What characteristics would the patient likely describe if the conjunctivitis is caused by a bacterial infection? 

The patient likely would complain of their eye being more watery, itching and having redness. They could endure thick drainage and their eyes could be “stuck” together in the a.m. (Dunphy et al., 2022).

What signs/symptoms would you expect to find during the physical exam?

Likely unilateral if bacterial conjunctivitis. Discharge, pain, or a feeling of something in the eye, normal visual acuity, abnormalities with the conjunctivae, normal pupillary response, no issues with light, no lymph node involvement (Dunphy et al., 2022). I would want to know the onset, duration of symptoms, if they feel their vision has been affected, if they have tried any treatment for the condition and if they have had any prior episodes (Pippin & Le, 2023).

What are the differential diagnoses for the patient?

1.Allergic Conjunctivitis – It would be important to determine whether the patient this is viral or bacterial as the treatment plan will be different if it is viral. Bilateral involvement, itching, some discharge, runny nose, watery eyes would indicate it could be viral (Dunphy et al., 2022)

2.Viral Conjunctivitis – watery eyes, itching, conjunctivae involvement, and lymph node involvement around the eyes would indicate it could be viral (Dunphy et al., 2022).

What symptoms, if present, would indicate the need to have another professional perform a dilated pupil exam?

If there is any concern of corneal damage, decreased visual acuity or increased inflammation they should be examined by an eye doctor (Dunphy et al., 2022).

What treatment should be prescribed for the patient’s bacterial conjunctivitis? Include full prescribing information.

Polymyxin B/Trimethoprim Ophthalmic 1mg/ml, 1 drop into affected eye every 3 hours for 7-10 day. Maximum dose 6 doses/day (Drugs.com). This should effectively treat bacterial conjunctivitis (Pippin & Le, 2023).

What additional patient teaching should be included?

They could still be contagious for up to 48 hours even with treatment. If redness does not resolve they should seek care from an eye doctor. They should avoid contact with other people in the household and use frequent handwashing to avoid spreading the condition (book). They should also not wear contact lenses until treatment is done (Pippin & Le, 2023).

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