Presentation:

• Infective conjunctivitis usually present with discharging or sticky eyes. There may be 

a history of contact with people with red eyes.
• Allergic conjunctivitis is commonly seen in patients with atopy or hay fever. Itchy red 

eye is a prominent feature

• The visual acuity is normal although in some cases of viral conjunctivitis caused by 

adenovirus, the vision may be blurred due to associated keratitis
• One or both eyes may be affected and the eyelids may be swollen
• The conjunctiva is oedematous and there are visible changes on the tarsal conjunctiva

• In the general practice, it is difficult to differentiate between bacterial from viral conjunctivitis.

However, it is acceptable to treat all infective conjunctivitis with topical antibiotics such as 
chloramphenicol as it can prevent secondary infection in viral conjunctivitis. The conjunctivitis 
usually takes about one or two weeks to settle.
• Patient with allergic conjunctivitis will benefit from topical sodium cromoglycate such as opticrom. 

Oral antihistamine (such as triludene) is useful in reducing itchiness. It is important to determine
the cause as the allergen (for example eye drops or cosmetic) may be eliminated.
• Refer the patient to the casualty only if the conjunctivitis fails to respond to treatment

Figure 1. A patient with conjunctivitis. Note the lumpy appearance of the tarasal conjunctiva  (best seen with the lid everted). These may be infectious or allergic. A history of  itchiness favours allergic conjunctivitis whereas sticky eye infective conjunctivitis.

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