Bacterial Conjunctivitis (Pink Eye) Differential Diagnoses

Updated: Feb 07, 2023
  • Author: Karen K Yeung, OD, FAAO; Chief Editor: Andrew A Dahl, MD, FACS  more...
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Diagnostic Considerations

Medicolegal concerns do arise in connection with bacterial conjunctivitis. As with all medical practice, careful discussion and documentation is paramount. A few general guidelines are helpful, as follows:

  • Know the differential diagnosis.
  • Perform an eye examination and, in particular, document that keratitis, iritis, and acute glaucoma have been ruled out.
  • Always document the best corrected visual acuity in each eye.
  • Ascertain the absence of glaucoma on every visit or the inability to safely do so. A simple ballpark bidigital applanation of each globe through the closed upper lid provides a useful and legally protective assessment of intraocular pressure (IOP). This assessment can be performed in immediate proximity to the digital assessment for preauricular lymphadenopathy, accompanied by thorough physician handwashing thereafter.
  • Be aware of more unusual conditions, such as carotid-cavernous fistula.
  • Always consider Chlamydia or N gonorrhoeae in the differential diagnosis. Be sure to treat systemically and ask for advice from other specialists when needed.

See the following for more information:

Differential Diagnoses