From the Guidelines
Conjunctivitis treatment depends on the cause but typically involves addressing symptoms while the condition resolves, with the most recent guidelines from 2024 emphasizing the importance of early detection and treatment to prevent complications 1. The treatment approach varies based on the type of conjunctivitis:
- For viral conjunctivitis, which is most common, treatment focuses on symptom relief with artificial tears (4-6 times daily) and cold compresses, as viral infections resolve on their own within 1-2 weeks.
- For bacterial conjunctivitis, antibiotic eye drops like polymyxin B-trimethoprim, ciprofloxacin, or erythromycin are prescribed, typically applied every 3-4 hours for 5-7 days.
- For allergic conjunctivitis, antihistamine eye drops such as ketotifen (Zaditor) or olopatadine (Pataday) twice daily, along with avoiding allergens, are effective, and in some cases, a brief course of topical corticosteroids may be added to the regimen 1. Good hygiene is essential for all types, including avoiding touching eyes, washing hands frequently, using separate towels, and replacing eye makeup, as emphasized in the 2019 guidelines 1. Contact lens wearers should temporarily switch to glasses until symptoms resolve, and if symptoms worsen, vision changes occur, or there's severe pain, medical attention should be sought immediately, as these may indicate a more serious condition requiring different treatment, highlighting the need for evaluation by an ophthalmologist in certain circumstances 1.
From the FDA Drug Label
Directions Adults and children 3 years and older: put 1 drop in the affected eye(s) twice daily, every 8-12 hours, no more than twice per day. Children under 3 years of age: consult a doctor The treatment for conjunctivitis (inflammation of the conjunctiva) with ketotifen (TOP) is to put 1 drop in the affected eye(s) twice daily, every 8-12 hours, no more than twice per day for adults and children 3 years and older 2.
- For children under 3 years of age, it is recommended to consult a doctor.
From the Research
Treatment Options for Conjunctivitis
The treatment for conjunctivitis depends on the underlying cause, which can be infectious (bacterial, viral, or fungal) or non-infectious (allergic) 3, 4, 5, 6, 7.
- For viral conjunctivitis, treatment is typically supportive, including artificial tears, cold compresses, and antihistamine eye drops 4, 5.
- For bacterial conjunctivitis, topical antibiotics may be prescribed to decrease the duration of the infection and allow for an earlier return to school or work 4, 5, 6.
- For allergic conjunctivitis, treatment consists of topical antihistamines and mast cell inhibitors 3, 4, 5, 6.
- In severe cases of conjunctivitis, corticosteroids may be used, but their use is generally recommended for short-term treatment (≤2 weeks) due to potential risks associated with long-term use 7.
Specific Treatment Approaches
- For atopic conjunctivitis, treatment may include antihistamines, anti-inflammatory agents, or chromoglycate, with subcutaneous or sublingual immunotherapy in severe cases 3.
- For vernal keratoconjunctivitis, treatment typically involves mast cell-stabilizing drops and antihistamines, with corticosteroids used in relapses 3.
- For nonallergic eosinophilic conjunctivitis (NAEC), basic therapy includes mast cell-stabilizing drops, with additional corticosteroids used in cases of eosinophilic inflammation 3.
Considerations for Treatment
- It is essential to recognize the different forms of conjunctivitis and start treatment early and intensively enough to avoid chronicity of the disease and accompanying tissue destruction 3.
- The use of topical corticosteroids in conjunctivitis treatment should be carefully considered due to potential risks, but they may be effective and well-tolerated when used for short-term treatment in combination with anti-infectives 7.