Bacterial conjunctivitis

 Bacterial Conjunctivitis




Definition:

Bacterial conjunctivitis is an infection of the conjunctiva (the thin, transparent membrane covering the white part of the eye and inner eyelids) caused by bacteria. It leads to redness, swelling, and discharge from the eye.


Common Causes

Gram-positive bacteria: 

  • Staphylococcus aureus, Streptococcus pneumoniae


Gram-negative bacteria: 

  • Haemophilus influenzae, Moraxella catarrhalis, Neisseria gonorrhoeae (severe, hyperacute cases)


Spread via:

  • Direct contact with infected secretions

  • Contaminated hands, towels, cosmetics

  • Poor hygiene


Signs & Symptoms

  • Redness in one or both eyes

  • Thick, yellow/green sticky discharge (especially in the morning)

  • Eyelids stuck together on waking

  • Grittiness or foreign body sensation

  • Mild eyelid swelling

  • Usually no significant pain or blurred vision (unless cornea involved)

Diagnosis

Clinical: 

  • Based on history and eye examination

Special tests (if needed):

  • Gram stain and culture of discharge (in severe/recurrent cases)


  • Fluorescein staining to check for corneal involvement

Treatment


Topical antibiotics (reduce duration & prevent spread):


Chloramphenicol 0.5% drops every 2 hours for first 2 days, then 4× daily for 5–7 days


Moxifloxacin 0.5% drops 3× daily for 5–7 days (more broad-spectrum, often used in severe cases)


Ointments (e.g., chloramphenicol 1% at night) for comfort


Supportive care:

  • Warm compresses to remove crusts

  • Lubricating drops for comfort

Avoid:

   Sharing towels, touching/rubbing eyes

Severe cases (e.g., N. gonorrhoeae, Chlamydia): require systemic antibiotics and urgent ophthalmology referral


Prognosis

  • Usually self-limiting within 7–10 days, but antibiotics shorten course & reduce contagiousness.

  • Most patients recover without complications; untreated severe cases may cause corneal ulcers.


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