This handout is for acute conjunctivitis (viral / bacterial / allergic, with red-flag red-eye routing). Your care team identified this based on: acute red eye with discharge or crusting/glued lids — the conjunctivitis presentation; subtype not yet assigned (azari jama 2013; aao conjunctivitis ppp, varu 2018).
Other reasons your team may use this plan: bilateral itchy, watery, chemotic eyes ± seasonality / atopy — allergic conjunctivitis entry (azari jama 2013 — itch is the most consistent allergic sign); unilateral (then fellow-eye) watery red eye, follicular reaction, tender preauricular node — adenoviral / ekc entry, infection-control flag (liu cochrane 2022; aao ppp varu 2018); hyperacute copious purulent discharge over hours with marked lid edema — gonococcal conjunctivitis (ophthalmic emergency, corneal-perforation risk) (cdc sti 2021; azari jama 2013).
Take these medications exactly as prescribed. Do not stop or change a dose without talking to your provider.
| Medication | Starting dose | How | When | What it does |
|---|---|---|---|---|
| sight_threat_screen_route_out_if_positive | — | — | — | AAO Conjunctivitis PPP (Varu 2018) — these features mean it is NOT simple conjunctivitis; route OUT to ophtho.acute-red-eye / keratitis / anterior-uveitis / acute-angle-closure-glaucoma by engine_id before treating as conjunctivitis. Contact-lens red eye: discontinue lens, NEVER patch. |
Plan: Acute conjunctivitis — subtype-stratified (stewardship-first; emergencies systemic + ophthalmology)
Contact your care team if any of the following happen:
Call 911 or go to the nearest emergency room right away if you have:
Stewardship + contagion + chronicity: counsel natural history and antibiotic-stewardship rationale (Everitt BMJ 2006 — immediate prescribing increases re-attendance and antibiotic belief); hygiene/return-to-activity guidance (adenoviral sheds ~10-14 d); ensure gonococcal/chlamydial partner treatment + STI follow-up + reporting; recurrent/chronic or treatment-refractory conjunctivitis → ophthalmology (chronic chlamydial, atopic/vernal keratoconjunctivitis, mucous membrane pemphigoid, or ocular surface malignancy mimic — AAO PPP Varu 2018); vernal/atopic → long-term ophthalmology (cyclosporine 0.1% per updated PPP).
Guideline: AAO Conjunctivitis Preferred Practice Pattern (Varu et al, Ophthalmology 2018; updated as Conjunctivitis PPP 2023, republished Ophthalmology 2024 — substance unchanged, confirmed current 2026-05-17) + Azari & Barney JAMA 2013 systematic review + Sheikh et al Cochrane 2012 (antibiotics vs placebo for acute bacterial conjunctivitis) + Rietveld et al BMJ 2004 (bacterial-cause clinical prediction rule) + Everitt et al BMJ 2006 (delayed-prescribing RCT) + CDC STI Treatment Guidelines 2021 (gonococcal/chlamydial/ophthalmia neonatorum) + Liu et al Cochrane 2022 (EKC topical therapy)