This guideline last updated 06/05/2022 17:46:29

Differential diagnosis

• Epidemic keratoconjunctivitis (e.g. adenovirus)
• Herpes simplex or Herpes zoster
• Chlamydial infection
• Allergy
• Angle closure glaucoma
• Infective keratitis
• Anterior uveitis

Possible management by Optometrist

• Beware corneal involvement in contact lens wearers
• Treatment with topical antibiotic for one week may improve short-term outcome and render patient less infectious to others
  • Ask if allergic to Chloramphenicol
  • If not, supply Chloramphenicol 1% eye ointment 3 times daily for a week
  • If allergic to Chloramphenicol, or pregnant, supply Fucidic acid 1% liquid gel twice a day for a week
• Bathe/clean the eyelids with proprietary sterile wipes, lint or cotton wool dipped in sterile saline or boiled (cooled) water to remove crusting

Advice

• Advise patient that condition is contagious (do not share towels, etc.)
• Contact lenses should not be worn during the treatment period
• Advise patient to return/seek further help if symptoms persist beyond 7 day
  • If no improvement, consider allergic reaction to medication, especially if there are new areas of periorbital redness or excoriation
  • If allergic to Chloramphenicol, explain symptoms will get better on stopping Chloramphenicol and to avoid using Chloramphenicol in the future
  • Refer to ophthalmology If no evidence of allergic reaction

Management Category

• Management to resolution
• Refer if:
• Condition fails to resolve
• There is corneal involvement

Possible management by Ophthalmologist

• Conjunctival swabs taken for microscopy and culture and/or PCR analysis
• Treatment with other antibiotics, based on culture results