Pharmacotherapeutic options for ophthalmic conjunctivitis

Conjunctivitis is a common eye condition involving inflammation and in some instances infection of the conjunctiva. In the majority of cases it is caused by adenoviruses and, to a lesser extent, bacteria. Conjunctivitis can also occur secondary to Chlamydial and Gonococcal infections and new-born infants can acquire it during the birthing process from infected mothers. Herpes simplex and Herpes zoster are the infective organisms also responsible for conjunctivitis while seasonal pollens are usually the cause for allergic conjunctivitis. Common symptoms and signs are redness, tearing, oedema of the eyelids, sensation of a foreign body and it may be accompanied by itching. Most often a purulent discharge and adherence of eyelids at awakening are indicators of a bacterial infection. Most of the uncomplicated acute cases are self-limiting. There is however a challenge in distinguishing between the various types of conjunctivitis due to the similarity in the symptoms and due to a lack of tests and prediction algorithms, thus antibiotic therapy is often incorrectly initiated. Treatment of acute uncomplicated conjunctivitis caused by adenoviruses and bacteria is mostly symptomatic. Topical eye drops and ointments are preferred to oral agents in the treatment of more severe bacterial and allergic conjunctivitis while oral agents are used in the treatment of conjunctivitis caused by Herpes simplex, Herpes zoster, Chlamydia trachomatis and Neisseria gonorrhoeae

A 'look' into conjunctivitis

Conjunctivitis is a common condition characterised by inflammation of the conjunctiva and is the most likely diagnosis in a patient with a red eye and discharge. Acute conjunctivitis is usually a self-limiting condition or one that is easily treated with topical ophthalmic preparations in most cases. Viral conjunctivitis is the most common cause of conjunctivitis followed by bacterial conjunctivitis. Purulent discharge and adherence of the eyelids upon awakening are strong indicators of bacterial conjunctivitis, however other similarities in presentation of conjunctivitis often leads to misdiagnoses. Acute viral conjunctivitis is most commonly caused by adenoviruses and allergic conjunctivitis is usually caused by seasonal pollens. Acute viral conjunctivitis is treated symptomatically while the use of topical antibiotics are useful in limiting the duration of conjunctivitis with a bacterial aetiology. Allergic conjunctivitis is also treated symptomatically with topical antihistamine/mast cell stabiliser preparations. Conjunctivitis secondary to sexually transmitted diseases such as chlamydia or gonorrhoea require systemic antimicrobials in addition to topical treatment