From the Guidelines
Pink eye treatment should be directed at the root cause, with a focus on symptom relief and avoiding indiscriminate use of topical antibiotics or corticosteroids, as stated in the 2024 conjunctivitis preferred practice pattern 1.
Treatment Approach
The treatment approach for pink eye, or conjunctivitis, depends on its cause. For viral conjunctivitis, which is most common, treatment focuses on symptom relief while the infection runs its course (typically 7-14 days).
- Use artificial tears like Refresh or Systane several times daily
- Apply cold compresses for 5-10 minutes 3-4 times daily
- Practice good hygiene by washing hands frequently and avoiding touching your eyes For bacterial conjunctivitis, antibiotic eye drops such as Polytrim (polymyxin B-trimethoprim) or Vigamox (moxifloxacin) are typically prescribed, used 1-2 drops every 4-6 hours for 5-7 days until symptoms resolve.
Special Considerations
Allergic conjunctivitis responds well to antihistamine eye drops like Pataday (olopatadine) or Zaditor (ketotifen), used twice daily, along with avoiding allergen triggers.
- For severe cases, topical cyclosporine or tacrolimus can be considered 1
- Patients with conjunctivitis should be evaluated by an ophthalmologist in cases of visual loss, moderate or severe pain, or severe, purulent discharge 1
Prevention and Hygiene
For all types, remove contact lenses until the condition clears completely. If symptoms worsen, vision becomes affected, or the condition doesn't improve within a few days, seek medical attention promptly. Pink eye spreads easily, so avoid sharing towels, pillowcases, or makeup, and stay home from work or school until discharge stops, typically 24 hours after starting antibiotics for bacterial cases.
From the FDA Drug Label
INDICATIONS AND USAGE: For the treatment of superficial ocular infections involving the conjunctiva and/or cornea caused by Bacitracin susceptible organisms. INDICATIONS AND USAGE For the treatment of superficial ocular infections involving the conjunctiva and/or cornea caused by organisms susceptible to erythromycin. The treatment for pink eye (conjunctivitis) can be done using bacitracin ophthalmic ointment or erythromycin ophthalmic ointment if the infection is caused by susceptible organisms 2, 3.
- The dosage of bacitracin ophthalmic ointment is applying the ointment directly into the conjunctival sac 1 to 3 times daily 2.
- It is essential to follow the instructions carefully to avoid contamination of the ointment when applying it to the infected eye 2.
From the Research
Types of Conjunctivitis
- Viral conjunctivitis
- Allergic conjunctivitis
- Bacterial conjunctivitis These types can present in either acute or chronic forms, and the age of the patient, time of year, and physical examination findings are crucial in distinguishing between them 4.
Diagnosis and Referral
- Distinguishing between acute viral and bacterial conjunctivitis can be challenging
- Patients with prolonged symptoms, poor response to initial management, or evidence of severe disease should be referred to ophthalmology for consultation 4.
Treatment Considerations
- The treatment approach may vary depending on the type of conjunctivitis
- Initial management is often attempted, but patients who do not respond well or have severe symptoms may require further evaluation and alternative treatment strategies 4.