schools (pinkeye quick reference), via secondary coverage (MDedge/The Hospitalist; a practice's summary at cvpeds.com)