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.

Given the increasing popularity of telemedicine and the increased quality of phone camera capabilities, many more patients are being diagnosed and treated via telemedicine.^[26] With a good health history and quality images, simple and straightforward conjunctivitis not involving the cornea may be treated remotely, though caution should be taken not to overprescribe antibiotics. Cases of conjunctivitis that do not resolve quickly or that are deemed more complicated should be referred to be seen by an eye care professional immediately.

See the following for more information:

Differential Diagnoses

Workup

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Author

Karen K Yeung, OD, FAAO Senior Optometrist, UCLA Arthur Ashe Student Health and Wellness Center; Clinical Assistant Professor, College of Optometry, Western University of Health Sciences

Karen K Yeung, OD, FAAO is a member of the following medical societies: American Academy of Optometry

Disclosure: Nothing to disclose.

Coauthor(s)

Barry A Weissman, OD, PhD, FAAO Retired Professor of Optometry, Southern California College of Optometry at Marshall B Ketchum University; Professor Emeritus of Ophthalmology, Stein Eye Institute, University of California, Los Angeles, David Geffen School of Medicine

Barry A Weissman, OD, PhD, FAAO is a member of the following medical societies: American Academy of Optometry, American Optometric Association, California Optometric Society, International Society for Contact Lens Research

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Andrew A Dahl, MD, FACS Assistant Professor of Surgery (Ophthalmology), New York College of Medicine (NYCOM); Director of Residency Ophthalmology Training, The Institute for Family Health and Mid-Hudson Family Practice Residency Program; Staff Ophthalmologist, Telluride Medical Center

Andrew A Dahl, MD, FACS is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, American Intraocular Lens Society, American Medical Association, American Society of Cataract and Refractive Surgery, Contact Lens Association of Ophthalmologists, Medical Society of the State of New York, New York State Ophthalmological Society, Outpatient Ophthalmic Surgery Society

Disclosure: Nothing to disclose.

Additional Contributors

Maria Elena De Shazer University of California at Los Angeles

Disclosure: Nothing to disclose.

Acknowledgements

Jerre Freeman, MD Founder, Chairman, Memphis Eye and Cataract Associates; Clinical Professor, Department of Ophthalmology, University of Tennessee Health Science Center College of Medicine

Jerre Freeman, MD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, American Society of Cataract and Refractive Surgery, and Tennessee Medical Association

Disclosure: Nothing to disclose.

Simon K Law, MD, PharmD Associate Professor of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, David Geffen School of Medicine

Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology

Disclosure: Nothing to disclose.

Christopher J Rapuano, MD Professor, Department of Ophthalmology, Jefferson Medical College of Thomas Jefferson University; Director of the Cornea Service, Co-Director of Refractive Surgery Department, Wills Eye Institute

Christopher J Rapuano, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, Contact Lens Association of Ophthalmologists, Cornea Society, Eye Bank Association of America, International Society of Refractive Surgery, and Pan-American Association of Ophthalmology

Disclosure: Allergan Honoraria Speaking and teaching; Allergan Consulting fee Consulting; Alcon Honoraria Speaking and teaching; Inspire Honoraria Speaking and teaching; RPS Ownership interest Other; Vistakon Honoraria Speaking and teaching; EyeGate Pharma Consulting; Inspire Consulting fee Consulting; Bausch & Lomb Honoraria Speaking and teaching; Bausch & Lomb Consulting fee Consulting

Sections Bacterial Conjunctivitis (Pink Eye)
Overview
Presentation
DDx
Workup
Treatment
Guidelines
Medication
Questions & Answers
References

Bacterial Conjunctivitis (Pink Eye) Differential Diagnoses

Diagnostic Considerations

Differential Diagnoses

References

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